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Komiyama T, Ohi T, Miyoshi Y, Kogure M, Nakaya N, Hozawa A, Tsuji I, Watanabe M, Hattori Y. Number of teeth and functional disability in community-dwelling older adults. Gerodontology 2024. [PMID: 38985947 DOI: 10.1111/ger.12775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2024] [Indexed: 07/12/2024]
Abstract
INTRODUCTION This study determined whether tooth loss was associated with the development of functional disability and estimated the population attributable fraction (PAF) of functional disability due to tooth loss, along with risk factors for functional disability such as physical function and cognitive impairment. METHODS The participants were 838 community-dwelling older adults aged ≥70 years living in the Tsurugaya district in Japan in 2003. The exposure variable was the number of remaining teeth (counted by trained dentists). Other variables were age, sex, depressive symptoms, cognitive impairment, educational attainment, physical function and social support. The Cox proportional hazards model was applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the incidence of functional disability for each risk factor, such as tooth loss. The functional disability PAF due to tooth loss was estimated, and risk factors for functional disability were identified. RESULTS In total, 619 (73.9%) participants developed functional disability during follow-up. A multivariable model showed that those with <20 teeth (HR, 1.28; 95% CI, 1.08-1.53) were more likely to develop functional disability than those with 20 teeth or more. PAF estimation for functional disability was shown to have decreasing values in the following order: age, female sex, tooth loss and reduced physical function. CONCLUSIONS Tooth loss was associated with the development of functional disability in community-dwelling older Japanese adults. While retaining teeth may be a potential strategy for avoiding functional disability, clinical studies on the effect of dental treatment on preventing functional disability are warranted.
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Affiliation(s)
- Takamasa Komiyama
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Takashi Ohi
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Miyagi, Japan
- Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan
| | - Yoshitada Miyoshi
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Mana Kogure
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Naoki Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Makoto Watanabe
- Institute of Living and Environmental Sciences, Miyagi Gakuin Women's University, Sendai, Miyagi, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Miyagi, Japan
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Woldemariam S, Stein VK, Haider S, Dorner TE. Trends over time in the deficit of (instrumental) activities of daily living in the Austrian population aged 65 years and older : Results from the Austrian Health Interview Survey series. Wien Klin Wochenschr 2024:10.1007/s00508-024-02388-4. [PMID: 38890264 DOI: 10.1007/s00508-024-02388-4] [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: 12/12/2023] [Accepted: 05/28/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Difficulties in activities of daily living (ADL) and instrumental activities of daily living (IADL) in older adults are associated with diminished quality of life and increased demand for long-term care. The present study examined the prevalence of disability among individuals aged 65 years and older in Austria, using data from the Austrian Health Interview Surveys (ATHIS). METHODS The ATHIS 2014 and 2019 surveys were used (N = 5853) for the analysis. Binary logistic regression was performed to measure the association between disability in at least one ADL or IADL limitation and independent variables adjusted for sociodemographic, health-related behavior and survey year. RESULTS The prevalence of ADL or IADL limitations increased in both sexes during the 5‑year follow-up period. For ADL limitations, the prevalence rose from 12.8% to 17.9% in men (p < 0.001) and from 19.2% to 25.7% in women (p < 0.001). The IADL limitations increased from 18.9% to 35.1% in men (p < 0.001) and from 38.2% to 50.8% in women (p < 0.001). Women reported significantly higher odds for ADL (odds ratio [OR]: 1.08, 95% confidence interval [CI]: 0.93-1.26) and IADL limitations (OR: 1.74, 95% CI: 1.53-1.98). In both sexes, participants aged 80 years and older reported higher odds for ADL (OR: 4.37, 95% CI:3.77-5.07) and IADL limitations (OR: 4.43, 95% CI: 3.86-5.09) compared to the younger group. Participants with at least one chronic disease reported higher odds for ADL (OR: 4.00, 95% CI: 3.41-4.70) and IADL limitations (OR: 4.37, 95% CI: 3.85-4.96). Primary education, single status, being born in non-EU/EFTA countries, and residing in Vienna were associated with higher odds of ADL and IADL limitations. CONCLUSION Gender, age, education, country of birth, residence, partnership status, number of chronic diseases, noncompliance with physical activity, and nutrition recommendations had a strong association with increased vulnerability to disability. Public health policy must address these factors for disability prevention strategies.
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Affiliation(s)
- Selam Woldemariam
- Karl Landsteiner Institute for Health Promotion Research, Kirchstetten, Austria.
- Center for Public Health, Department for Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria.
| | - Viktoria K Stein
- Karl Landsteiner Institute for Health Promotion Research, Kirchstetten, Austria
| | - Sandra Haider
- Center for Public Health, Department for Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
| | - Thomas E Dorner
- Karl Landsteiner Institute for Health Promotion Research, Kirchstetten, Austria
- Center for Public Health, Department for Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
- Academy for Ageing Research, "Haus der Barmherzigkeit", Vienna, Austria
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White J, Maier AB, Iacobaccio L, Iseli R. Foot Problems in Older Adults Presenting to a Falls and Balance Clinic. Gerontology 2024; 70:732-740. [PMID: 38697042 DOI: 10.1159/000539160] [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: 10/20/2023] [Accepted: 04/23/2024] [Indexed: 05/04/2024] Open
Abstract
INTRODUCTION Foot problems, including musculoskeletal problems, peripheral neuropathy, peripheral arterial disease and dermatologic pathology are common in older adults and are associated with an increased risk of falling. Multicomponent podiatry interventions have been shown to reduce the incidence of falls. This paper aimed to identify older adults requiring podiatry input in a Falls and Balance clinic; to describe the model of foot health care they receive; to explore cross-sectional associations between foot problems and function and ultimately demonstrate the role of podiatry input in the multidisciplinary management of falls risk. METHODS Cohort study of patients attending a Falls and Balance Clinic for Comprehensive Geriatric Assessment. Demographic information was collected and functional independence, mobility, foot problems, and footwear were assessed in the clinic. RESULTS One-hundred and two patients were included; median age 79.3 (73-84.3) years, 68.6% female, 93.1% residing independently, 62.7% used a gait aid. Podiatry referrals were made in 80.4% of cases, with muscle weakness being the most common problem identified (90.2%); 74.8% were found to be wearing inappropriate footwear. Most patients received footwear education and half were prescribed foot and ankle strengthening exercises. Hallux and lesser toe weakness were associated with lower Short Physical Performance Battery scores (p < 0.001). CONCLUSION The majority of older adults in the Falls and Balance Clinic required podiatry input, with foot weakness and inappropriate footwear being common reasons for referral. Those with weakness of the hallux and lesser toes had poorer balance and mobility, which is known to be associated with greater falls risk. This highlights the need for podiatry assessment and interventions as part of the multidisciplinary approach to the management of falls risk in older adults.
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Affiliation(s)
- Josephine White
- Department of Medicine, Dentistry and Health Science, University of Melbourne, Parkville, Victoria, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Healthy Longevity, National University Health System, Singapore, Singapore
| | - Laura Iacobaccio
- Department of Podiatry, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Rebecca Iseli
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
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Jafari-Koulaee A, Mohammadi E, Fox MT, Rasekhi A, Akha O. Predictors of basic and instrumental activities of daily living among older adults with multiple chronic conditions. BMC Geriatr 2024; 24:383. [PMID: 38689212 PMCID: PMC11062009 DOI: 10.1186/s12877-024-04947-w] [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: 02/07/2024] [Accepted: 04/04/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Understanding the predictors of functional status can be useful for improving modifiable predictors or identifying at-risk populations. Researchers have examined the predictors of functional status in older adults, but there has not been sufficient study in this field in older adults with multiple chronic conditions, especially in Iran. Consequently, the results of this body of research may not be generalizable to Iran. Therefore, this study was conducted to determine the predictors of functional status in Iranian older adults with multiple chronic conditions. METHODS In this cross-sectional study, 118 Iranian older adults with multiple chronic conditions were recruited from December 2022 to September 2023. They were invited to respond to questionnaires inquiring about their demographic and health information, basic activities of daily living (BADL) and instrumental activities of daily living (IADL), depression and cognitive status. The predictors included age, gender, marital status, education, number of chronic conditions, and depression. Descriptive and analytical statistical tests (univariate and multiple regression analysis) were used to analyze the data. RESULTS The majority of participants were married (63.9%) and women (59.3%). Based on the results of the multiple regression analysis, age (B=-0.04, P = 0.04), depression (B=-0.12, P = 0.04), and IADL (B = 0.46, P < 0.001) were significant predictors for functional status in terms of BADL. Also, marital status (B=-0.51, P = 0.05), numbers of chronic conditions (B=-0.61, P = 0.002), and BADL (B = 0.46, P < 0.001) were significant predictors for functional status in terms of IADL. CONCLUSION The findings support the predictive ability of age, marital status, number of chronic diseases, and depression for the functional status. Older adults with multiple chronic conditions who are older, single, depressed and with more chronic conditions number are more likely to have limitations in functional status. Therefore, nurses and other health care providers can benefit from the results of this study and identify and pay more attention to the high risk older adult population.
