1
|
Huang J, Wang X. Association of depressive symptoms with risk of incidence low back pain in middle-aged and older Chinese adults. J Affect Disord 2024; 354:627-633. [PMID: 38522815 DOI: 10.1016/j.jad.2024.03.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Elevated Depressive symptoms (DS) and low back pain (LBP) pose significant and growing public health challenges, and China is no exception. This study innovatively examined the relationship between specific DS and distinct patterns of DS and incident LBP. METHODS This study extracted data from 4713 participants aged 45+ years from the China and Health Retirement Longitudinal Study (CHARLS), followed-up for incidence LBP (June 2011-September 2020). DS was assessed by the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). The incident LBP was determined by self-reported. Latent class analysis (LCA) was employed to categorize patterns of DS. Cox proportional hazards regression models were used to examine the association between DS and incident LBP. RESULTS Over the 9.25-year follow-up period, 2234 incident LBP cases were identified. There was a significant independent association between positive DS and incident LBP with an HR of 1.73 (95 % CI = 1.55-1.94). Of the 10-item DS, difficulty concentrating (adjusted HR = 1.16, 95 % CI = 1.03-1.31), effortfulness (adjusted HR = 1.32, 95 % CI = 1.18-1.49), hopelessness (adjusted HR = 1.13, 95 % CI = 1.02-1.25), restless sleep (adjusted HR = 1.17, 95 % CI = 1.06-1.30), and loneliness (adjusted HR = 1.18, 95 % CI = 1.02-1.36), each independently associated with incident LBP. Regarding patterns of DS, compared to the "healthy" pattern of DS, four patterns showed significant association with incident LBP, especially the cumulative pattern of DS. LIMITATIONS DS and LBP were assessed based on self-reported. CONCLUSIONS In middle-aged and older Chinese adults, 5 specific DS (difficulty concentrating, effortfulness, hopelessness, restless sleep, and loneliness) and distinct patterns of DS indicate varied risks of developing LBP.
Collapse
Affiliation(s)
- Jinghong Huang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiaohui Wang
- School of Public Health, Lanzhou University, Lanzhou, China.
| |
Collapse
|
2
|
van der Ploeg T, Gobbens RJJ. Disability transitions in Dutch community-dwelling older people aged 75 years or older. Arch Gerontol Geriatr 2024; 116:105165. [PMID: 37639841 DOI: 10.1016/j.archger.2023.105165] [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: 03/03/2023] [Revised: 08/10/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Recent world population predictions show that the world population aged >=65 years will increase from 10% in 2022 to 16% in 2050. Population aging is accompanied by an increase in people with disability. It is important to pay special attention to people with disability, as these people are at high risk of adverse outcomes. Our study aimed to investigate the transitions of disability among Dutch community-dwelling older people aged 75 years or older, using a follow-up of nine years. We used socio-demographic factors gender, age, marital status, education, and income, but also lifestyle, diseases, and life events to predict the disability transitions over time. METHODS We used a sample of 484 people that was randomly drawn from the municipality of Roosendaal (the Netherlands), a municipality with 78,000 inhabitants. A subset of people who completed part A of the Tilburg Frailty Indicator (TFI) at baseline and the Groningen Activity Restriction Scale (GARS) questionnaires was used with a nine-year follow-up. Paired Wilcoxon tests were used to compare the consecutive measurements. Socio-demographic factors gender, age, marital status, education, and income, but also lifestyle, diseases, and life events were included to predict the disability transitions over time. For the univariable and multivariable analysis of the measurements over time with the predictor variables, we used generalized estimation equations (GEE). A p-value <0.05 was considered significant. R version 3.4.4 was used for all analyses. RESULTS Of the participants, 65% were younger than 80 years, 50% were married or cohabiting, 87% reported a healthy lifestyle, and 63% had no diseases or chronic disorders. Each year, more participants changed from status not disabled to disabled than vice versa. The GEE analyses showed that lifestyle ('not healthy') and diseases or chronic disorders ('two or more') were significant in the multivariable analysis for the disability score and only diseases or chronic disorders ('two or more') was significant in the multivariable analysis for the dichotomous disability score. CONCLUSIONS The transition of the disability score is strongly influenced by lifestyle and diseases or disorders. This applies to a lesser extent to the dichotomous disability score. There, only diseases or disorders are an important predictor. For health care professionals our study provides starting points for interventions focused on the prevention of worsening disability and for community-dwelling older people >= 75, the most important recommendation is: live healthy!
Collapse
Affiliation(s)
- Tjeerd van der Ploeg
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, The Netherlands.
| | - Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, The Netherlands; Zonnehuisgroep Amstelland, Amstelveen, The Netherlands; Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Tranzo, Tilburg University, Tilburg, The Netherlands
| |
Collapse
|
3
|
Lee E, Jun SS. Trajectories of Disability and Related Factors in Korean Adults Aged ≥75 years. J Appl Gerontol 2023; 42:1953-1964. [PMID: 37077170 DOI: 10.1177/07334648231170148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
This study aimed to identify distinct trajectories of activities of daily living (ADL) disability in older adults aged ≥75 years over 6 years. A growth mixture model and the multinomial logistic regression analysis were used to identify different disability trajectories and to investigate each trajectory. Four distinct disability trajectories were identified: low, moderate, high, and progressive. Activity restriction due to fear of falling, being underweight, impaired vision, and impaired cognition were highly associated with the progressive groups, compared with the low disability group. Activity restriction due to fear of falling, depression, impaired cognition, and poor subjective health status were associated with moderate and high disability. These findings contribute to increasing the understanding of ADL disability among older adults.
Collapse
Affiliation(s)
- Eunyoung Lee
- College of Nursing, Pusan National University, Busan, Republic of Korea
| | - Seong Sook Jun
- College of Nursing, Pusan National University, Busan, Republic of Korea
| |
Collapse
|
4
|
Xiang C, Wu Y, Jia M, Fang Y. Machine learning-based prediction of disability risk in geriatric patients with hypertension for different time intervals. Arch Gerontol Geriatr 2023; 105:104835. [PMID: 36335673 DOI: 10.1016/j.archger.2022.104835] [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: 07/03/2022] [Revised: 10/06/2022] [Accepted: 10/09/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND The risk of disability in older adults with hypertension is substantially high, and prediction of disability risk is crucial for subsequent management. This study aimed to construct prediction models of disability risk for geriatric patients with hypertension at different time intervals, as well as to assess the important predictors and influencing factors of disability. METHODS This study collected data from the Chinese Longitudinal Healthy Longevity and Happy Family Study. There were 1576, 1083 and 506 hypertension patients aged 65+ in 2008 who were free of disability at baseline and had completed outcome information in follow-up of 2008-2012, 2008-2014, 2008-2018. We built five machine learning (ML) models to predict the disability risk. The classic statistical logistic regression (classic-LR) and shapley additive explanations (SHAP) was further introduced to explore possible causal factors and interpret the optimal models' decisions. RESULTS Among the five ML models, logistic regression, extreme gradient boosting, and deep neural network were the optimal models for detecting 4-, 6-, and 10-year disability risk with their AUC-ROCs reached 0.759, 0.728, 0.694 respectively. The classic-LR revealed potential casual factors for disability and the results of SHAP demonstrated important features for risk prediction, reinforcing the trust of decision makers towards black-box models. CONCLUSION The optimal models hold promise for screening out hypertensive old adults at high risk of disability to implement further targeted intervention and the identified key factors may be of additional value in analyzing the causal mechanisms of disability, thereby providing basis to practical application.
Collapse
Affiliation(s)
- Chaoyi Xiang
- The State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an Nan Road, Xiang'an District, Xiamen, Fujian 361102, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, China
| | - Yafei Wu
- The State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an Nan Road, Xiang'an District, Xiamen, Fujian 361102, China; National Institute for Data Science in Health and Medicine, Xiamen University, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, China
| | - Maoni Jia
- The State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an Nan Road, Xiang'an District, Xiamen, Fujian 361102, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, China
| | - Ya Fang
- The State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an Nan Road, Xiang'an District, Xiamen, Fujian 361102, China; National Institute for Data Science in Health and Medicine, Xiamen University, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, China.
| |
Collapse
|
5
|
Beltz S, Gloystein S, Litschko T, Laag S, van den Berg N. Multivariate analysis of independent determinants of ADL/IADL and quality of life in the elderly. BMC Geriatr 2022; 22:894. [PMID: 36418975 PMCID: PMC9682836 DOI: 10.1186/s12877-022-03621-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/14/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This study evaluated the determinants of disability and quality of life in elderly people who participated at the multi-centred RubiN project (Regional ununterbrochen betreut im Netz) in Germany. METHODS Baseline data of the subjects aged 70 years and older of the RubiN project were used and only subjects with complete data sets were considered for the ensuing analysis (complete case analysis (CCA)). Disability was examined using the concepts of ADL (activities of daily living) and IADL (instrumental activities of daily living). Subjects exhibiting one or more deficiencies in ADL respectively IADL were considered as ADL respectively IADL disabled. Quality of life was assessed using the WHOQOL-BREF and the WHOQOL-OLD. Applying multivariate analysis, sociodemographic factors, psychosocial characteristics as well as the functional, nutritional and cognitive status were explored as potential determinants of disability and quality of life in the elderly. RESULTS One thousand three hundred seventy-five subjects from the RubiN project exhibited data completeness regarding baseline data. ADL and IADL disability were both associated with the respective other construct of disability, sex, a reduced cognitive and functional status as well as domains of the WHOQOL-BREF. Furthermore, ADL disability was related to social participation, while IADL disability was linked to age, education and social support. Sex, ADL and IADL disability, income, social support and social participation as well as the functional status were predictors of the domain 'Physical Health' (WHOQOL-BREF). The facet 'Social Participation' (WHOQOL-OLD) was affected by both ADL and IADL disability, income, social participation, the nutritional and also the functional status. CONCLUSIONS Several potential determinants of disability and quality of life were identified and confirmed in this study. Attention should be drawn to prevention schemes as many of these determinants appear to be at least partly modifiable.