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Affiliation(s)
- Azar Jafari-Koulaee
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Eesa Mohammadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Mary T Fox
- School of Nursing, Faculty of Health, York University Centre for Aging Research and Education, York University, Toronto, Ontario, Canada
| | - Aliakbar Rasekhi
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ozra Akha
- Department of Endocrinology, Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Mobasseri K, Matlabi H, Allahverdipour H, Kousha A. Home-based supportive and health care services based on functional ability in older adults in Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:124. [PMID: 38784273 PMCID: PMC11114482 DOI: 10.4103/jehp.jehp_422_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/22/2023] [Indexed: 05/25/2024]
Abstract
BACKGROUND Home-based care is affordable due to population aging, increased chronic disease, and higher hospitalization costs. The objective was to evaluate home-based supportive and health care services provided to older adults and identify possible associations between activities of daily living (ADLs), instrumental ADL (IADLs) classifications, sociodemographic variables, clinical characteristics, and perceived social support among older adults. MATERIALS AND METHODS In this cross-sectional study, 700 people aged 60 years and older were selected by stratified cluster sampling. Areas of Tabriz City were selected as clusters, and 55 comprehensive urban health centers were selected as stratifies. Chi-square, Pearson's and Spearman's tests, and multiple linear regression were used for statistical analyses. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS 24.0, SPSS Inc., Chicago, USA). The study instrument included demographic characteristics of older adults and caregivers, health services provided at home, and two valid questionnaires, including the KATZ index of independence in (instrumental) activities of daily living and a multidimensional scale of perceived social support. Scores on scales and demographic variables were collected during telephone interviews. The study lasted from April 25, 2022, to October 30, 2022. RESULTS A high level of perceived social support was 56.6%. The study found that 51.3% of participants had family caregivers. Most participants had ADL independence (85.4%), while 22.9% and 24.3% were dependent and needed assistance with IADL, respectively. Women had a lower ADL score and a higher IADL score than men (P < 0.05). The obtained results of multiple regression analysis revealed a negative and significant association between unemployment, illiteracy, increasing age, five and more medications, and ADL and IADL dependency (P < 0.05). CONCLUSION Empowering older adults to reduce dependency, and designing a formal home-based care system is recommended.
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Affiliation(s)
- Khorshid Mobasseri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Geriatric Health, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Matlabi
- Department of Geriatric Health, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Department of Health Education and Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Kousha
- Department of Health Education and Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Han EJ, Han ZA, Kim H, Jung TR. Monitoring healthy ageing for the next decade: South Korea's perspective. Age Ageing 2023; 52:iv10-iv12. [PMID: 37902513 PMCID: PMC10615044 DOI: 10.1093/ageing/afad102] [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: 03/25/2023] [Indexed: 10/31/2023] Open
Abstract
South Korea is the fastest ageing country among OECD countries. Unlike the older generation growing up in the aftermath of the Korean war, the first and second baby boomer generations have heightened expectations regarding public services. In addition to the demand in higher quality of both social and health services by these newer older population, there is a concomitant increased quantitative demand. It is imperative that Korea reimagines their health, social welfare and economic policies to reflect the rapidly changing needs of such generations. One way to do this is to mainstream and continually monitor healthy ageing in all aspects of future policies. In 2021, the Korean Longitudinal Healthy Aging Study was launched in this context, to better understand the needs of the new-older age generation and to produce evidence to support formulation of better tailored policies that could promote healthy ageing. However, Korea is only in its early stage in developing a monitoring system that looks into the performance level of policies that support healthy ageing. As a country that is preparing for such rapid demographic transition and has already commenced developing its healthy ageing indicators, it will be important to assess and monitor uniformly the level of healthy ageing from the framework perspective of WHO. Korea welcomes WHO's development of an internationally applicable M&E framework for healthy ageing. We hope that WHO's M&E framework on healthy ageing will help Korea align to the international standards in its journey through the UN Decade of Healthy Ageing 2021-2030 and beyond.
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Affiliation(s)
- Eun-Jeong Han
- Health Insurance Research Institute, National Health Insurance Service, Wonju 26465, Republic of Korea
| | - Zee-A Han
- Department of Rehabilitation Medicine, Uijeongbu Eulji Medical Center, College of Medicine, Eulji University, Uijeongbu 11759, Republic of Korea
| | - Hansuk Kim
- Division of Disease Control Policy, Ministry of Health and Welfare, Sejong 30133, Republic of Korea
| | - Tong Ryoung Jung
- Division of Public Health Emergency Management, Korea Disease Control and Prevention Agency, Cheongju 28159, Republic of Korea
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Zhang N, Wang C, Li Y, Chen F, Yan P. Hypothetical interventions on risk factors for depression among middle-aged and older community-dwellers in China: An application of the parametric g-formula in a longitudinal study. J Affect Disord 2023; 327:355-361. [PMID: 36754095 DOI: 10.1016/j.jad.2023.01.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND Sleep disturbances, frailty, and body pain are widespread in middle-aged and older adults with depression, and have been identified as depression risk factors. However, there is a scarcity of research on the benefits of sleep improvement, frailty amelioration, and pain management on incident depression. METHODS A total of 8895 respondents aged above 45 years were derived from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2018. The parametric g-formula was used to estimate the 7-year risks of depression under independent hypothetical interventions on nighttime sleep duration (NSD), daytime napping duration (DND), perceived sleep quality (PSQ), frailty, and pain, as well as their various combinations. RESULTS The observed depression risk was 41.77 %. The independent intervention on frailty was the most effective in lowering incident depression, with a risk ratio (RR) of 0.61 (95 % CI: 0.57-0.64), followed by PSQ (RR: 0.75, 95 % CI: 0.73-0.78), pain (RR: 0.90, 95 % CI: 0.87-0.91), and NSD (RR: 0.96, 95 % CI: 0.93-0.98). In subgroup analysis, intervention on NSD was more effective in men, PSQ was more effective in middle-aged individuals, and frailty and pain were more effective in older persons. The combined intervention of NSD, PSQ, frailty, and pain lowered the risk the greatest (RR: 0.35, 95 % CI: 0.32-0.37). LIMITATIONS Generalizing our results to other populations should be possible if they have the same distribution of effect modifiers and interference patterns because of the calculation principle of the parametric g-formula. CONCLUSIONS Interventions for sleep disturbances, frailty, and body pain can minimize the risk of depression.
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Affiliation(s)
- Nan Zhang
- School of Nursing, Xinjiang Medical University, Urumqi, China
| | - Cui Wang
- School of Nursing, Peking University, Beijing, China
| | - Yuli Li
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Fenghui Chen
- School of Nursing, Xinjiang Medical University, Urumqi, China
| | - Ping Yan
- School of Nursing, Xinjiang Medical University, Urumqi, China.
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Sun T, Li Y, Xiao Z, Ding Y, Wang X. Semiparametric copula method for semi-competing risks data subject to interval censoring and left truncation: Application to disability in elderly. Stat Methods Med Res 2023; 32:656-670. [PMID: 36735020 PMCID: PMC11070129 DOI: 10.1177/09622802221133552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We aim to evaluate the marginal effects of covariates on time-to-disability in the elderly under the semi-competing risks framework, as death dependently censors disability, not vice versa. It becomes particularly challenging when time-to-disability is subject to interval censoring due to intermittent assessments. A left truncation issue arises when the age time scale is applied. We develop a flexible two-parameter copula-based semiparametric transformation model for semi-competing risks data subject to interval censoring and left truncation. The two-parameter copula quantifies both upper and lower tail dependence between two margins. The semiparametric transformation models incorporate proportional hazards and proportional odds models in both margins. We propose a two-step sieve maximum likelihood estimation procedure and study the sieve estimators' asymptotic properties. Simulations show that the proposed method corrects biases in the marginal method. We demonstrate the proposed method in a large-scale Chinese Longitudinal Healthy Longevity Study and provide new insights into preventing disability in the elderly. The proposed method could be applied to the general semi-competing risks data with intermittently assessed disease status.
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Affiliation(s)
- Tao Sun
- Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China
| | - Yunlong Li
- Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China
| | - Zhengyan Xiao
- Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China
| | - Ying Ding
- Department of Biostatistics, University of Pittsburgh, PA, USA
| | - Xiaojun Wang
- Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China
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Rodriguez MA, Chou LN, Sodhi JK, Markides KS, Ottenbacher KJ, Snih SA. Arthritis, physical function, and disability among older Mexican Americans over 23 years of follow-up. ETHNICITY & HEALTH 2022; 27:1915-1931. [PMID: 34802363 PMCID: PMC9124228 DOI: 10.1080/13557858.2021.2002271] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/29/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Arthritis is a common chronic condition in the ageing population. Its impact on physical function varies according to sociodemographic and race/ethnic factors. The study objective was to examine the impact of arthritis on physical function and disability among non-disabled older Mexican Americans over time. DESIGN A 23-year prospective cohort study of 2230 Mexican Americans aged 65 years and older from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1993/94-2016). The independent variable was self-reported physician-diagnosed arthritis, and the outcomes included Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), mobility, Short Physical Performance Battery (SPPB), and handgrip strength. Covariates were sociodemographic, medical conditions, body mass index, depressive symptoms, and cognitive function. General linear mixed models were performed to estimate the change in SPPB and muscle strength. General Equation Estimation models estimated the odds ratios (OR) of becoming ADL- or IADL- or mobility - disabled as a function of arthritis. All variables were used as time-varying except for sex, education, and nativity. RESULTS Overall, participants with arthritis had higher odds ratio (OR) of any ADL [OR = 1.35, 95% Confidence Interval (CI) = 1.09-1.68] and mobility (OR = 1.34, 95% CI = 1.18-1.52) disability over time than those without arthritis, after controlling for all covariates. Women, but not men, reporting arthritis had increased risk for ADL and mobility disability. The total SPPB score declined 0.18 points per year among those with arthritis than those without arthritis, after controlling for all covariates (p-value < .010). CONCLUSIONS Our study demonstrates the independent effect of arthritis in increasing ADL and mobility disability and decreased physical function in older Mexican Americans over 23-years of follow-up.
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Affiliation(s)
| | - Lin-Na Chou
- Preventive Medicine and Population Health. The University of Texas Medical Branch, Galveston TX
| | - Jaspreet K. Sodhi
- Department of Nutrition, Metabolism, and Rehabilitation Sciences/School of Health Professions. The University of Texas Medical Branch, Galveston TX
| | - Kyriakos S. Markides
- Preventive Medicine and Population Health. The University of Texas Medical Branch, Galveston TX
| | - Kenneth J. Ottenbacher
- Department of Nutrition, Metabolism, and Rehabilitation Sciences/School of Health Professions. The University of Texas Medical Branch, Galveston TX
| | - Soham Al Snih
- Sealy Center of Aging. The University of Texas Medical Branch, Galveston TX
- Department of Nutrition, Metabolism, and Rehabilitation Sciences/School of Health Professions. The University of Texas Medical Branch, Galveston TX
- Division of Geriatrics-Palliative Care/Department of Internal Medicine. The University of Texas Medical Branch, Galveston TX
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Han EJ, Song MK, Lee Y. The 10-year multimorbidity trajectory and mortality risk in older people with long-term care needs. Arch Gerontol Geriatr 2022; 103:104775. [PMID: 35843024 DOI: 10.1016/j.archger.2022.104775] [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: 04/27/2022] [Revised: 06/15/2022] [Accepted: 07/07/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND This study aimed to identify trajectories of multimorbidity in older adults prior to receiving long-term care benefits and to demonstrate their value in predicting mortality. METHODS This study included 1,004,924 Korean beneficiaries who completed the National Long-Term Care Insurance (NLTCI) eligibility assessment between 2010 and 2016. Multimorbidity was defined as the coexistence of 2 or more out of 23 chronic diseases related to disability in the 10 years before transitioning to long-term care. Mortality was defined as all-cause deaths after the date of the NLTCI needs assessment. Latent class growth modeling was performed to identify groups that exhibited similar trajectory patterns over time. Sex, age, and long-term care grade were used as covariates. Cox proportional hazards models were used to analyze the mortality rates by trajectories. RESULTS Three patterns emerged in the multimorbidity trajectory in the 10 years prior to entering the long-term care system: consistently low morbidity ("consistently low"), an abrupt increase in morbidity in less than one year ("catastrophic"), and an increment in morbidity over a longer period ("progressive"). In multiple Cox regression adjusting for covariates, the hazard ratios (95% confidence interval) of 1-year mortality for the catastrophic and progressive groups were 1.38 (1.36-1.39) and 1.43 (1.41-1.45), respectively, compared to the consistently low group. CONCLUSIONS This study identified distinct trajectories of multimorbidity in older people accessing the long-term care system and demonstrated their prognostic value for the survival of those with long-term care needs. Treatment and management strategies targeting individuals with a high-risk trajectory are warranted.
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Affiliation(s)
- Eun-Jeong Han
- Health Insurance Policy Research Institute, National Health Insurance Service, Wonju, South Korea
| | - Mi Kyung Song
- Health Insurance Policy Research Institute, National Health Insurance Service, Wonju, South Korea
| | - Yunhwan Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, 164 World cup-ro, Youngtong-gu, Suwon 16499, South Korea..
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Yuan J, Wang Y, Liu Z. Chronic disease and depression among the elderly in China: the mediating role of instrumental activities of daily living and the moderating role of area of residence. CURRENT PSYCHOLOGY 2022; 42:1-8. [PMID: 36258891 PMCID: PMC9561327 DOI: 10.1007/s12144-022-03782-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 09/08/2022] [Accepted: 09/15/2022] [Indexed: 12/02/2022]
Abstract
Chronic diseases are associated with depressive symptoms in older adults. However, the mechanism of this relation is not clear. In this study, we explored the mediating role of instrumental activities of daily living and the moderating role of area of residence in the relationship between chronic diseases and depression. The data was from the Chinese Longitudinal Healthy Longevity Study. Results showed that chronic diseases were positively correlated with depression, and negatively associated with instrumental activities of daily living (IADLs). Moreover, IADLs mediated the relationship between chronic diseases and depression. In addition, area of residence (rural/urban) moderated the relation between IADLs and depression, such that this negative relation was stronger for old adults lived in rural area than for urban area. These results have important significance for prevention and intervention of depression in the elderly.
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Affiliation(s)
- Jing Yuan
- School of Nursing, Hebei University, Baoding, Hebei China
| | - Yan Wang
- School of Nursing, Hebei University, Baoding, Hebei China
| | - Zejun Liu
- Department of Psychology, Educational College, Shanghai Normal University, Shanghai, China
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12
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Schneider P, Love-Koh J, McNamara S, Doran T, Gutacker N. Socioeconomic inequalities in HRQoL in England: an age-sex stratified analysis. Health Qual Life Outcomes 2022; 20:121. [PMID: 35918765 PMCID: PMC9347153 DOI: 10.1186/s12955-022-02024-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/20/2022] [Indexed: 11/19/2022] Open
Abstract
Background Socioeconomic status is a key predictor of lifetime health: poorer people can expect to live shorter lives with lower average health-related quality-of-life (HRQoL) than richer people. In this study, we aimed to improve understanding of the socioeconomic gradient in HRQoL by exploring how inequalities in different dimensions of HRQoL differ by age. Methods Data were derived from the Health Survey for England for 2017 and 2018 (14,412 participants). HRQoL was measured using the EQ-5D-5L instrument. We estimated mean EQ-5D utility scores and reported problems on five HRQoL dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) for ages 16 to 90+ and stratified by neighbourhood deprivation quintiles. Relative and absolute measures of inequality were assessed. Results Mean EQ-5D utility scores declined with age and followed a socioeconomic gradient, with the lowest scores in the most deprived areas. Gaps between the most and least deprived quintiles emerged around the age of 35, reached their greatest extent at age 60 to 64 (relative HRQoL of most deprived compared to least deprived quintile: females = 0.77 (95% CI: 0.68–0.85); males = 0.78 (95% CI: 0.69–0.87)) before closing again in older age groups. Gaps were apparent for all five EQ-5D dimensions but were greatest for mobility and self-care. Conclusion There are stark socioeconomic inequalities in all dimensions of HRQoL in England. These inequalities start to develop from early adulthood and increase with age but reduce again around retirement age. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-022-02024-7.