Collapse
Affiliation(s)
- Sebastian Beltz
- grid.5603.0Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Simone Gloystein
- grid.5603.0Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Litschko
- grid.5603.0Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Sonja Laag
- Department for Product Strategy/Development, BARMER Health Insurance, Wuppertal, Germany
| | - Neeltje van den Berg
- grid.5603.0Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| |
Collapse
|
6
|
Tian F, Yang H, Pan J. Association between functional disability and long-term trajectories of depressive symptoms: Evidence from the China Health and Retirement Longitudinal Study. J Affect Disord 2022; 310:10-16. [PMID: 35525506 DOI: 10.1016/j.jad.2022.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/17/2022] [Accepted: 05/02/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Prior research has suggested that functional disability was associated with increased risk of incident depressive symptoms in the elderly. However, little is known about the potential role of functional disability on the long-term trajectories of depressive symptoms among middle-aged and older Chinese adults. METHODS Data were drawn from the China Health and Retirement Longitudinal Study. A total of 8415 participants with up to four measurements of depressive symptoms assessed by the Center for Epidemiologic Studies Depression Scale (CESD) were included. Functional disability was evaluated by activities of daily living (ADLs) and instrumental ADLs (IADLs) at baseline. We identified the trajectories of depressive symptoms over 7-year follow-up using group-based trajectory modelling, and examined the association between functional disability and depressive symptom trajectories using multinomial logistic regression. RESULTS We identified four trajectories of depressive symptoms throughout the follow-up, characterized by maintaining a low CES-D score (low symptoms); maintaining a moderate CES-D score (moderate symptoms); increasing progressively and reaching a high CES-D score at the end of follow-up (increasing symptom); and increasing quickly and maintaining a high CES-D score (high symptoms). We found that participants with severe functional disability were at increased likelihood of being in the moderate (odds ratio [OR] = 2.27, 95% confidence interval [CI] 1.68-3.07), increasing (OR = 2.31, 95% CI 1.49-3.59), and high (OR = 4.74, 95% CI 3.07-7.31) depressive symptom trajectories. LIMITATIONS Depressive symptoms and functional disability were evaluated based on self-reported scales. CONCLUSIONS Our findings suggest that functional disability was associated with unfavorable depressive symptom trajectories among middle-aged and older Chinese adults.
Collapse
Affiliation(s)
- Fan Tian
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huazhen Yang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan, China
| | - Jay Pan
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China; Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
7
|
Olsen PØ, Tully MA, Del Pozo Cruz B, Wegner M, Caserotti P. Community-based exercise enhanced by a self-management programme to promote independent living in older adults: a pragmatic randomised controlled trial. Age Ageing 2022; 51:6632480. [PMID: 35797431 DOI: 10.1093/ageing/afac137] [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: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND older adults face several modifiable barriers for engaging in physical activity (PA) programmes such as incontinence, loneliness and fear of falling. Enhancing PA programmes with behavioural components to support self-management of such barriers may increase the effectiveness to preserve functional capacity and independent living. OBJECTIVE this study aimed at assessing the effects of a complex active lifestyle intervention (CALSTI) on objective and self-report measures of functional capacity and disability in community-dwelling older adults. SUBJECTS AND METHODS about 215 older adults (79.9 ± 0.4 years) at increased risk of functional decline were randomly allocated to (i) CALSTI consisting of 12-weeks progressive explosive resistance training (24 sessions) enhanced by a 24-week multi-factorial self-management programme (8 sessions), or (ii) an extended version of the self-management intervention (SEMAI; 12 sessions) to reflect a reinforcement of usual care. The interventions were embedded in a nationally regulated preventive care pathway. Blinded assessors collected primary (the Short Physical Performance Battery; SPPB) and secondary outcome data (self-reported difficulty in activities of daily living, the short version of the Late-Life Function and Disability Index, and the EQ-health VAS scale) at baseline and after 12 and 24 weeks. RESULTS after 24 weeks, CALSTI led to a clinically superior increase in SPPB compared with SEMAI (+0.77 points, P < 0.01), and the CALSTI group also demonstrated improvements in selected self-reported outcomes. CONCLUSIONS a novel complex exercise and multi-factorial self-management intervention embedded in preventive care practice had large and clinically meaningful effects on a key measure of functional capacity and predictor of disability.
Collapse
Affiliation(s)
- Pia Øllgaard Olsen
- Centre of Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry , UK
| | - Borja Del Pozo Cruz
- Centre of Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Manfred Wegner
- Department of Sports Psychology and Movement Science, Kiel University, Germany
| | - Paolo Caserotti
- Centre of Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
8
|
Early strong predictors of decline in instrumental activities of daily living in community-dwelling older Japanese people. PLoS One 2022; 17:e0266614. [PMID: 35381051 PMCID: PMC8982840 DOI: 10.1371/journal.pone.0266614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 03/23/2022] [Indexed: 11/19/2022] Open
Abstract
Objective Our aim is to determine the strong predictors of the onset of instrumental activities of daily living (IADL) decline in community-dwelling older people. Design A prospective cohort study with a two-year follow-up. Setting Kashiwa City, Chiba Prefecture, Japan and Toshima Ward, Tokyo Metropolitan, Japan. Participants The data were acquired from two cohorts. The final sample comprised 1,523 community-dwelling older people aged 65–94 years (681 men, 842 women). They were individuals who were independent in IADL at baseline and participated in follow-up IADL assessments two years later. Measurements At baseline, comprehensive assessments were performed including: health interview, gait function, hand-grip strength, skeletal muscle mass, balance function, oral function, dietary lifestyle, cognitive function, quality of life, mental status, and social network. When the two-year follow-up was performed, IADL declines were observed in 53 out of 1,523 people. The association of each Z-transformed parameter with the occurrence of IADL decline was examined by employing a binominal logistic regression model adjusting for age, gender, body weight, body height, and medical history. An odds ratio (OR) and a 95% confidence interval were calculated and compared between different parameters. Results A decrease in walking speed and one-legged stance time, whereas an increased timed up & go test time was associated with significant ORs for the occurrence of IADL decline. Conclusion Gait-related parameters appear to be the strong predictors of the onset of IADL decline in community-dwelling older people.
Collapse
|
9
|
Newman-Griffis D, Camacho Maldonado J, Ho PS, Sacco M, Jimenez Silva R, Porcino J, Chan L. Linking Free Text Documentation of Functioning and Disability to the ICF With Natural Language Processing. FRONTIERS IN REHABILITATION SCIENCES 2021; 2. [PMID: 35694445 PMCID: PMC9180751 DOI: 10.3389/fresc.2021.742702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background: Invaluable information on patient functioning and the complex interactions that define it is recorded in free text portions of the Electronic Health Record (EHR). Leveraging this information to improve clinical decision-making and conduct research requires natural language processing (NLP) technologies to identify and organize the information recorded in clinical documentation. Methods: We used natural language processing methods to analyze information about patient functioning recorded in two collections of clinical documents pertaining to claims for federal disability benefits from the U.S. Social Security Administration (SSA). We grounded our analysis in the International Classification of Functioning, Disability, and Health (ICF), and used the Activities and Participation domain of the ICF to classify information about functioning in three key areas: mobility, self-care, and domestic life. After annotating functional status information in our datasets through expert clinical review, we trained machine learning-based NLP models to automatically assign ICF categories to mentions of functional activity. Results: We found that rich and diverse information on patient functioning was documented in the free text records. Annotation of 289 documents for Mobility information yielded 2,455 mentions of Mobility activities and 3,176 specific actions corresponding to 13 ICF-based categories. Annotation of 329 documents for Self-Care and Domestic Life information yielded 3,990 activity mentions and 4,665 specific actions corresponding to 16 ICF-based categories. NLP systems for automated ICF coding achieved over 80% macro-averaged F-measure on both datasets, indicating strong performance across all ICF categories used. Conclusions: Natural language processing can help to navigate the tradeoff between flexible and expressive clinical documentation of functioning and standardizable data for comparability and learning. The ICF has practical limitations for classifying functional status information in clinical documentation but presents a valuable framework for organizing the information recorded in health records about patient functioning. This study advances the development of robust, ICF-based NLP technologies to analyze information on patient functioning and has significant implications for NLP-powered analysis of functional status information in disability benefits management, clinical care, and research.
Collapse
Affiliation(s)
- Denis Newman-Griffis
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, United States
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States
- *Correspondence: Denis Newman-Griffis
| | - Jonathan Camacho Maldonado
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, United States
| | - Pei-Shu Ho
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, United States
| | - Maryanne Sacco
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, United States
| | - Rafael Jimenez Silva
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, United States
| | - Julia Porcino
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, United States
| | - Leighton Chan
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, United States
| |
Collapse
|
10
|
Choi HG, Yeom HA, Lee MA, Ra JR. A structural equation modeling approach to understanding physical function of terminal cancer patients. Support Care Cancer 2021; 30:1149-1158. [PMID: 34435210 DOI: 10.1007/s00520-021-06444-x] [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: 01/29/2021] [Accepted: 07/15/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Understanding the activities of daily living (ADL) of cancer patients at the end-of-life stage may help healthcare providers develop interventions for preserving physical function and enhance patient's dignity in an everyday care context. This study aims to develop and test a causal effect model of physical function in terminal cancer patients. METHODS A total of 238 participants were recruited from two hospitals in South Korea. The data were collected using a structured questionnaire including demographics, visual analogue scale for pain, Functional Assessment of Chronic Illness Therapy-Fatigue, and Katz index of independence in ADL. The collected data were analyzed using SPSS WIN 25.0 and AMOS 23.0 programs for structural equation modeling procedures. RESULTS Most participants were aged 65 years or older (65.5%), male (53.8%), and inpatients (74.4%). The most common primary cancer site was gastrointestinal tract (44.1%). Physical function of the participants was positively influenced by regular exercise and negatively influenced by hospitalization, fatigue, and pain, explaining 35.1% of the variance. In this study, regular exercise improved participants' ADL level directly and indirectly either by reducing fatigue or decreasing fatigue through controlling pain. Pain did not affect ADL directly but decreased ADL level indirectly through fatigue as a mediator. CONCLUSION ADL was positively influenced by regular exercise and was negatively influenced by hospitalization, fatigue, and pain. Based on these results, in order to minimizing the problems of physical function in terminal cancer patients, interventions that reduce pain and fatigue and provide regular exercise are required.