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Affiliation(s)
- Paul Schneider
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - James Love-Koh
- Centre for Health Economics, University of York, York, UK
| | - Simon McNamara
- School of Health and Related Research, University of Sheffield, Sheffield, UK.,Lumanity, Sheffield, UK
| | - Tim Doran
- Department of Health Sciences, University of York, York, UK
| | - Nils Gutacker
- Centre for Health Economics, University of York, York, UK.
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Tran Ngoc Hoang P, Kadota A, Yuichiro Y, Akiko H, Takehito H, Shohei O, Miyagawa N, Kondo K, Nagako O, Kita Y, Okayama A, Yukihiro F, Maegawa H, Miura K, Okamura T, Ueshima H. Effect of diabetes and prediabetes on the development of disability and mortality among middle-aged adult Japanese: a 22-year follow-up of NIPPON DATA90. J Diabetes Investig 2022; 13:1897-1904. [PMID: 35717665 PMCID: PMC9623524 DOI: 10.1111/jdi.13871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/27/2022] [Accepted: 06/15/2022] [Indexed: 11/29/2022] Open
Abstract
Aims/Introduction To examine the association between diabetes and prediabetes at baseline, and disability, mortality over a 22‐year period among middle‐aged Japanese adults. Materials and Methods Participants consisted of 1,788 adults aged 45–64 years at baseline from the cohort study National Integrated Project for Prospective Observation of Non‐communicable Disease and its Trends in the Aged 1990 (NIPPON DATA90). Disability, defined as having a decline in activities of daily living (ADL), was assessed by a modified Katz questionnaire at four time points. Disability and death without disability for 22‐year follow up were used as outcomes to test the association with a diagnosis of diabetes or prediabetes at baseline, using multinomial logistic regression. Adjusted odds ratios (ORs) were obtained from four models that contained appropriate adjustment factors, such as age, sex, smoking status, drinking status, body mass index and cardiovascular risk factors (hypertension, hypercholesterolemia, triglycerides, low serum high‐density lipoprotein), at baseline. Results In the present study, 334 participants (18.7%) reported at least one disability, and 350 (19.6%) were reported dead without observation of disability during follow up. Adjusting sex and other risk factors, participants with diabetes and prediabetes had a higher risk for disability (OR 1.43, 95% confidence interval [CI] 1.07–1.91 and OR 1.66, 95% CI 1.10–2.50, respectively) and for mortality (OR 1.56, 95% CI 1.16–2.08 and OR 1.77, 95% CI 1.18–2.65, respectively) than individuals with normal glucose tolerance. Conclusions In middle‐aged Japanese adults, individuals with diabetes and prediabetes were more likely to be associated with disability and mortality. Our findings suggest that prediabetes and diabetes in middle‐aged adults should be paid more attention, and requires more intervention to prevent disability and mortality in later life.
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Affiliation(s)
- Phap Tran Ngoc Hoang
- Department of Medicine, Shiga University of Medical science.,Non-communicable diseases (NCD) Epidemiology Research Center, Shiga University of Medical science
| | - Aya Kadota
- Non-communicable diseases (NCD) Epidemiology Research Center, Shiga University of Medical science.,NCD Epidemiology Research Center, Shiga University of Medical science, Seta Tsukinowa-cho, Otsu, Shiga, 521-0092, Japan
| | - Yano Yuichiro
- Non-communicable diseases (NCD) Epidemiology Research Center, Shiga University of Medical science
| | - Harada Akiko
- Non-communicable diseases (NCD) Epidemiology Research Center, Shiga University of Medical science
| | - Hayakawa Takehito
- Research Center for Social Studies of Health and Community, Ritsumeikan University
| | - Okamoto Shohei
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Naoko Miyagawa
- Department of Public health, Shiga University of Medical science
| | - Keiko Kondo
- Non-communicable diseases (NCD) Epidemiology Research Center, Shiga University of Medical science
| | | | | | | | | | | | - Katsuyuki Miura
- Non-communicable diseases (NCD) Epidemiology Research Center, Shiga University of Medical science
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine
| | - Hirotsugu Ueshima
- Non-communicable diseases (NCD) Epidemiology Research Center, Shiga University of Medical science
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14
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Kontto J, Paalanen L, Sund R, Sainio P, Koskinen S, Demakakos P, Tolonen H, Härkänen T. Using multiple imputation and intervention-based scenarios to project the mobility of older adults. BMC Geriatr 2022; 22:311. [PMID: 35397525 PMCID: PMC8994920 DOI: 10.1186/s12877-022-03008-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 03/30/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Projections of the development of mobility limitations of older adults are needed for evidence-based policy making. The aim of this study was to generate projections of mobility limitations among older people in the United States, England, and Finland.
Methods
We applied multiple imputation modelling with bootstrapping to generate projections of stair climbing and walking limitations until 2026. A physical activity intervention producing a beneficial effect on self-reported activities of daily living measures was identified in a comprehensive literature search and incorporated in the scenarios used in the projections. We utilised the harmonised longitudinal survey data from the Ageing Trajectories of Health – Longitudinal Opportunities and Synergies (ATHLOS) project (N = 24,982).
Results
Based on the scenarios from 2012 to 2026, the prevalence of walking limitations will decrease from 9.4 to 6.4%. A physical activity intervention would decrease the prevalence of stair climbing limitations compared with no intervention from 28.9 to 18.9% between 2012 and 2026.
Conclusions
A physical activity intervention implemented on older population seems to have a positive effect on maintaining mobility in the future. Our method provides an interesting option for generating projections by incorporating intervention-based scenarios.
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15
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Lu Y, Matsuyama S, Sugawara Y, Sone T, Tsuji I. Dairy intake and incident functional disability among older Japanese adults: the Ohsaki Cohort 2006 Study. Eur J Nutr 2022; 61:2627-2637. [PMID: 35246747 DOI: 10.1007/s00394-022-02843-w] [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: 08/25/2021] [Accepted: 02/16/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Previous studies have investigated the association between dairy intake and functional disability, but their results were inconsistent. Our study aimed to investigate whether dairy intake may protect against incident functional disability among Japanese older adults. METHODS We conducted a longitudinal analysis of dairy intake with incident functional disability in a prospective cohort study of 11,911 Japanese individuals aged ≥ 65 years who were followed up for 8.2 years on average. Data on milk, yogurt, and cheese intake were collected using a validated food frequency questionnaire. Total dairy intake was the sum of the daily intake of milk, yogurt, and cheese, which was sex-specifically categorized in quintiles. Data on functional disability were retrieved from the public Long-term Care Insurance database. The Cox proportional hazards model was used to estimate the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (95%CIs) for incident functional disability. RESULTS During 97,234 person-years of follow-up, 4874 persons (40.9%) were ascertained as having functional disability. Our study suggested a null association between total dairy intake and incident risk of functional disability; compared to Q1 (the lowest quintile) group, the multivariable-adjusted HRs (95%CIs) were 0.96 (0.88-1.05) for Q2, 0.93 (0.85-1.02) for Q3, 0.93 (0.85-1.02) for Q4, and 1.01 (0.92-1.10) for Q5 (p-trend = 0.840). We did not find any associations between milk, yogurt, or cheese intake and incident risk of functional disability. CONCLUSION We found no evidence showing that dairy intake was associated with functional disability among Japanese older adults.
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Affiliation(s)
- Yukai Lu
- Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Sanae Matsuyama
- Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Yumi Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Toshimasa Sone
- Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
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16
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Raina P, Ali MU, Joshi D, Gilsing A, Mayhew A, Thompson M, Griffith LE. Associations of functional disability and behavioural risk factors with social participation of older adults: a cross-sectional analysis from the Canadian Longitudinal Study on Aging. BMJ Open 2022; 12:e052173. [PMID: 35045997 PMCID: PMC8772424 DOI: 10.1136/bmjopen-2021-052173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To examine: (1) the associations of functional disability and behavioural risk factors with social participation; and (2) whether the association between functional disability and social participation is modified by co-occurrence of behavioural risk factors. DESIGN A cross-sectional analysis of data from the Canadian Longitudinal Study on Aging. SETTING A national stratified sample of 51 388 individuals living in the 10 Canadian provinces at the time of baseline data collection (2011-2015). PARTICIPANTS Participants included men and women aged 45-85 years and residing in the communities in the 10 Canadian provinces. OUTCOME MEASURES Social participation was assessed using frequency of participant involvement in eight different social activities in the past 12 months. Responses for each category were converted into number of days per month. Total social participation score (range: 0-180) was based on summing frequencies over all eight activities representing number of social activities per month. RESULTS Functional disability was associated with participating in fewer social activities (difference in mean total social participation score, b=-1.1, 95% CI -1.5 to -0.7). In comparison to no behavioural risk factors, presence of any one (b=-2.7, 95% CI -3.1 to -2.3), any two (b=-4.6, 95% CI -5.0 to -4.2), any three (b=-6.3, 95% CI -6.8 to -5.9) and all four (b=-7.8, 95% CI -9.0 to -6.6) behavioural risk factors was associated with lower social participation. The association between functional disability and social participation was modified by the presence of behavioural risk factors with the lowest social participation observed for adults with disability and all four behavioural risk factors (b=-4.3, 95% CI -7.5 to -1.2). CONCLUSIONS Individuals with functional disabilities and behavioural risk factors are more likely to experience restrictions in social participation. Public health interventions that encourage healthy lifestyle behaviours may help mitigate the impact of functional disabilities on social participation in the ageing population.
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Affiliation(s)
- Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Muhammad Usman Ali
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Divya Joshi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Anne Gilsing
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Alexandra Mayhew
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Mary Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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17
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Hu Y, Zhou F, Kaminga AC, Yan S, Hu Z. Associations of depressive symptoms and chronic diseases with activities of daily living among middle-aged and older population in China: A population-based cohort study. Front Psychiatry 2022; 13:848255. [PMID: 36003971 PMCID: PMC9393545 DOI: 10.3389/fpsyt.2022.848255] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Activities of daily living (ADL) disability is a concern in the aging population and can lead to increased health service demands and lower quality of life. The aim of this longitudinal study was to assess the associations of chronic conditions and depressive symptoms with ADL disability. METHODS This prospective cohort study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study (CHARLS). A total of 10,864 participants aged 45 and older were included for analysis. Chronic diseases were assessed by self-report and depressive symptoms were assessed using the validated 10-item of Center for Epidemiologic Studies Depression Scale at baseline. Incidents of ADL disability during follow-up were assessed using the Katz ADL scales. RESULTS After 4 years of follow-up, there were 704 participants incidents of ADL disability. The incident rate was 17.22 per 1,000 person-years. Having at least one chronic disease was independently associated with a 39% increased risk of incident ADL disability (adjusted HR, 1.39; 95%CI: 1.16, 1.67). The presence of depression symptoms was independently associated with a 54% increased risk of incident ADL disability (adjusted HR, 1.54; 95%CI: 1.30, 1.82). However, there was no significant additive interaction effect between chronic diseases and depressive symptoms on ADL disability. CONCLUSION Chronic diseases and depressive symptoms are associated with an increased risk of ADL disability in middle-aged and older Chinese adults. Improving chronic diseases and depressive symptoms can prevent ADL disability.
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Affiliation(s)
- Yingyun Hu
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Feixiang Zhou
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Atipatsa Chiwanda Kaminga
- Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi.,Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shipeng Yan
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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18
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Li A, Wang D, Lin S, Chu M, Huang S, Lee CY, Chiang YC. Depression and Life Satisfaction Among Middle-Aged and Older Adults: Mediation Effect of Functional Disability. Front Psychol 2021; 12:755220. [PMID: 34899497 PMCID: PMC8656258 DOI: 10.3389/fpsyg.2021.755220] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 10/25/2021] [Indexed: 12/29/2022] Open
Abstract
With increasing age, middle-aged and older persons face a series of physical and mental health problems. This study aimed to explore the latent relationships among age, functional disability, depression, and life satisfaction. The data were obtained from the Wave 2 (in 2013–2014) and Wave 3 (in 2015–2016) surveys of the China Health and Retirement Longitudinal Study. The analytic sample in the present study included 15,950 individuals aged 45 years and over. The participants answered the same questions concerning depression and life satisfaction in both study waves, and functional disability was measured based on the activities of daily living and instrumental activities of daily living. Age was directly associated with functional disability, life satisfaction, and depression. Functional disability was positively correlated with depression and negatively correlated with life satisfaction. Functional disability strongly mediated the relationships among age, depression, and life satisfaction. Depression and life satisfaction were found to have enduring effects and effects on each other. Additionally, the model revealed a gender difference. Depression in middle-aged people should receive closer attention. Avoiding or improving functional disability may be an effective way to improve life satisfaction and reduce the level of depression in middle-aged and older persons. If prevention work successfully decreases depression, the life dissatisfaction of middle-aged and older people could be improved. Additionally, for the prevention of functional disability and depression and improvement in life satisfaction, gender differences need to be considered.
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Affiliation(s)
- An Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Dewen Wang
- School of Public Affairs, Xiamen University, Xiamen, China
| | - Shengnan Lin
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Meijie Chu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Shiling Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Chun-Yang Lee
- School of International Business, Xiamen University Tan Kah Kee College, Zhangzhou, China
| | - Yi-Chen Chiang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
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19
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Qiao Y, Liu S, Li G, Lu Y, Wu Y, Shen Y, Ke C. Longitudinal Follow-Up Studies on the Bidirectional Association between ADL/IADL Disability and Multimorbidity: Results from Two National Sample Cohorts of Middle-Aged and Elderly Adults. Gerontology 2021; 67:563-571. [PMID: 34182559 DOI: 10.1159/000513930] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/20/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Few studies have investigated the bidirectional relationship between disability and multimorbidity, which are common conditions among the older population. Based on the data from the China Health and Retirement Longitudinal Study (CHARLS) and the Survey of Health, Ageing and Retirement in Europe (SHARE), we aimed to investigate the bidirectional relationship between disability and multimorbidity. METHODS The activities of daily living (ADLs) and the instrumental activities of daily living (IADLs) scales were used to measure disability. In stage I, we used multinomial logistic regression to assess the longitudinal association between ADL/IADL disability and follow-up multimorbidity. In stage II, binary logistic regression was used to evaluate the multimorbidity effect on future disability. RESULTS Compared with those free of disability, people with disability possessed ascending risks for developing an increasing number of diseases. For ADL disability, the odds ratio (OR) (95% confidence interval [CI]) values of developing ≥4 diseases were 4.10 (2.58, 6.51) and 6.59 (4.54, 9.56) in CHARLS and SHARE; for IADL disability, the OR (95% CI) values were 2.55 (1.69, 3.84) and 4.85 (3.51, 6.70) in CHARLS and SHARE. Meanwhile, the number of diseases at baseline was associated, in a dose-response manner, with future disability. Compared with those without chronic diseases, participants carrying ≥4 diseases had OR (95% CI) values of 4.82 (3.73, 6.21)/4.66 (3.65, 5.95) in CHARLS and 3.19 (2.59, 3.94)/3.28 (2.71, 3.98) in SHARE for developing ADL/IADL disability. CONCLUSION The consistent findings across 2 national longitudinal studies supported a strong bidirectional association between disability and multimorbidity among middle-aged and elderly adults. Thus, tailored interventions should be taken to prevent the mutual development of disability and multimorbidity.
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Affiliation(s)
- Yanan Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Siyuan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Guochen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yanqiang Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Ying Wu
- Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yueping Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
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20
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Liu CJ, Chang PS, Griffith CF, Hanley SI, Lu Y. The Nexus of Sensory Loss, Cognitive Impairment, and Functional Decline in Older Adults: A Scoping Review. THE GERONTOLOGIST 2021; 62:e457-e467. [PMID: 34131697 DOI: 10.1093/geront/gnab082] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The prevalence of cognitive impairment and sensory loss in hearing or vision increases with age. Based on the Information Processing Model, cognitive impairment coupled with sensory loss may exacerbate disability in late life. Yet this issue has not been systematically studied. The purpose of this scoping review was to examine the literature that studied the relationship between cognitive impairment, sensory loss, and activities of daily living in older adults. RESEARCH DESIGN AND METHODS Two reviewers independently screened 1,410 studies identified from five electronic databases (Medline, EMBASE, PsycINFO, CINHAL, and the Web of Science). The search was completed in June 2020. A study was eligible if it included measurements of cognitive function, vision or hearing, and activities of daily living. Additionally, the data analyses must address how cognitive impairment and sensory loss are related to the performance of activities of daily living. RESULTS The final review included 15 studies. Findings show an additive effect of cognitive impairment and sensory loss on the activities of daily living. Cognitive impairment or vision loss independently relates to the decline in activities of daily living. Hearing loss relates to the decline only when the loss is severe, or if the daily task is hearing specific. DISCUSSION AND IMPLICATIONS Older adults with coexisting sensory loss and cognitive impairment have the highest risk or prevalence of disability, comparing to cognitive impairment or sensory loss alone. This finding highlights the importance of developing interventions to reduce the risk of disability for older adults experiencing multiple impairments.