Collapse
Affiliation(s)
- Han-Gyo Choi
- College of Nursing, The Catholic University of Korea, Seoul, South Korea
| | - Hye-Ah Yeom
- College of Nursing, The Catholic University of Korea, Seoul, South Korea.
| | - Myung Ah Lee
- Division of Medical Oncology, Department of Internal Medicine, Cancer Research Institute, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jeong-Ran Ra
- Hospice & Palliative Care Team, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| |
Collapse
|
11
|
Paul R, Srivastava S, Muhammad T, Rashmi R. Determinants of acquired disability and recovery from disability in Indian older adults: longitudinal influence of socio-economic and health-related factors. BMC Geriatr 2021; 21:426. [PMID: 34271879 PMCID: PMC8283946 DOI: 10.1186/s12877-021-02372-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 07/02/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There is a higher burden of functional disability for Indian older adults with substantial variations across different geographic regions and socioeconomic groups as compared to other ageing Asian countries. Thus, using a national sample of older adults aged 60+ years, we aim to explore how common is acquiring of disability and recovery from disability among the older population of a developing country like India, and how do the various socioeconomic and health-related conditions impact this transition in disability status. METHOD The current study uses two waves of the India Human Development Survey (IHDS) and is based on panel data of 10,527 older adults. Both bivariate and multiple variable regression analysis were performed using two binary outcome variables in this study - whether older adults acquired disability and recovered from disability between round-I and round-II, respectively. RESULTS Nearly 31.5% and 4.4 % of older adults have acquired and recovered disability across the two rounds respectively. About 38.5% and 45.8 % of female older adults' disability status changes to disable and recovered in round-II respectively. A lesser proportion of older adults have recovered from a disability who have a chronic disease in round-I. Cataract chronic conditions among older adults in round-I had shown 1.45 times (CI: 1.07-1.97) a significantly higher likelihood of acquiring disability in round-I. Older adults who were unmarried and were not working in round-I have 1.12 times (CI: 1.01-1.25) and 1.21 times (CI: 1.06-1.39) higher likelihood of acquiring disability in round-II respectively. Recovering from disability was mostly seen among older adults who belong to the richest (OR: 2.38, CI: 1.31-4.33) and medium (OR: 2.16, CI: 1.27-3.69) wealth quintile households. Older adults residing in the central region of India have 2.72 times (CI: 2.31-3.19) significantly higher chance of acquiring disability than those who were residing in northern regions. CONCLUSION Appropriate measures are required to highlight the importance of chronic physical diseases and several socio-demographic factors that may negatively affect the trajectory of disability in older ages.
Collapse
Affiliation(s)
- Ronak Paul
- International Institute for Population Sciences, Maharashtra 400088 Mumbai, India
| | - Shobhit Srivastava
- International Institute for Population Sciences, Maharashtra 400088 Mumbai, India
| | - T. Muhammad
- International Institute for Population Sciences, Maharashtra 400088 Mumbai, India
| | - Rashmi Rashmi
- International Institute for Population Sciences, Maharashtra 400088 Mumbai, India
| |
Collapse
|
12
|
Wei Qi L, Barclay A, Garcia T, Sullivan L. Fostering Interprofessional Patient-centred Collaboration in Healthcare through CPD: Our Learnings from the PARTNER Programme. J Eur CME 2020; 9:1834763. [PMID: 33178491 PMCID: PMC7594731 DOI: 10.1080/21614083.2020.1834763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Interprofessional patient-centred collaboration in healthcare is necessary for the effective management of chronic diseases. Continuing professional development (CPD) programmes that offer a platform for healthcare professionals of different disciplines to convene and learn together may function as an effective platform to both foster greater collaboration between them and increase awareness of patient perspectives. We report on our learnings from organising the PARTNER programme – a CPD initiative on the management of psoriasis and/or psoriatic arthritis – that targeted both specialists (comprising rheumatologists and dermatologists) and primary care. After participating in the programme, learners demonstrated a stronger intent to collaborate with each other and a heightened awareness of patient perspectives. However, changes at a practice level could not be evaluated due to the lack of substantial follow-up data. Our experience offers useful insights as to the effectiveness and limitations of organising CPD programmes to promote interprofessional collaboration and patient-centred care. The role of such programmes in the management of chronic diseases, and their ideal format, should be further explored as they have potential to effect change in practice.
Collapse
Affiliation(s)
- Loh Wei Qi
- In Vivo Academy, Strawberry Hills, New South Wales, Australia
| | - Audra Barclay
- In Vivo Academy, Strawberry Hills, New South Wales, Australia
| | - Tina Garcia
- In Vivo Academy, Strawberry Hills, New South Wales, Australia
| | - Lisa Sullivan
- In Vivo Academy, Strawberry Hills, New South Wales, Australia
| |
Collapse
|
13
|
Gobbens RJJ, van der Ploeg T. The Prediction of Mortality by Disability Among Dutch Community-Dwelling Older People. Clin Interv Aging 2020; 15:1897-1906. [PMID: 33116444 PMCID: PMC7547136 DOI: 10.2147/cia.s271800] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 08/09/2020] [Indexed: 11/23/2022] Open
Abstract
Objective To predict mortality by disability in a sample of 479 Dutch community-dwelling people aged 75 years or older. Methods A longitudinal study was carried out using a follow-up of seven years. The Groningen Activity Restriction Scale (GARS), a self-reported questionnaire with good psychometric properties, was used for data collection about total disability, disability in activities in daily living (ADL) and disability in instrumental activities in daily living (IADL). The mortality dates were provided by the municipality of Roosendaal (a city in the Netherlands). For analyses of survival, we used Kaplan–Meier analyses and Cox regression analyses to calculate hazard ratios (HR) with 95% confidence intervals (CI). Results All three disability variables (total, ADL and IADL) predicted mortality, unadjusted and adjusted for age and gender. The unadjusted HRs for total, ADL and IADL disability were 1.054 (95%-CI: [1.039;1.069]), 1.091 (95%-CI: [1.062;1.121]) and 1.106 (95%-CI: [1.077;1.135]) with p-values <0.001, respectively. The AUCs were <0.7, ranging from 0.630 (ADL) to 0.668 (IADL). Multivariate analyses including all 18 disability items revealed that only “Do the shopping” predicted mortality. In addition, multivariate analyses focusing on 11 ADL items and 7 IADL items separately showed that only the ADL item “Get around in the house” and the IADL item “Do the shopping” significantly predicted mortality. Conclusion Disability predicted mortality in a seven years follow-up among Dutch community-dwelling older people. It is important that healthcare professionals are aware of disability at early stages, so they can intervene swiftly, efficiently and effectively, to maintain or enhance the quality of life of older people.
Collapse
Affiliation(s)
- Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands.,Zonnehuisgroep Amstelland, Amstelveen, the Netherlands.,Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Tjeerd van der Ploeg
- Faculty of Engineering, Design and Computer Technology, Inholland University of Applied Sciences, Alkmaar, the Netherlands
| |
Collapse
|
14
|
Ng R, Lim SQ, Saw SY, Tan KB. 40-Year Projections of Disability and Social Isolation of Older Adults for Long-Range Policy Planning in Singapore. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4950. [PMID: 32659983 PMCID: PMC7399997 DOI: 10.3390/ijerph17144950] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/27/2020] [Accepted: 07/02/2020] [Indexed: 01/05/2023]
Abstract
Against a rapidly aging population, projections are done to size up the demand for long-term care (LTC) services for long-range policy planning. These projections are typically focused on functional factors such as disability. Recent studies indicate the importance of social factors, for example, socially isolated seniors living alone are more likely to be institutionalized, resulting in higher demand for LTC services. This is one the first known studies to complete a 40-year projection of LTC demand based on disability and social isolation. The primary micro dataset was the Retirement and Health Survey, Singapore's first nationally representative longitudinal study of noninstitutionalized older adults aged 45 to 85 with over 15,000 respondents. Disability prevalence across the mild to severe spectrum is projected to increase five-fold over the next 40 years, and the number of socially isolated elders living alone is projected to grow four-fold. Regression models of living arrangements revealed interesting ethnic differences: Malay elders are 2.6 times less likely to live alone than their Chinese counterparts, controlling for marital status, age, and housing type. These projections provide a glimpse of the growing demand for LTC services for a rapidly aging Singapore and underscore the need to shore up community-based resources to enable seniors to age-in-place.
Collapse
Affiliation(s)
- Reuben Ng
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore 259772, Singapore;
- Lloyds Register Foundation Institute for the Public Understanding of Risk, National University of Singapore, Singapore 117602, Singapore
| | - Si Qi Lim
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore 259772, Singapore;
| | - Su Ying Saw
- Ministry of Health, Singapore 169854, Singapore; (S.Y.S.); (K.B.T.)
| | - Kelvin Bryan Tan
- Ministry of Health, Singapore 169854, Singapore; (S.Y.S.); (K.B.T.)
| |
Collapse
|
15
|
Nielsen TL, Nielsen LM. Can strengthening older adults' problem-solving skills through occupational therapy improve their occupational performance? A protocol for a systematic review and meta-analysis. Scand J Occup Ther 2020; 28:348-353. [PMID: 32544358 DOI: 10.1080/11038128.2020.1775886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Older adults' occupational performance is challenged due to chronic health conditions, aging processes, and deteriorating functioning. Thus, their occupational performance cannot be expected to remain stable in the long term after an occupational therapy intervention. Older adults may therefore need to strengthen their problem-solving skills during occupational therapy not only to solve current occupational performance issues but also to maintain their improvements and deal with new such issues a later point in time. AIMS This systematic review and meta-analysis aims to identify, analyse and present current scientific knowledge about the effectiveness and contents of occupational therapy interventions aimed at improving older adults' occupational performance by strengthening their problem-solving skills. METHODS MEDLINE, EMBASE, CINAHL and PsycINFO will be searched systematically to identify trials of occupational therapy interventions aimed at improving older adults' occupational performance by strengthening their problem-solving skills. We will include randomized controlled trials and quasi-experimental trials in populations aged 65+. Three reviewers will independently screen and select references, extract data and assess the quality of included studies using the Cochrane Collaboration's risk of bias tool. SIGNIFICANCE The findings can inform and inspire clinical practice and will help to identify the need for further research.