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Affiliation(s)
- Chiung-Ju Liu
- Department of Occupational Therapy, University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA
| | - Pei-Shiun Chang
- Department of Community and Health Systems, Indiana University School of Nursing, Bloomington, Indiana, USA
| | - Cheryl F Griffith
- Academic Affairs, Office of Clinical Education, Indiana University Health, Indianapolis, Indiana, USA
| | - Stephanie I Hanley
- Department of Occupational Therapy, University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA
| | - Yvonne Lu
- Indiana University School of Nursing, Indianapolis, Indiana, USA
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21
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Cao G, Wang K, Han L, Zhang Q, Yao S, Chen Z, Huang Z, Luo Y, Hu Y, Xu B. Visual trajectories and risk of physical and cognitive impairment among older Chinese adults. J Am Geriatr Soc 2021; 69:2877-2887. [PMID: 34111310 DOI: 10.1111/jgs.17311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/11/2021] [Accepted: 05/20/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND/OBJECTIVES To identify visual trajectories and examine their relationships with physical and cognitive function in older Chinese adults. DESIGN Population-based longitudinal study. SETTING The Chinese Longitudinal Healthy Longevity Survey. PARTICIPANTS A total of 16,151 participants aged ≥65 years. MEASUREMENTS Visual, physical (including activities of daily living [ADL] and instrumental ADL [IADL]), and cognitive function were assessed at baseline and subsequently every 3 years. ADI disability and IADL disability were defined as needing any help in any item of the Katz scale and a modified Lawton's scale, respectively. Cognitive impairment was defined as a Chinese version of the Mini-Mental State Examination score below 24. A group-based trajectory model was used to determine visual trajectories adjusted for age, sex, and education. Associations of visual trajectories with ADL disability, IADL disability, and cognitive impairment were evaluated using generalized estimating equation models adjusted for potential confounders. RESULTS This study identified three distinct visual trajectories, including no decline (32.4%), moderate decline (48.3%), and progressive decline (19.3%) during the follow-up period. Compared with the no decline trajectory, both the moderate decline (ADL disability: OR = 2.75, 95% CI: 2.30-3.28; IADL disability: OR = 3.01, 95% CI: 2.74-3.31; cognitive impairment: OR = 3.37, 95% CI: 3.02-3.76) and the progressive decline (ADL disability: OR = 8.50, 95% CI: 6.55-11.02; IADL disability: OR = 12.96, 95% CI: 9.95-16.87; cognitive impairment: OR = 10.84, 95% CI: 8.89-13.23) trajectories were significantly associated with an increased risk of functional impairment. Compared with the moderate decline trajectory, the progressive decline trajectory was significantly associated with an increased risk of ADL disability (OR = 3.09, 95% CI: 2.46-3.89), IADL disability (OR = 4.30, 95% CI: 3.29-5.61), and cognitive impairment (OR = 3.22, 95% CI:2.63-3.93). CONCLUSION Older Chinese adults exhibit three distinct visual trajectories and those with decline trajectories in vision have an increased risk of functional impairment than those with a trajectory of no decline in vision.
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Affiliation(s)
- Guiying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Ling Han
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Qin Zhang
- Department of Ophthalmology, Peking University People's Hospital, Beijing, China.,College of Optometry, Peking University Health Science Center, Beijing, China.,Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Shanshan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Zishuo Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Ziting Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Yan Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Beibei Xu
- Medical Informatics Center, Peking University, Beijing, China
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22
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Shin DY, Hwang HS, Kim HS, Kim MS, Kim EC. Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction. BMC Ophthalmol 2021; 21:203. [PMID: 33964915 PMCID: PMC8106217 DOI: 10.1186/s12886-021-01966-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 04/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study is to analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is -3 diopter (D) in cataract patients with corneal astigmatism > 1.5 diopters (D). METHODS We performed a retrospective chart review for patients with corneal astigmatism > 1.5D who underwent cataract surgery and their target refraction is -3D. 100 eyes (100 patients; monofocal IOL, 60; toric IOL, 40) were enrolled in the current study. Near and distant uncorrected visual acuity (UCVA), corrected VA, spherical equivalent and refractive, corneal astigmatism were evaluated before and after surgery. RESULTS The near UCVA of the toric IOL group (0.26 ± 0.33) after cataract surgery was significantly better than that of the monofocal IOL group (0.48 ± 0.32) (p = 0.030). The distant UCVA of the toric IOL group (0.38 ± 0.14) was also significantly better than that of the monofocal IOL group (0.55 ± 0.22) (p = 0.026). Best-corrected visual acuity (p = 0.710) and mean spherical equivalent (p = 0.465) did not show significant differences between the toric IOL group and the monofocal IOL group. In the toric IOL group, postoperative refractive astigmatism was - 0.80 ± 0.46D and postoperative corneal astigmatism was - 1.50 ± 0.62D, whereas the corresponding values in the monofocal IOL group were - 1.65 ± 0.77D and - 1.45 ± 0.64D; residual refractive astigmatism was significantly lower with toric IOL implantation compared with monofocal IOL implantation (p = 0.001). There were no postoperative complications. CONCLUSIONS When myopic refraction such as -3D was determined as the target power in patients with corneal astigmatism, toric IOL implantation led to excellent improvement in both near and distant UCVA.
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Affiliation(s)
- Da Young Shin
- Department of Ophthalmology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho Sik Hwang
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hyun Seung Kim
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Man Soo Kim
- Department of Ophthalmology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eun Chul Kim
- Department of Ophthalmology, Bucheon St. Mary's Hospital, Catholic University of Korea, #327 Sosa-ro, 14647, Bucheon, Korea.
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23
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Lee Y, Cho CC. Examining the effects of multiple chronic conditions on cognitive decline and potential moderators among older Koreans: Findings from the Korean Longitudinal Study of Ageing 2006-2016. Arch Gerontol Geriatr 2021; 95:104424. [PMID: 34038816 DOI: 10.1016/j.archger.2021.104424] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/04/2021] [Accepted: 04/18/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND More than half of older Koreans have two or more chronic conditions, known as multiple chronic conditions (MCC). Successful self-management (e.g., diet control, exercise, taking medications) is critical to prevent worsening of condition or acquisition of additional chronic conditions. This study investigated the effects of MCC on cognitive decline and risk factors in each chronic condition group over a 10-year period. METHODS Six waves (2006-2016) of the Korean Longitudinal Study of Ageing were used, featuring 2,198 older adults who were cognitively healthy at baseline. MCC were categorized into three groups: no chronic condition (n=831), one chronic condition (n=813), and two or more chronic conditions (n=554). Linear mixed-effects model analyses were conducted using SAS 9.4. RESULTS Individuals with MCC showed greater cognitive decline than those with no or one chronic condition. Different factors were associated with cognition in each group. Among those with no chronic condition, age, income, education, and functional limitation were associated with cognitive decline. Among those with one chronic condition, age, marital status, working status, self-rated health, and arthritis were associated with cognitive decline. Among those with two or more chronic conditions, age, income, marital status, and living arrangement were associated with cognitive decline. Listed factors have p-values less than .05. CONCLUSIONS Findings indicate MCC is significantly related with cognitive decline. Risk factors for cognitive decline differed across three chronic condition groups. Self-management programs that target each group can be a promising strategy to mitigate cognitive decline among older Koreans.
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Affiliation(s)
- Yura Lee
- Department of Social Work, Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, WI.
| | - Chi C Cho
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI.
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24
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Iseli RK, Duncan G, Lee EK, Lewis E, Maier AB. Incorporating foot assessment in the comprehensive geriatric assessment. BMC Geriatr 2021; 21:223. [PMID: 33794805 PMCID: PMC8015740 DOI: 10.1186/s12877-021-02164-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/18/2021] [Indexed: 12/16/2022] Open
Abstract
Background Foot problems are common in older adults and associated with poorer physical function, falls, frailty and reduced quality of life. Comprehensive Geriatric Assessment (CGA), a multidisciplinary process that is considered the gold standard of care for older adults, does not routinely include podiatry assessment and intervention in hospitalized older adults. Aims To introduce foot assessment to inpatient CGA to determine prevalence of foot disease, foot disease risk factors and inappropriate footwear use, assess inter-rater reliability of foot assessments, determine current podiatry input and examine associations between patient characteristics and foot disease risks. Methods Prospective, observational cohort study of older adults on geriatric rehabilitation wards. Foot assessment completed using the Queensland Foot Disease Form (QFDF) in addition to routine CGA. Results Fifty-two patients (median age [inter-quartile range] 86.4 [79.2–90.3] years, 54% female) were included. Six patients (12%) had foot disease and 13 (25%) had a ‘high risk’ or ‘at risk’ foot. Foot disease risk factor prevalence was peripheral arterial disease 9 (17%); neuropathy 10 (19%) and foot deformity 11 (22%). Forty-one patients (85%) wore inappropriate footwear. Inter-rater agreement was substantial on presence of foot disease and arterial disease, fair to moderate on foot deformity and fair on neuropathy and inappropriate footwear. Eight patients (15%) saw a podiatrist during admission: 5 with foot disease, 1 ‘at risk’ and 2 ‘low risk’ for foot disease. Patients with an at risk foot or foot disease had significantly longer median length of hospital stay (25 [13.7–32.1] vs 15.2 [8–22.1] days, p = 0.01) and higher median Malnutrition Screening Test scores (2 [0–3] vs 0 [0–2], p = 0.03) than the low-risk group. Patients with foot disease were most likely to see a podiatrist (p < 0.001). Conclusion Foot disease, foot disease risk factors and inappropriate footwear are common in hospitalized older adults, however podiatry assessment and intervention is mostly limited to patients with foot disease. Addition of routine podiatry assessment to the multidisciplinary CGA team should be considered. Examination for arterial disease and risk of malnutrition may be useful to identify at risk patients for podiatry review. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02164-3.
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Affiliation(s)
- Rebecca K Iseli
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia. .,Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia.
| | - Gregory Duncan
- Eastern Health Clinical School, Monash University
- , Box Hill, Victoria, Australia
| | - Elton K Lee
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ellen Lewis
- Podiatry Department, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia.,Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore, Singapore
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25
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Menz HB, Harrison C, Bayram C. Characteristics of general practitioner referrals to podiatrists in Australia, 2000-2016. Public Health 2021; 193:10-16. [PMID: 33677392 DOI: 10.1016/j.puhe.2021.01.015] [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] [Received: 11/03/2020] [Revised: 01/15/2021] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of the study was to describe patterns of referral to podiatrists by general practitioners (GPs) in Australia. STUDY DESIGN This is a continuous cross-sectional study of Australian general practice activity. METHODS We analysed data from the Bettering the Evaluation and Care of Health program, collected from April 2000 to March 2016 inclusive. Data were summarised using descriptive statistics with 95% confidence intervals around point estimates. Multivariate logistic regression was used to identify GP and patient characteristics independently associated with referral. RESULTS The data set included 1,568,100 encounters, including 5,912 podiatry referrals. Referrals increased from 7.0 to 39.5 per 1000 population over the evaluation period. In multivariate analyses, female GPs were more likely than male GPs to refer, and GPs aged ≥55 years were less likely to refer. Patients referred to podiatrists were more likely to be aged ≥85 years, be Indigenous, be from an English-speaking background and have previously been seen at the practice. The problem generating the highest number of referrals was diabetes. After the introduction of Medicare funding, referred patients were more likely to be women, be aged >45 years, have a healthcare card, be socio-economically disadvantaged and have previously been seen at the practice. CONCLUSIONS GP referral to podiatrists in Australia increased markedly after the introduction of Medicare funding and appears to be targeted to those with the greatest need. Further research is required to determine whether this policy has improved outcomes and is cost-effective.
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Affiliation(s)
- H B Menz
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria 3086, Australia.
| | - C Harrison
- Menzies Centre for Health Policy, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales 2006, Australia
| | - C Bayram
- Menzies Centre for Health Policy, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales 2006, Australia
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26
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Vaughan K, Terashima M, Clark K, Deturbide K. Exploring Stakeholder Perspectives on the UK’s Regulatory Tools for Accessible Housing: Lessons for Canada. JOURNAL OF AGING AND ENVIRONMENT 2021. [DOI: 10.1080/26892618.2021.1877861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Katie Vaughan
- School of Planning, Dalhousie University, Halifax, Canada
| | | | - Kate Clark
- School of Planning, Dalhousie University, Halifax, Canada
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27
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Abstract
Although employment can provide older people with both financial and nonfinancial rewards, it is questionable whether those benefits extend to all older workers, particularly those with physically demanding jobs. This study aimed to examine whether the perceived level of physical demands placed on older workers 55 or older is significantly associated with their cognitive function. Using the Health and Retirement Study (HRS) 2010 wave, we analyzed two domains of cognition: verbal episodic memory and reasoning. After controlling for demographics and risk factors for age-related cognitive deterioration, the perceived level of physical demands placed on older workers was still significantly and negatively linked with both memory and reasoning domains of cognition. Older workers with more physically demanding jobs tended to have poorer cognitive function. Further longitudinal studies are needed to confirm this relationship. Supplementary Information The online version contains supplementary material available at 10.1007/s12126-020-09404-8.
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28
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Iseli RK, Lee EK, Lewis E, Duncan G, Maier AB. Foot disease and physical function in older adults: A systematic review and meta-analysis. Australas J Ageing 2020; 40:35-47. [PMID: 33314652 DOI: 10.1111/ajag.12892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/22/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To systematically assess the literature examining the association between foot disease (foot ulceration, infection, critical ischaemia and/or Charcot neuroarthropathy) and physical function in older adults. METHODS Literature search of MEDLINE, Embase and CINAHL was performed. Studies were included if foot disease and physical function were assessed in participants of mean or median age ≥ 65 years. RESULTS Of 2,574 abstracts screened, 19 studies (13 longitudinal, 6 cross-sectional) reporting on 5634 participants, 43% female, were included. Diabetes-related foot disease and critical ischaemia were most studied (n = 5017, 40% female). In 8 studies with control groups, foot disease was associated with poorer physical function. Meta-analysis of 5 studies (n = 1503, 45% female) found an association between foot disease and poorer physical function (SMD (95% CI): 1.00 (0.40, 1.62), P < 0.001). CONCLUSION Foot disease is associated with poorer physical function in older adults. Future research should include broader study populations and intervention strategies.
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Affiliation(s)
- Rebecca K Iseli
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Vic., Australia.,Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Vic., Australia
| | - Elton K Lee
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Vic., Australia
| | - Ellen Lewis
- Podiatry Department, The Royal Melbourne Hospital, Parkville, Vic., Australia
| | - Gregory Duncan
- Eastern Health Clinical School, Monash University, Box Hill, Vic., Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Vic., Australia.,Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
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29
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Amegbor PM, Rosenberg MW. Health and socioeconomic risk factors for overnight admission among older adults in Ghana. JOURNAL OF POPULATION AGEING 2020. [DOI: 10.1007/s12062-020-09294-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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30
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Individual and population level impact of chronic conditions on functional disability in older adults. PLoS One 2020; 15:e0229160. [PMID: 32078637 PMCID: PMC7032687 DOI: 10.1371/journal.pone.0229160] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 01/30/2020] [Indexed: 11/30/2022] Open
Abstract
Background It is unknown if the relationship between multimorbidity and disability differs by combinations of chronic conditions. The objective of our study was to elucidate how joint effect of different combinations of chronic conditions impact the five year risk of functional disability at the population level. Methods Participants ≥65 years from the Canadian Study of Health and Aging were assessed for functional disability measured using activities of daily living (ADL) and instrumental ADL (IADL), and the presence of conditions in five disease domains; cardiometabolic, neurological, sensory, musculoskeletal, and respiratory. Logistic regression was used to assess the relationship between each disease domain and incident ADL and IADL measured at five years of follow up and population attributable risk (PAR) was modeled for diseases domains that were significantly associated with disability. Results were stratified by sex and age (65–74 years, ≥75 years). Results There were 6272 participants free of ADL disability and 4571 participants free from IADL disability at baseline. For incident ADL, the greatest PAR values were 21.3 (9.8–32.8) for the cardiometabolic domain in males 65–74 years, 22.7 (4.7–40.8) for the musculoskeletal domain for females aged 65–74 years, and 11.2 (2.8–19.7) for the musculoskeletal domain in males ≥75 years. The PAR for the musculoskeletal, sensory, and neurological domains were similar in females ≥75 years(9.3–9.9). PAR values were lower but followed similar patterns for IADL disability. Conclusion The chronic disease domains which most strongly predicted incident ADLs and IADLs did not account for the greatest amount of disability at the population level.