Collapse
Affiliation(s)
- Tove Lise Nielsen
- Department of Occupational Therapy, VIA University College, Aarhus, Denmark.,Programme for rehabilitation, VIA University College Research Centre for Health and Welfare Technology, Aarhus, Denmark
| | - Louise Moeldrup Nielsen
- Department of Occupational Therapy, VIA University College, Aarhus, Denmark.,Programme for rehabilitation, VIA University College Research Centre for Health and Welfare Technology, Aarhus, Denmark
| |
Collapse
|
16
|
Zhang L, Ma L, Sun F, Tang Z, Chan P. A Multicenter Study of Multimorbidity in Older Adult Inpatients in China. J Nutr Health Aging 2020; 24:269-276. [PMID: 32115607 PMCID: PMC7026204 DOI: 10.1007/s12603-020-1311-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 10/18/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Multimorbidity is common in older hospitalized adults. To date, however, few studies have addressed multimorbidity in the older population of Chinese inpatients. We aimed to investigate the multimorbidity rate and associated risk factors in older adult inpatients in China. DESIGN, SETTING, PARTICIPANTS This study was conducted in the medical wards of a tertiary-care hospital from. The patients were recruited aged between 60 to 101 (74.14±8.46) years. MEASUREMENTS Data were obtained from the China Comprehensive Geriatric Assessment Study, conducted in 2011-2012 in China. A total of 4,633 inpatients older than 60 years was recruited from 12 hospitals in 7 cities throughout China. The prevalence of comorbidity, distribution of common chronic diseases, and the associated risk factors were studied. RESULTS A total of 4,348 people aged 60 to 101 (74.14±8.46) years completed questionnaires. The average frequency of multimorbidity was 69.3% (95% CI, 67.9% to 70.6%). The prevalence of multimorbidity increased with age and was higher in men (71.6%; 95% CI, 69.9% to 73.3%) than in women (65.3%, 95% CI 63.0% to 67.6%), and higher in the northern region (71.7%, 95% CI 69.9% to 73.5%) than in the southern region (66.0%; 95% CI, 63.8% to 68.1%). The most frequent chronic diseases were hypertension, coronary heart disease, diabetes, cataract, and stroke. Area (OR=0.556; 95% CI, 0.465 to 0.666), region (OR=0.834; 95% CI, 0.723 to 0.962), body mass index (BMI) (OR=1.124; 95% CI, 1.017 to 1.242), and impairment of activities of daily living (OR=0.911; 95% CI, 0.855 to 0.970) were independent factors associated with multimorbidity. CONCLUSIONS Multimorbidity is common in older Chinese inpatients with a national prevalence of 69.3% that increases in line with age. Age, region, area, BMI, and daily activities were independent factors significantly associated with multimorbidity in older inpatients. Clinicians should therefore focus more attention on multimorbidity.
Collapse
Affiliation(s)
- L Zhang
- Piu Chan, MD, Department of Neurobiology, Xuanwu Hospital of Capital MedicalUniversity, Beijing 100053, China. . Zhe Tang, MD, Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | | | | | | | | |
Collapse
|
17
|
Liu W, Shaw C, Chen X. Dental-related function and oral health in relation to eating performance in assisted living residents with and without cognitive impairment. SPECIAL CARE IN DENTISTRY 2019; 39:497-504. [PMID: 31287185 DOI: 10.1111/scd.12405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 06/26/2019] [Accepted: 06/30/2019] [Indexed: 12/23/2022]
Abstract
AIMS Despite the physiologic relationship, there is a lack of evidence on how dental-related function and oral health impact eating performance. This study aims to examine the association of eating performance with dental-related function and oral health among assisted living residents. METHODS AND RESULTS This study was a secondary analysis of observational data collected from an instrument development study. Participants included 90 residents with normal to severely impaired cognition from three assisted livings. Multilevel mixed-effects ordered logistic models were used. The dependent variable was eating performance measured by the single "eating" item (scored from 0 to 4 on level of dependence). Independent variables were resident age, gender, dental-related function, and oral health. The resident and facility clustering effects accounted for 88% of variance in eating performance, among which 84% was explained by dental-related function and oral health. Eating performance was associated with dental-related function (coefficient = -0.10, 95% CI = -0.19, -0.01, P = .025), and was not associated with other characteristics. CONCLUSION Eating performance is influenced by the complex relationship with dental-related function and oral health. Novel interventions using interdisciplinary partnerships are needed to maintain dental-related function and oral health to optimize eating performance.
Collapse
Affiliation(s)
- Wen Liu
- College of Nursing, The University of Iowa, Iowa City, Iowa
| | - Clarissa Shaw
- College of Nursing, The University of Iowa, Iowa City, Iowa
| | - Xi Chen
- Department of Preventive & Community Dentistry, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, Iowa
| |
Collapse
|
18
|
Lestari SK, Ng N, Kowal P, Santosa A. Diversity in the Factors Associated with ADL-Related Disability among Older People in Six Middle-Income Countries: A Cross-Country Comparison. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1341. [PMID: 31013975 PMCID: PMC6518276 DOI: 10.3390/ijerph16081341] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/27/2019] [Accepted: 04/11/2019] [Indexed: 11/16/2022]
Abstract
The low- and middle-income countries (LMICs) are experiencing rapid population ageing, yet knowledge about disability among older populations in these countries is scarce. This study aims to identify the prevalence and factors associated with disability among people aged 50 years and over in six LMICs. Cross-sectional data from the World Health Organization (WHO) Study on global AGEing and adult health Wave 1 (2007-2010) in China, Ghana, India, Mexico, the Russian Federation, and South Africa was used. Multivariable logistic regression analyses were undertaken to examine the association between sociodemographic factors, health behaviours, chronic conditions, and activities of daily living (ADL) disability. The prevalence of disability among older adults ranged from 16.2% in China to 55.7% in India. Older age, multimorbidity, and depression were the most common factors related to disability in all six countries. Gender was significant in China (OR = 1.14, 95% CI: 1.01-1.29), Ghana (OR = 1.22, 95% CI: 1.01-1.48) and India (OR = 1.65, 95% CI: 1.37-1.99). Having no access to social capital was significantly associated with ADL disability in China (OR = 2.57, 95% CI: 1.54-4.31) and South Africa (OR = 4.11, 95% CI: 1.79-9.43). Prevalence data is valuable in these six ageing countries, with important evidence on mitigating factors for each. Identifying determinants associated with ADL disability among older people in LMICs can inform how to best implement health prevention programmes considering different country-specific factors.
Collapse
Affiliation(s)
- Septi Kurnia Lestari
- Department of Epidemiology and Global Health, Umeå University, 90187 Umeå, Sweden.
- Centre for Demographic and Ageing Research, Umeå University, 90187 Umeå, Sweden.
| | - Nawi Ng
- Department of Epidemiology and Global Health, Umeå University, 90187 Umeå, Sweden.
- Centre for Demographic and Ageing Research, Umeå University, 90187 Umeå, Sweden.
| | - Paul Kowal
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand.
- Vantage Health Solutions, Yangon 11072, Myanmar.
| | - Ailiana Santosa
- Centre for Demographic and Ageing Research, Umeå University, 90187 Umeå, Sweden.
| |
Collapse
|
19
|
Athayde FTS, Mancuzo EV, Ferreira LCV, Vinhas LB, Corrêa RA. Association between contextual and clinical factors and disability in people with chronic obstructive pulmonary disease. Physiother Theory Pract 2019; 36:1137-1144. [DOI: 10.1080/09593985.2018.1563930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Filipe T. S. Athayde
- School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Eliane V. Mancuzo
- Department of Internal Medicine, School of Medicine, Division of Pulmonology and Thoracic Surgery, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Luiza C. V. Ferreira
- School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lucas B. Vinhas
- School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ricardo A. Corrêa
- Department of Internal Medicine, School of Medicine, Division of Pulmonology and Thoracic Surgery, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
20
|
Cho S, Park S, Takahashi S, Yoshiuchi K, Shephard RJ, Aoyagi Y. Changes in and Interactions between Physical and Mental Health in Older Japanese: The Nakanojo Study. Gerontology 2018; 65:340-352. [PMID: 30566936 DOI: 10.1159/000494383] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/10/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND An age-related decrease in functional capacity is consistently reported, but it is not consistently related to a worsening of health-related quality of life (HRQOL) or psychological adjustment. A poor functional capacity and HRQOL have been associated with anxiety or depression, but the possible causal nature and direction of the relationship remain to be explored using long-term longitudinal data. OBJECTIVE The purpose of this study was to examine age-related changes in functional capacity, HRQOL, and scores on the Hospital Anxiety and Depression Scale (HADS), and possible causal interrelationships between these variables. METHODS Study participants were 5,124 Japanese aged ≥65 years. After the baseline study (2003), annual follow-up observations continued for 10 years. Generalized linear mixed models examined age-related changes in Barthel index (BI), Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), HRQOL, and HADS. Cross-lagged effects models tested possible causal interrelationships. RESULTS With age, functional capacity and HRQOL scores showed similar declines in both sexes. Changes in mental health, anxiety, and depression developed more slowly than decreases in physical health (BI, TMIG-IC, and physical functioning scores). Cross-lagged effects models demonstrated that functional capacity had positive effects on psychological adjustment, and that psychological adjustment had positive effects on functional capacity 5 years later. Interactions between functional capacity and psychological adjustment showed no sex differences. A decline in functional capacity negatively affected psychological adjustment, but reduced psychological adjustment had no significant impact on functional capacity 5 and 10 years later. Moreover, functional capacity and poor psychological adjustment showed no interactions in either sex. CONCLUSION Functional capacity and mood state are interrelated. Greater function could sustain vitality and mental health, possibly reducing anxiety and depression.
Collapse
Affiliation(s)
- Sunyoung Cho
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Sungjin Park
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shin Takahashi
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Roy J Shephard
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Yukitoshi Aoyagi
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan,
| |
Collapse
|
21
|
MCGRATH RYANP, VINCENT BRENDAM, LEE IMIN, KRAEMER WILLIAMJ, PETERSON MARKD. Handgrip Strength, Function, and Mortality in Older Adults: A Time-varying Approach. Med Sci Sports Exerc 2018; 50:2259-2266. [DOI: 10.1249/mss.0000000000001683] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
22
|
Gobbens RJ. Associations of ADL and IADL disability with physical and mental dimensions of quality of life in people aged 75 years and older. PeerJ 2018; 6:e5425. [PMID: 30123720 PMCID: PMC6087617 DOI: 10.7717/peerj.5425] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 07/22/2018] [Indexed: 12/21/2022] Open
Abstract
Background Quality of life is an important health outcome for older persons. It predicts the adverse outcomes of institutionalization and premature death. The aim of this cross-sectional study was to determine the influence of both disability in activities of daily living (ADL) and instrumental activities of daily living (IADL) on physical and mental dimensions of quality of life. Methods A total of 377 Dutch people aged 75 years and older completed a web-based questionnaire. This questionnaire contained the Groningen Activity Restriction Scale (GARS) for measuring ADL and IADL and the Short-Form Health Survey (SF-12) for measuring quality of life. The SF-12 distinguishes two dimensions of quality of life, a physical and mental dimension. Results All ADL disability items combined and all IADL disability items combined explained a significant part of the variance of the physical and the mental dimension of quality of life. Only ADL item "stand up from sitting in a chair", and IADL items "do "heavy" household activities" and "do the shopping" were negatively associated with both quality of life dimensions after controlling for all the variables in the model. Discussion This study showed that disability in ADL and IADL is negatively associated with quality of life in older people. Therefore, it is important for health care professionals to carry out interventions aimed to prevent and diminish disability or the adverse outcomes of disability such as a lower quality of life. In order to be effective these interventions should be inexpensive, feasible, and easy to implement.
Collapse
Affiliation(s)
- Robbert J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, The Netherlands.,Zonnehuisgroep Amstelland, Amstelveen, The Netherlands.,Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
23
|
Body mass index and mobility limitations: An analysis of middle-aged and older Black, Hispanic, and White women in the U.S. Obes Res Clin Pract 2018; 12:547-554. [PMID: 29921542 DOI: 10.1016/j.orcp.2018.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/31/2018] [Accepted: 06/01/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION While the Body Mass Index (BMI) did not change significantly for men from 2005 to 2014 in the United States, women exhibited an upward linear trend. Hispanic and Black women, in particular, showed a dramatic increase. Therefore, the objective of this study was to examine the association between BMI and mobility limitations for non-institutionalised middle-aged and older Black, Hispanic, and White women. METHODS The International Classification of Functioning, Disability, and Health model was applied to a sample of 2865 Black, 1846 Hispanic, and 9721 White women categorised as middle-aged and older (i.e., at least 50 years of age) from the 2010 and 2014 Rand Health and Retirement Study. A random effects ordered logit was employed. RESULTS After accounting for personal/activity characteristics, the analyses revealed Black women with greater BMI were associated with a higher likelihood for mobility limitations with an odds ratio of 1.11 [1.06-1.16, 95% CI]. A significant association was also found for Hispanic women with an odds ratio of 1.16 [1.11-1.23, 95% CI] and White women with an odds ratio of 1.16 [1.13-1.19, 95% CI]. Even after accounting for the possibility of endogeneity, BMI remained robust. CONCLUSION Higher-levels of BMI were associated with an increased probability for mobility limitations for Black, Hispanic, and White middle-aged and older women. Those with a vigorous exercise regimen were less likely to be in this category across all ranges of BMI. These results are useful for prioritising minority health policy, particularly given the limited amount of existing research in this specific area.
Collapse
|
24
|
BMI, Psychosocial Correlates, Pain and Activities of Daily Living in Sickle Cell Disease Patients. PROGRESS IN PREVENTIVE MEDICINE 2018. [DOI: 10.1097/pp9.0000000000000019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
25
|
Athayde F, Mancuzo EV, Corrêa RDA. [Environmental influence on physical disability: a systematic review of the literature]. CIENCIA & SAUDE COLETIVA 2017; 22:3645-3652. [PMID: 29211170 DOI: 10.1590/1413-812320172211.01992017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 04/14/2017] [Indexed: 11/21/2022] Open
Abstract
People with physical disabilities may, in interaction with facilitators and barriers, modify their participation in society. The environment, in the panorama of the International Classification of Functioning, Disability and Health (ICF), plays a relevant role in health and in the expression of functioning. Thus, the aim of this study was to investigate the influence of environmental factors on physical disability, based on the theoretical framework of the ICF. A systematic review of the literature was performed based on the recommendations of the following documents: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Strengthening the Reporting of Observational Studies in Epidemiology Statement (STROBE). The studies selected confirmed the theoretical precepts of the ICF. The interference of the physical and social environment, in general, might be attributed to different clinical conditions, especially in neurology, both in quantitative and qualitative studies. Methodological limitations were observed that may be obstacles to consolidating some guidelines, which should encourage further research on the subject with judicious methods, validated instruments and carefully selected samples.
Collapse
Affiliation(s)
- Filipe Athayde
- Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Pres. Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | - Eliane Viana Mancuzo
- Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Pres. Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | - Ricardo de Amorim Corrêa
- Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Pres. Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| |
Collapse
|
26
|
Weidung B, Toots A, Nordström P, Carlberg B, Gustafson Y. Systolic blood pressure decline in very old individuals is explained by deteriorating health: Longitudinal changes from Umeå85+/GERDA. Medicine (Baltimore) 2017; 96:e9161. [PMID: 29390448 PMCID: PMC5758150 DOI: 10.1097/md.0000000000009161] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Declining systolic blood pressure (SBP) is common in very old age and is associated with adverse events, such as dementia. Knowledge of factors associated with SBP changes could explain the etiology of this decline in SBP. This study investigated longitudinal changes in socioeconomic factors, medical conditions, drug prescriptions, and assessments and their associations with SBP changes among very old followed individuals.The study was based on data from the Umeå85+/Gerontological Regional Database (GERDA) cohort study, which provided cross-sectional and longitudinal data on participants aged 85, 90, and ≥95 years from 2000 to 2015. Follow-up assessments were conducted after 5 years. The main outcome was a change in SBP. Factors associated with SBP changes were assessed using multivariate linear regression models.In the Umeå85+/GERDA study, 454 surviving individuals underwent follow-up assessment after 5 years. Of these, 297 had SBP measured at baseline and follow-up. The mean change ± standard deviation in SBP was -12 ± 25 mm Hg. SBP decline was associated independently with later investigation year (P = .009), higher baseline SBP (P < .001), baseline antidepressant prescription (P = .011), incident acute myocardial infarction during follow-up (P = .003), new diuretic prescription during follow-up (P = .044), and a decline in the Barthel Activities of Daily Living index at follow-up (P < .001).In conclusion, SBP declines among very old individuals. This decline seems to be associated with initial SBP level, investigation year, and health-related factors.
Collapse
Affiliation(s)
- Bodil Weidung
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå
- Department of Public Health and Caring Sciences, Geriatric Medicine, Uppsala University, Uppsala
| | - Annika Toots
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå
- Department of Community Medicine and Rehabilitation, Physiotherapy
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå
| | - Bo Carlberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Yngve Gustafson
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå
| |
Collapse
|
27
|
Associations of obesity and weight change with physical and mental impairments in elderly Chinese people. Maturitas 2017; 108:77-83. [PMID: 29290219 DOI: 10.1016/j.maturitas.2017.11.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/14/2017] [Accepted: 11/26/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To examine the associations between anthropometric measurements and functional impairments in a sample of urban elderly Chinese people. METHODS In two population-based cohort studies, the Shanghai Women's Health Study (SWHS) and Shanghai Men's Health Study (SMHS), 11,505 men and 17,166 women aged 70-88 years at the time of the functional assessment were studied. Weight history was collected and anthropometric data were taken at study enrollment (from 1996 to 2000 for the SWHS, 2002-2006 for the SMHS). Information on functional status and current weight was collected at the most recent follow-up survey (from 2011 to 2015). Logistic regression analyses were applied to estimate the associations of body mass index (BMI), waist-hip-ratio (WHR), and weight changes with functional decline. RESULTS After a median follow-up of 14.4 years (range 5.4-18.2 years), we found that BMI/WHR at or after middle age, and weight gain during adulthood were significantly associated with impaired walking ability and mental functioning. Being underweight after age 70 was associated with poorer hearing and/or vision as well as poorer memory. The associations between obesity and functional impairment were generally not modified by sex, comorbidity or exercise. CONCLUSION Weight gain, obesity at or after middle age, and underweight after age 70 were associated with physical and mental functional impairments among elderly Chinese people. These findings highlight the importance of maintaining healthy weight to reduce age-related functional decline.
Collapse
|
28
|
Liu W, Jao YL, Williams K. The association of eating performance and environmental stimulation among older adults with dementia in nursing homes: A secondary analysis. Int J Nurs Stud 2017; 71:70-79. [PMID: 28340390 PMCID: PMC5495475 DOI: 10.1016/j.ijnurstu.2017.03.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 03/02/2017] [Accepted: 03/08/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Nursing home residents with dementia experience increased risk for compromised eating performance due to intrapersonal, interpersonal, and environmental factors. Environmental stimulation is physical, social, and/or sensory stimulation present in the environment that can potentially trigger individuals' emotion or motivate physical reactions. Beyond the personal factors, there is a lack of evidence on how environmental stimulation influences individuals' eating performance at mealtimes. OBJECTIVES This study examined the association between environmental stimulation and eating performance among nursing home residents with dementia. DESIGN This study was a secondary analysis using baseline videos selected from a communication intervention study, where videos were recorded to capture staff-resident interactions during care activities for nursing home residents with dementia. Videos were included in this study only if residents demonstrated eating activities at mealtimes. SAMPLE AND SETTING A total of 36 videos were selected (mean length=4min). The sample included 15 residents with dementia (mean age=86), and 19 certified nursing assistants (mean age=36) in 8 nursing homes. METHODS The dependent variable was eating performance as measured by the Level of Eating Independence scale (range: 15-36, with higher scores indicating better eating performance). The independent variables were characteristics of environmental stimulation measured by the Person-Environment Apathy Rating-Environment subscale (stimulation clarity, stimulation strength, stimulation specificity, interaction involvement, physical accessibility, and environmental feedback). Each characteristic was rated on a 1-4 scale with higher scores indicating more desirable environmental stimulation. Multilevel models were used to examine the association between eating performance and environmental stimulation, adjusting for resident characteristics (i.e., age, gender, dementia stage, function, comorbidity, psychoactive medication use) and nesting effects of residents and staff. RESULTS Resident participants demonstrated moderate levels of eating performance (M=27.08, SD=5.16). Eating performance was significantly lower among older residents, those with more advanced dementia, and higher comorbidity. After controlling for resident characteristics, eating performance was significantly associated with stimulation specificity (how the stimulation is delivered and tailored to the resident), and was not associated with other environmental stimulation characteristics. For each 1 point increase in stimulation specificity, eating performance increased by 8.78 points (95% CI=0.59, 16.97). CONCLUSIONS Environmental stimulation that is personally tailored to a resident' needs and preferences and directly offered to a resident contributed to better eating performance among residents with dementia. The findings will direct future development and implementation of person-directed mealtime care programs and dining environment arrangements for residents with dementia in nursing homes.
Collapse
Affiliation(s)
- Wen Liu
- The University of Iowa, College of Nursing, 432 CNB, 50 Newton Road, Iowa City, IA, 52242, USA.
| | - Ying-Ling Jao
- Pennsylvania State University, College of Nursing, University Park, PA, USA
| | | |
Collapse
|
29
|
Wang XX, Lin WQ, Chen XJ, Lin YY, Huang LL, Zhang SC, Wang PX. Multimorbidity associated with functional independence among community-dwelling older people: a cross-sectional study in Southern China. Health Qual Life Outcomes 2017; 15:73. [PMID: 28412945 PMCID: PMC5392938 DOI: 10.1186/s12955-017-0635-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 03/20/2017] [Indexed: 12/22/2022] Open
Abstract
Background Multimorbidity, the coexistence of two or more chronic diseases, is common in older adults. And it may lead to many adverse health outcomes, such as disability. However, data on multimorbidity and its relationship with functional independence are scarce in Asian countries. Therefore, this study aims to investigate the relationship between multimorbidity and functional status among older people in China. Methods Based on a cross-sectional survey, the information regarding 2705 older adults, who were of at least 60 years of age, was collected through interviews and analyzed. To assess functional status, we used the Functional Independence Measure (FIM). Exploratory factor analysis was performed to assess correlations among chronic diseases. Several logistic regression models were run in the study. Results The presence of two or more chronic conditions and the number of multimorbidity group overlaps were independent risk factors for the loss of functional independence in older adults. Hypertension and chronic pain, emerged as the most prevalent multimorbidity pair, was significantly associated with functional independence (OR = 1.64, 95% CI = 1.25–2.16), followed by the co-occurrence of hypertension and heart diseases with a lower prevalence but a higher OR compared with the former pair (OR = 1.72, 95% CI = 1.15–2.58). Of the five multimorbidity groups used for factor analysis, the bones and pain group (OR = 1.47, 95% CI = 1.23–1.77) and the cardiometabolic group (OR = 1.34, 95% CI = 1.13–1.59) were both found to be significantly correlated with lower functional independence. Conclusions Multimorbidity was common among older people in Southern China. Studying the relationship between multimorbidity and functional status could be useful to find potential correlations among chronic diseases. Additionally, it may also be meaningful to identify multimorbidity combinations, posing an increased risk of loss of functional independence, and further improve functional status in older adults with comorbidities.
Collapse
Affiliation(s)
- Xiao-Xiao Wang
- Institute of Public Health, School of Nursing, Henan University, Kaifeng, 475004, China
| | - Wei-Quan Lin
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Xu-Jia Chen
- Community health service management center, Luohu hospital group, Shenzhen, 518007, China
| | - Ying-Yu Lin
- Baoan Central Hospital of Shenzhen, Shenzhen, 518102, China
| | - Ling-Ling Huang
- Institute of Public Health, School of Nursing, Henan University, Kaifeng, 475004, China
| | | | - Pei-Xi Wang
- Institute of Public Health, School of Nursing, Henan University, Kaifeng, 475004, China. .,Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 510182, China.
| |
Collapse
|
30
|
The effects of 12 weeks Pilates-inspired exercise training on functional performance in older women: A randomized clinical trial. J Bodyw Mov Ther 2017; 21:251-258. [DOI: 10.1016/j.jbmt.2016.06.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/06/2016] [Accepted: 06/10/2016] [Indexed: 12/25/2022]
|
31
|
Mueller-Schotte S, Bleijenberg N, van der Schouw YT, Schuurmans MJ. Fatigue as a long-term risk factor for limitations in instrumental activities of daily living and/or mobility performance in older adults after 10 years. Clin Interv Aging 2016; 11:1579-1587. [PMID: 27877027 PMCID: PMC5108501 DOI: 10.2147/cia.s116741] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objectives Decline in the performance of instrumental activities of daily living (IADL) and mobility may be preceded by symptoms the patient experiences, such as fatigue. The aim of this study is to investigate whether self-reported non-task-specific fatigue is a long-term risk factor for IADL-limitations and/or mobility performance in older adults after 10 years. Methods A prospective study from two previously conducted cross-sectional studies with 10-year follow-up was conducted among 285 males and 249 females aged 40–79 years at baseline. Fatigue was measured by asking “Did you feel tired within the past 4 weeks?” (males) and “Do you feel tired?” (females). Self-reported IADLs were assessed at baseline and follow-up. Mobility was assessed by the 6-minute walk test. Gender-specific associations between fatigue and IADL-limitations and mobility were estimated by multivariable logistic and linear regression models. Results A total of 18.6% of males and 28.1% of females were fatigued. After adjustment, the odds ratio for fatigued versus non-fatigued males affected by IADL-limitations was 3.3 (P=0.023). In females, the association was weaker and not statistically significant, with odds ratio being 1.7 (P=0.154). Fatigued males walked 39.1 m shorter distance than those non-fatigued (P=0.048). For fatigued females, the distance was 17.5 m shorter compared to those non-fatigued (P=0.479). Conclusion Our data suggest that self-reported fatigue may be a long-term risk factor for IADL-limitations and mobility performance in middle-aged and elderly males but possibly not in females.
Collapse
Affiliation(s)
- Sigrid Mueller-Schotte
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Department for the Chronically Ill, University of Applied Sciences Utrecht, the Netherlands; Department of Optometry and Orthoptics, University of Applied Sciences Utrecht, the Netherlands
| | - Nienke Bleijenberg
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Department for the Chronically Ill, University of Applied Sciences Utrecht, the Netherlands; Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, the Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Marieke J Schuurmans
- Department for the Chronically Ill, University of Applied Sciences Utrecht, the Netherlands; Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, the Netherlands
| |
Collapse
|
32
|
Nielsen TL, Petersen KS, Nielsen CV, Strøm J, Ehlers MM, Bjerrum M. What are the short-term and long-term effects of occupation-focused and occupation-based occupational therapy in the home on older adults’ occupational performance? A systematic review. Scand J Occup Ther 2016; 24:235-248. [DOI: 10.1080/11038128.2016.1245357] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Tove Lise Nielsen
- Division of Rehabilitation, DEFACTUM, Central Denmark Region, Aarhus, Denmark
- VIA Department of Occupational Therapy, Aarhus, Denmark
| | | | - Claus Vinther Nielsen
- Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Aarhus University, Denmark
| | - Janni Strøm
- Division of Rehabilitation, DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Silkeborg Regional Hospital, Interdisciplinary Research Unit, Elective Surgery Center, Denmark
| | | | - Merete Bjerrum
- Division of Rehabilitation, DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Section for Nursing Science, Aarhus University, Denmark
| |
Collapse
|
33
|
Okabe T, Abe Y, Tomita Y, Mizukami S, Kanagae M, Arima K, Nishimura T, Tsujimoto R, Tanaka N, Goto H, Horiguchi I, Aoyagi K. Age-specific risk factors for incident disability in activities of daily living among middle-aged and elderly community-dwelling Japanese women during an 8-9-year follow up: The Hizen-Oshima study. Geriatr Gerontol Int 2016; 17:1096-1101. [PMID: 27401720 DOI: 10.1111/ggi.12834] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Revised: 04/18/2016] [Accepted: 04/24/2016] [Indexed: 12/28/2022]
Abstract
AIM The purposes of the present study were to investigate risk factors for incident disability in activities of daily living (ADL) among middle-aged and older women, and to determine whether there are differences in risk factors according to age groups. METHODS The participants were 264 Japanese women aged 40 years and older. A self-administered questionnaire was used to survey participants about difficulty in carrying out selected basic and instrumental ADL at baseline and at follow up. ADL disability was defined as difficulty carrying out three or more ADL. Information on knee joint or back pain and comorbidities (heart disease, lung disease, stroke or diabetes mellitus) was obtained using a self-administered questionnaire at baseline. Physical performance measurements (grip strength, chair stand time, rapid walking speed and functional reach) were also carried out at baseline. RESULTS The prevalence of incident ADL disability was 44 (27.5%) in women aged 40-64 years, and 57 (54.8%) in women aged ≥65 years (P < 0.001). Multiple logistic regression analysis showed that decreased grip strength and having pain were significantly associated with a higher risk for incident ADL disability among women aged 40-64 years. For women aged ≥65 years, decreased rapid walking speed, having a comorbidity and having pain were associated with incident ADL disability. CONCLUSIONS The present study showed that a different set of risk factors was associated with incident ADL disability among women aged 40-64 years and women aged ≥65 years. Age-specific screening and intervention strategies are necessary for effective prevention of incident ADL disability. Geriatr Gerontol Int 2017; 17: 1096-1101.
Collapse
Affiliation(s)
- Takuhiro Okabe
- Departments of Public Health, Nagasaki, Japan.,Department of Rehabilitation, Nishi-Isahaya Hospital, Isahaya, Japan
| | - Yasuyo Abe
- Departments of Public Health, Nagasaki, Japan
| | - Yoshihito Tomita
- Departments of Public Health, Nagasaki, Japan.,Department of Rehabilitation, Nishi-Isahaya Hospital, Isahaya, Japan
| | - Satoshi Mizukami
- Departments of Public Health, Nagasaki, Japan.,Department of Rehabilitation, Nishi-Isahaya Hospital, Isahaya, Japan
| | - Mitsuo Kanagae
- Departments of Public Health, Nagasaki, Japan.,Department of Rehabilitation, Nishi-Isahaya Hospital, Isahaya, Japan
| | | | | | - Ritsu Tsujimoto
- Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Natsumi Tanaka
- Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Itsuko Horiguchi
- Center for Public Relations Strategy, Nagasaki University, Nagasaki, Japan
| | | |
Collapse
|
34
|
Connolly D, Garvey J, McKee G. Factors associated with ADL/IADL disability in community dwelling older adults in the Irish longitudinal study on ageing (TILDA). Disabil Rehabil 2016; 39:809-816. [PMID: 27045728 DOI: 10.3109/09638288.2016.1161848] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To identify the factors associated with disability across many domains using a large powered sample in the activities of daily living (ADL) and instrumental activities of daily living (IADL). METHODS Those aged ≥65 years from the Irish longitudinal study on ageing (TILDA) were included in this cross sectional analysis. Three logistic regression models were used to examine the relationships between 25 health, psychological and sociodemographic variables and difficulties in ADL, IADL and ADL/IADL combined. RESULTS The proportion of those reporting combined ADL/IADL difficulties was 18%. More individuals reported difficulty with ADLs (13%) than IADLS (11%). The main model showed that after age, the top three factors associated with difficulty in ADL/IADL combined were pain, taking five or more medications and depression. After age, the factors with the highest impact on ADL disability were pain, taking five or more medications and body mass index (BMI); the factors with the highest impact on IADL were being separated or divorced, living with others (non-spouse) and self-rated memory. CONCLUSIONS Awareness of sociodemographics and early interventions for pain and cognitive deficits could reduce ADL/IADL disability and promote successful ageing. Identification of variables that influence ADL/IADLs can be used to inform policy and practice. Implications for rehabilitation After age, pain and taking five or more medications were the strongest factors associated with difficulty in ADL/IADL combined and ADL alone. Practice therefore needs to be cognizant that it is not the disease label but the symptoms of a disease that affect ADL and IADL activities. Given the strong influence of pain on difficulties with ADL and IADL, there is a need for early interventions from a multidisciplinary perspective for pain reduction, control, and self-management. These interventions should include development of pain-coping strategies and exercises to maintain mobility. After age, being separated/divorced or living with non-spouse others are the strongest factors associated with IADL difficulties. Awareness of these social factors can be used to inform support mechanisms, such as development of community services and suitable housing for those with these changing sociodemographics. Unsurprisingly, cognitive impairments were strongly associated with IADL difficulties. Simple cognitive screening assessments could be used for early detection of cognitive changes. In order to maintain optimal cognitive functioning, rehabilitation professionals should facilitate older adults' engagement in activities that are cognitively demanding and socially interactive.
Collapse
Affiliation(s)
| | - Jess Garvey
- a Discipline of Occupational Therapy , Trinity College , Dublin
| | - Gabrielle McKee
- b School of Nursing and Midwifery , Trinity College , Dublin
| |
Collapse
|
35
|
Liu W, Galik E, Boltz M, Nahm ES, Lerner N, Resnick B. Factors associated with eating performance for long-term care residents with moderate-to-severe cognitive impairment. J Adv Nurs 2015; 72:348-60. [DOI: 10.1111/jan.12846] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2015] [Indexed: 01/26/2023]
Affiliation(s)
- Wen Liu
- The University of Iowa College of Nursing; Iowa USA
| | - Elizabeth Galik
- University of Maryland School of Nursing; Baltimore Maryland USA
| | - Marie Boltz
- Boston College Connell School of Nursing; Chestnut Hill Massachusetts USA
| | - Eun-Shim Nahm
- University of Maryland School of Nursing; Baltimore Maryland USA
| | - Nancy Lerner
- University of Maryland School of Nursing; Baltimore Maryland USA
| | - Barbara Resnick
- University of Maryland School of Nursing; Baltimore Maryland USA
| |
Collapse
|
36
|
Jiménez-Monreal AM, Murcia MA, Gómez-Murcia V, Bibiloni MDM, Pons A, Tur JA, Martínez-Tomé M. Anthropometric and Quality-of-Life Parameters in Acute Intermittent Porphyria Patients. Medicine (Baltimore) 2015; 94:e1023. [PMID: 26222840 PMCID: PMC4554130 DOI: 10.1097/md.0000000000001023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 05/08/2015] [Accepted: 05/26/2015] [Indexed: 11/26/2022] Open
Abstract
The porphyrias are a group of rare metabolic disorders. The incidence and prevalence are low because the acute intermittent porphyria (AIP) is rare. Our aim was to assess the use of anthropometric and quality-of-life parameters in porphyric patients in order to identify predictor factors that might help in characterizing AIP patients.Sixteen AIP patients from Murcia (Spain) were recruited from local health centers in 2008 and 2009. A control group of 16 healthy people was established. Body composition was assessed by bioelectrical impedance analysis (BIA) and anthropometric measurements: body weight; height; knee-heel height; waist, hip, upper arm and calf circumferences (CCs); biacromion and biiliac diameters; bicondylar and biepicondylar width; and triceps, subscapular, supraspinale, and calf skinfold thickness. Anthropometric indicators were obtained from anthropometric measurements. A quality-of-life evaluation was carried out using the EuroQol-5D (EQ-5D) questionnaire and Barthel and Katz indexes. Significant differences in means were tested by unpaired Student t test. Group differences in anthropometric measurements were tested with a 2-way analysis of variance (group × condition: age group, overweight, and adiposity degree). Relative frequencies were obtained for noncontinuous variables. Significant differences in prevalence were calculated by means of χ.AIP patients showed statistically significant differences in terms of knee-heel height, biiliac diameter, CC, triceps skinfold thickness, BIA, ponderal index, endomorphy, and ectomorphy. Only 1 quality-of-life indicator, visual analog scale, in the EQ-5D questionnaire showed significant differences between porphyric and control groups.Some anthropometric parameters and the EQ-5D questionnaire could be used to appreciate the presence or follow the evolution of the disease in AIP patients.
Collapse
Affiliation(s)
- Antonia M Jiménez-Monreal
- From the Department of Food Science (AMJ-M, AM, VG-M, MM-T), Regional Campus of International Excellence "Campus Mare Nostrum," University of Murcia, Murcia; CIBEROBN (Fisiopatología de la Obesidad y la Nutrición CB12/03/30038) (AMJ-M, AM, MMB, AP, JAT, MM-T), Instituto de Salud Carlos III, Madrid; and Research Group on Community Nutrition and Oxidative Stress (MMB, AP, JAT), University of the Balearic Islands, Palma de Mallorca, Spain
| | | | | | | | | | | | | |
Collapse
|
37
|
The relationship of body mass index and the functional status of community-dwelling female older people admitting to a geriatric outpatient clinic. Aging Clin Exp Res 2015; 27:303-8. [PMID: 25476106 DOI: 10.1007/s40520-014-0291-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 11/03/2014] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The relationship of body mass index (BMI) with functional status differs in diversified geriatric population and various settings. In this study, we aimed to investigate whether BMI is related to functional status independent of age, nutritional status, multimorbidity, and polypharmacy in a group of Turkish community-dwelling female elderly. DESIGN This study was conducted using a cross-sectional study design. SETTING Geriatric outpatient clinic of a university hospital. PARTICIPANTS There were 438 female patients aged 60 years or older included in the analysis. MEASUREMENTS Body mass indexes were calculated from weight (kg) divided by the square of height (m). Functional status was assessed with the evaluation of activities of daily living (ADL) and instrumental activities of daily living (IADL) scales. Diseases and drugs were determined after the evaluation of the patients with comprehensive geriatric assessment, physical examination, first-line biochemical tests, and using the patients' self-report and current medication lists. RESULTS In total, 438 subjects comprised our study cohort. Mean age was 73.3 ± 6.9 years. Mean BMI was 27.8 ± 5.2 kg/m(2). Linear regression analysis revealed significant and independent association of lower BMI with higher ADL and IADL scores (p = 0.02, B = -0.10; p < 0.001, B = -0.17, respectively). ADL and IADL were significantly negatively correlated with BMI in subjects with normal nutrition (p = 0.03, r = -0.122; p = 0.001, r = -0.183) but not in subjects with malnutrition risk or malnutrition. We suggest that lower BMI is associated with better functional status in Turkish community-dwelling female older people. This association is prominent in the subjects with normal nutritional status. CONCLUSIONS Our study recommends the need for further studies accounting for the nutritional status on the relationship between BMI and functionality in different populations and in different settings. It represents an important example for diversity in BMI-functionality relationship.
Collapse
|
38
|
Philibert M, Pampalon R, Daniel M. Conceptual and operational considerations in identifying socioenvironmental factors associated with disability among community-dwelling adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:3814-34. [PMID: 25854297 PMCID: PMC4410217 DOI: 10.3390/ijerph120403814] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 03/31/2015] [Accepted: 04/01/2015] [Indexed: 11/23/2022]
Abstract
Disability is conceived as a person–context interaction. Physical and social environments are identified as intervention targets for improving social participation and independence. In comparison to the body of research on place and health, relatively few reports have been published on residential environments and disability in the health sciences literature. We reviewed studies evaluating the socioenvironmental correlates of disability. Searches were conducted in Medline, Embase and CINAHL databases for peer-reviewed articles published between 1997 and 2014. We found many environmental factors to be associated with disability, particularly area-level socioeconomic status and rurality. However, diversity in conceptual and methodological approaches to such research yields a limited basis for comparing studies. Conceptual inconsistencies in operational measures of disability and conceptual disagreement between studies potentially affect understanding of socioenvironmental influences. Similarly, greater precision in socioenvironmental measures and in study designs are likely to improve inference. Consistent and generalisable support for socioenvironmental influences on disability in the general adult population is scarce.
Collapse
Affiliation(s)
- Mathieu Philibert
- Département de Sexologie, Université du Québec à Montréal, Montréal, QC H3C 3P8, Canada.
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada.
- Departement de Medecine Sociale et Preventive, Université de Montréal, Montréal, QC H3N 1X9, Canada.
| | - Robert Pampalon
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada.
- Departement de Medecine Sociale et Preventive, Université Laval, Quebec, QC G1V 0A6, Canada.
| | - Mark Daniel
- Departement de Medecine Sociale et Preventive, Université de Montréal, Montréal, QC H3N 1X9, Canada.
- Spatial Epidemiology and Evaluation Research Group, School of Population Health, Sansom Institute for Health Research, University of South Australia, Adelaide, SA 5000, Australia.
- Department of Medicine, St. Vincent's Hospital, The University of Melbourne, Fitzroy, VIC 3065, Australia.
| |
Collapse
|
39
|
Foley MP, Barnes VA, Hasson SM. Effects of a community-based multimodal exercise program on physical function and quality of life in cancer survivors: a pilot study. Physiother Theory Pract 2015; 31:303-12. [PMID: 25613524 DOI: 10.3109/09593985.2015.1004390] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The purpose of this single-arm pilot study was to examine the effects of a community-based multimodal exercise program on: physical function (Timed-Up-and-Go [TUG], 6-min walk test [6MWT], leg and chest press strength, and functional reach [FR]); and quality of life, QoL [FACT-G]), in cancer survivors. Fifty-nine cancer survivors (91.5% female; mean age 59 ± 12 years) completed supervised exercise training for 90 min twice weekly for 12 weeks. Exercise training consisted of 30 min of each of the following: (1) aerobic conditioning; (2) resistance training; and (3) balance and flexibility training. Pre-post-outcome measures were compared for statistically significant differences (p < 0.01) and were related to the International Classification of Functioning, Disability and Health Model. Effect sizes (ES), minimal clinically important differences, and minimal detectable change at 90% confidence intervals were calculated. Participants decreased TUG time by 21.1% and walked 15.5% farther during 6-MWT (p < 0.001). Leg and chest press strength increased by 34.5% and 32.7%, respectively (p < 0.001). FR increased by 15.1% (p < 0.001). Significant improvements for physical well-being (13.9%), emotional well-being (6.7%), functional well-being (13.0%), and total well-being (9.6%) were found (p < 0.01). Improvements in physical function and QoL showed "moderate to large" ESs indicating improvements in physical function and QoL are clinically meaningful.
Collapse
Affiliation(s)
- Michael P Foley
- Department of Physical Therapy, Georgia Regents University , Augusta, GA , USA
| | | | | |
Collapse
|
40
|
Bahat G, Muratlı S, İlhan B, Tufan A, Tufan F, Aydin Y, Erten N, Karan MA. Body mass index and functional status in community dwelling older Turkish males. Aging Male 2015; 18:228-32. [PMID: 26134728 DOI: 10.3109/13685538.2015.1061493] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Disability is utmost important on an aging population's health. Obesity is associated with increased risk for disability. On-the-other-hand, higher-BMI is reported as associated with better functionality in older people in some reports defined as "obesity paradox". There is some evidence on differential relationship between body weight status and functionality by living setting gender, and different populations. We studied the relation between body mass index and functionality in Turkish community dwelling older males accounting for the most confounding factors: age, multimorbidity, polypharmacy and nutritional status. This is a cross-sectional study in a geriatric outpatient clinic of a university hospital. Functionality was assessed with evaluation of activities of daily living (ADL) and instrumental activities of daily living (IADL) scales. Nutrition was assessed by mini-nutritional assessment test. Two hundred seventy-four subjects comprised our study cohort. Mean age was 74.4 ± 7.1 years, BMI was 25.8 ± 4.4 kg/m(2). Linear regression analysis revealed significant and independent association of lower BMI with higher ADL and IADL scores (B = 0.047 and B = 0.128, respectively) (p < 0.05) and better nutritional status (B = 1.94 and B = 3.05, respectively) (p < 0.001) but not with the total number of medications. Higher IADL score was associated with younger age and lower total number of diseases (B = 0.121, B = 0.595, respectively) (p < 0.05) while ADL was not. We suggest that lower BMI is associated with better functional status in Turkish community-dwelling male older people. Our study recommends longitudinal studies with higher participants from different populations, genders and living settings are needed to comment more.
Collapse
Affiliation(s)
- Gulistan Bahat
- a Department of Internal Medicine, Division of Geriatrics , Istanbul Medical School, Istanbul University , Istanbul , Turkey
| | - Sevilay Muratlı
- a Department of Internal Medicine, Division of Geriatrics , Istanbul Medical School, Istanbul University , Istanbul , Turkey
| | - Birkan İlhan
- a Department of Internal Medicine, Division of Geriatrics , Istanbul Medical School, Istanbul University , Istanbul , Turkey
| | - Asli Tufan
- a Department of Internal Medicine, Division of Geriatrics , Istanbul Medical School, Istanbul University , Istanbul , Turkey
| | - Fatih Tufan
- a Department of Internal Medicine, Division of Geriatrics , Istanbul Medical School, Istanbul University , Istanbul , Turkey
| | - Yucel Aydin
- a Department of Internal Medicine, Division of Geriatrics , Istanbul Medical School, Istanbul University , Istanbul , Turkey
| | - Nilgun Erten
- a Department of Internal Medicine, Division of Geriatrics , Istanbul Medical School, Istanbul University , Istanbul , Turkey
| | - Mehmet Akif Karan
- a Department of Internal Medicine, Division of Geriatrics , Istanbul Medical School, Istanbul University , Istanbul , Turkey
| |
Collapse
|
41
|
Vascular risk factor burden, atherosclerosis, and functional dependence in old age: a population-based study. Int J Behav Med 2014; 21:597-604. [PMID: 24057410 DOI: 10.1007/s12529-013-9352-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Vascular risk factors such as hypertension and obesity have been associated with physical limitations among older adults. PURPOSE The purpose of this study is to examine whether individual and aggregated vascular risk factors (VRFs) are associated with functional dependence and to what extent carotid atherosclerosis (CAS) or peripheral artery disease (PAD) may mediate the possible associations of aggregated VRFs with functional dependence. METHOD This cross-sectional study included 1,451 community-living participants aged ≥60 years in the Confucius Hometown Aging Project of China. Data on demographic features, hypertension, high total cholesterol, obesity, smoking, physical inactivity, diabetes, CAS, PAD, and cardiovascular diseases (CVDs) were collected through an interview, a clinical examination, and laboratory tests. Functional dependence was defined as being dependent in at least one activity in the personal or instrumental activities of daily living. Data were analyzed using multiple logistic models controlling for potential confounders. We used the mediation model to explore the potential mediating effect of CAS and PAD on the associations of aggregated VRFs with functional dependence. RESULTS Of the 1,451 participants, 222 (15.3%) had functional dependence. The likelihood of functional dependence increased linearly with increasing number of VRFs (hypertension, high total cholesterol, abdominal obesity, and physical inactivity) (p for trend <0.002). Mediation analysis showed that controlling for demographics and CVDs up to 11% of the total association of functional dependence with clustering VRFs was mediated by CAS and PAD. CONCLUSION Aggregation of multiple VRFs is associated with an increased likelihood of functional dependence among Chinese older adults; the association is partially mediated by carotid and peripheral artery atherosclerosis independently of CVDs.
Collapse
|
42
|
Laan W, Zuithoff NPA, Drubbel I, Bleijenberg N, Numans ME, de Wit NJ, Schuurmans MJ. Validity and reliability of the Katz-15 scale to measure unfavorable health outcomes in community-dwelling older people. J Nutr Health Aging 2014; 18:848-54. [PMID: 25389963 DOI: 10.1007/s12603-014-0558-5] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To predict the risk of future unfavourable health outcomes in older people it is common to assess the level of both basic and instrumental activities of daily living. To accomplish this, the commonly used Katz-6 and the Lawton IADL questionnaires can be combined to form the 'Modified Katz ADL' scale, also known as the Katz-15 scale. So far, the validity and reliability of the Katz-15 scale is unknown. The objective of the current study is to investigate how well the Katz-15 is able to predict future unfavorable health outcomes and how this is related to the existing Katz-6 scale. DESIGN We performed a follow-up study using data from a group of 60 year and older participants from a large Dutch clinical trial. PARTICIPANTS We included 2321 participants in the analysis. The average age of the study population was 74 years and 44% was male. MEASUREMENTS We studied the relation between the Katz-15 scale and a number of unfavourable health outcomes, such as hospitalization, admission to a nursing home, admission to a home for the aged and death within one year of follow-up. RESULTS We found the Katz-15 to be both internally consistent and strongly associated with quality of life measures. We observed moderate to strong associations between the Katz-15 and the unfavourable health outcomes All associations studied were stronger for the Katz-15 scale as compared to the Katz-6 scale. CONCLUSION The results of our study indicate that the Katz-15 scale is able to reliably and validly predict future unfavorable health outcomes. This makes the scale a valuable measure in determining both basic and instrumental activities of daily living.
Collapse
Affiliation(s)
- W Laan
- Wijnand Laan, Assistant Professor, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | | | | | | | | | | | | |
Collapse
|
43
|
Schoufour JD, Mitnitski A, Rockwood K, Hilgenkamp TIM, Evenhuis HM, Echteld MA. Predicting disabilities in daily functioning in older people with intellectual disabilities using a frailty index. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2267-2277. [PMID: 24950014 DOI: 10.1016/j.ridd.2014.05.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 05/26/2014] [Accepted: 05/29/2014] [Indexed: 06/03/2023]
Abstract
Frailty is a state of increased vulnerability to adverse health outcomes compared to others of the same age. People with intellectual disabilities (ID) are more frequently and earlier frail compared to the general population. Frailty challenges much of health care, which will likely further increase due to the aging of the population. Before effective interventions can start, more information is necessary about the consequences of frailty in this, already disabled, population. Here we report whether frailty predicts disabilities in daily functioning. Frailty was measured with a frailty index (FI). At baseline and follow-up activities of daily living (ADL), instrumental activities of daily living (IADL) and mobility were collected by informant report. For 703 older people with ID (≥50 yr) baseline and follow-up measures were known. Multivariate linear regression models were used to predict ADL, IADL and mobility at follow-up. The FI was significantly associated with disabilities in daily functioning independent of baseline characteristics (age, gender, level of ID, Down syndrome) and baseline ADL, IADL or mobility. The FI showed to be most predictive for those with relative high independence at baseline. These results stress the importance for interventions that limit the progression of frailty and, thereby, help to limit further disability.
Collapse
Affiliation(s)
- Josje D Schoufour
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Arnold Mitnitski
- Department of Medicine (Geriatric Medicine), Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Kenneth Rockwood
- Department of Medicine (Geriatric Medicine), Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Thessa I M Hilgenkamp
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Heleen M Evenhuis
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Michael A Echteld
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| |
Collapse
|
44
|
den Ouden ME, Schuurmans MJ, Mueller-Schotte S, Bots ML, van der Schouw Y. Do subclinical vascular abnormalities precede impaired physical ability and ADL disability? Exp Gerontol 2014; 58:1-7. [DOI: 10.1016/j.exger.2014.06.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 05/09/2014] [Accepted: 06/02/2014] [Indexed: 10/25/2022]
|
45
|
Marventano S, Ayala A, Gonzalez N, Rodríguez-Blázquez C, Garcia-Gutierrez S, Forjaz MJ. Multimorbidity and functional status in community-dwelling older adults. Eur J Intern Med 2014; 25:610-6. [PMID: 24997486 DOI: 10.1016/j.ejim.2014.06.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 06/12/2014] [Accepted: 06/14/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND Multimorbidity is common in older people and may contribute to many adverse health events, such as disability. The aim of the study was to investigate how chronic health conditions (single, paired, and grouped) affect functional independence. METHOD We used two samples (a one-time, convenience sample and a nationally representative cross-sectional survey) of community-dwelling people of 65 years old or over, with a total of 2818 subjects in Spain. To assess functional independence, we used the Barthel index, administered as an interview. Information about the presence of 11 chronic health problems was collected by interview or review of their medical chart. Explanatory factor analysis was performed to assess associations between chronic health conditions. RESULTS Diabetes mellitus and hypertension emerged as the pair of chronic health conditions that most affected functional status [OR 1.98; 95% CI (1.51-2.60)], followed by visual and hearing impairment. A synergistic effect was found (p<0.05) for the cardiovascular disease and hypertension pair. Four multimorbidity groups emerged from the factor analysis: sensory and bone; cancer, lung and gastrointestinal; cardiovascular and metabolic; neuropsychiatric disorders. The neuropsychiatric disorders group was the most strongly associated with physical impairment [OR 4.94; 95% CI (2.71-8.99)], followed by the sensory and bones group [OR 1.90; 95% CI (1.56-2.31)]. CONCLUSION Despite its low prevalence, the neuropsychiatric disorders group was most strongly associated with lower functional status. Analysis of the relationship between chronic medical conditions and functional status could be useful to develop primary health care strategies to improve functional independence in older people with comorbidities.
Collapse
Affiliation(s)
- Stefano Marventano
- Department "G.F. Ingrassia" Section of Hygiene and Public Health University of Catania, Italy.
| | - Alba Ayala
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Nerea Gonzalez
- Research Unit of Galdakao-Usansolo Hospital, Bilbao, Spain; Research Network on Health Services and Chronicity (REDISSEC), Spain
| | - Carmen Rodríguez-Blázquez
- National Centre of Epidemiology and Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Susana Garcia-Gutierrez
- Research Unit of Galdakao-Usansolo Hospital, Bilbao, Spain; Research Network on Health Services and Chronicity (REDISSEC), Spain
| | - Maria João Forjaz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain; Research Network on Health Services and Chronicity (REDISSEC), Spain
| |
Collapse
|