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31
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Fillenbaum GG, Sloane R, Burchett BM, Hall K, Pieper CF, Whitson HE, Colón-Emeric CS. Determinants of Maintenance and Recovery of Function in a Representative Older Community-Resident Biracial Sample. J Am Med Dir Assoc 2020; 21:1141-1147.e1. [PMID: 32037299 DOI: 10.1016/j.jamda.2019.12.021] [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: 06/21/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Focus on decline in performance of activities of daily living (ADL) has not been matched by studies of recovery of function. Advised by a broad conceptual model of physical resilience, we ascertain characteristics that identify (1) maintenance, (2) decline, and (3) recovery of personal self-maintenance activities over six years in an older, community representative, African American and white sample. DESIGN Longitudinal study, analyses included descriptive statistics and repeated measures proportional hazards. SETTING/PARTICIPANTS Community-representative participants of the Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE), unimpaired at baseline (n = 3187; 46% white, 54% African American; 64% female, 36% male), followed annually for up to 6 years. MEASURES Data included information on basic activities of daily living (BADL), demographic characteristics, health status, social services provided and received, household size, neighborhood safety, and survival status. RESULTS Over 6 years, ∼75% remained unimpaired, of whom 30% were unimpaired when they dropped out or died. Of ∼25% who became impaired, just under half recovered. Controlled analyses indicated that those who became impaired were in poorer health, younger, and more likely to be African American. Characteristics of recovery included younger age, not hospitalized in the previous year, and larger household size. CONCLUSIONS/IMPLICATIONS Maintenance of health status facilitated continued unimpaired BADL. While decline was associated with poorer health, younger age, and being African American, recovery was also associated with younger age, together with larger household size, and no further deterioration in health as measured here. Maintenance of good health is preferred, but following decline in functioning, increased effort to improve health and avoid further decline, which takes into account not only physical but also personal social conditions, is needed.
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Affiliation(s)
- Gerda G Fillenbaum
- Duke University School of Medicine, Durham, NC; Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC.
| | - Richard Sloane
- Duke University School of Medicine, Durham, NC; Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC
| | | | - Katherine Hall
- Duke University School of Medicine, Durham, NC; Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC; Geriatric Research Education and Clinical Center, Durham Veteran Affairs Health Care System, Durham, NC
| | - Carl F Pieper
- Duke University School of Medicine, Durham, NC; Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC; Geriatric Research Education and Clinical Center, Durham Veteran Affairs Health Care System, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC
| | - Heather E Whitson
- Duke University School of Medicine, Durham, NC; Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC; Geriatric Research Education and Clinical Center, Durham Veteran Affairs Health Care System, Durham, NC
| | - Cathleen S Colón-Emeric
- Duke University School of Medicine, Durham, NC; Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC; Geriatric Research Education and Clinical Center, Durham Veteran Affairs Health Care System, Durham, NC
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32
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Pieris D. Understanding Empathic and Cooperative Intergenerational Relationships: A New Theoretical Framework. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2020. [DOI: 10.1080/15350770.2020.1723775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Joe A, Dickins M, Enticott J, Ogrin R, Lowthian J. Community-Dwelling Older Women: The Association Between Living Alone and Use of a Home Nursing Service. J Am Med Dir Assoc 2020; 21:1273-1281.e2. [PMID: 31889634 DOI: 10.1016/j.jamda.2019.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/10/2019] [Accepted: 11/12/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the use of home nursing by community-dwelling older women to determine the nature of services required by those living alone. DESIGN A retrospective cohort study using routinely collected data. SETTING AND PARTICIPANTS Women aged 55 years and older living in metropolitan Melbourne who received an episode of nursing care from a large community home-based nursing service provider between January 1, 2006 and December 31, 2015. METHODS Descriptive and inferential statistical analyses were used to examine the relationship between client- and service-related factors and use of community nursing services. The primary outcome of interest was the hours of service received in a care episode. RESULTS A total of 134,396 episodes of care were analyzed, in which 51,606 (38.4%) episodes involved a woman who lived alone. The median hours of care per episode to women who lived alone was almost 70% more than that for women who lived with others. Multivariable regression identified factors influencing the amount of service use: living alone status, cognitive health status, and number of required home nursing activities. After adjusting for confounding and interactions, living alone was associated with at least 13% more hours of care than is provided to those not living alone. Compared with women who lived with others, women living alone required almost double the amount of assistance with medication management and were 30% more likely to experience a deterioration in their condition or be discharged from home nursing care into an acute hospital. From 2006 to 2015, for all women there was a trend toward fewer hours of nursing service provided per episode. CONCLUSIONS AND IMPLICATIONS Community-dwelling older women who live alone have greater service needs and higher rates of discharge to hospital. This knowledge will help guide provision of services and strategies to prevent clinical deterioration for this population.
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Affiliation(s)
- Angela Joe
- Bolton Clarke Research Institute, Bolton Clarke, Bentleigh, Victoria, Australia.
| | - Marissa Dickins
- Bolton Clarke Research Institute, Bolton Clarke, Bentleigh, Victoria, Australia; Southern Synergy, Department of Psychiatry at Monash Health, Southern Clinical School, Monash University, Dandenong, Victoria, Australia
| | - Joanne Enticott
- Southern Synergy, Department of Psychiatry at Monash Health, Southern Clinical School, Monash University, Dandenong, Victoria, Australia; Department of General Practice, School of Primary and Allied Health Care, Monash University, Notting Hill, Victoria, Australia
| | - Rajna Ogrin
- Bolton Clarke Research Institute, Bolton Clarke, Bentleigh, Victoria, Australia; Department of International Business and Asian Studies, Griffith University, Gold Coast, Queensland, Australia; Biosignals for Affordable Healthcare, Royal Melbourne Institute of Technology University, Melbourne, Victoria, Australia; Austin Health Department of Medicine, University of Melbourne, Heidelberg, Victoria, Australia
| | - Judy Lowthian
- Bolton Clarke Research Institute, Bolton Clarke, Bentleigh, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia; Institute of Future Environments, Queensland University of Technology, Brisbane, Queensland, Australia
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34
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Association between frailty and incident risk of disability in community-dwelling elder people: evidence from a meta-analysis. Public Health 2019; 175:90-100. [PMID: 31454631 DOI: 10.1016/j.puhe.2019.06.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/11/2019] [Accepted: 06/19/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Frailty is considered to be one of the risk factors of disability. However, the results of original reported studies are not consistent with respect to the frailty and incidence of disability, and previously published meta-analyses have also shown inconsistent results. This meta-analysis was conducted to investigate the relationship between the different stages of frailty and the incidence of disability by examining updated overall trends in community-dwelling elders. STUDY DESIGN Cohort studies in English or Chinese based on associations between frailty and incident disability risks that were published from 2000 until the current date were researched using PubMed, Embase, Web of Science, and CENTRAL databases. METHODS The Q test and I2 statistic were used to examine between-study heterogeneity. Random-effect models were adopted to synthesize the results based on the study heterogeneity. Subgroup analyses were also conducted to explore the possible sources of between-study heterogeneity based on the characteristics of participants. RESULTS Eighteen cohort studies with 88,906 participants were included in our meta-analyses. Compared with the non-frailty category, the combined relative risks (RRs) (95% confidence interval [CI]) of the disability were 1.66 (1.49-1.85) and 2.53 (2.01-3.14) for the category of prefrailty and frailty, respectively. Results suggested that the incident risk of disability at follow-up times <5 (RR = 3.19, 95% CI = 2.25-4.53) was significantly higher than for follow-up times ≥5 in the frailty category (RR = 2.00, 95% CI = 1.55-2.56). The risk in a sample size of ≥1000 (RR = 2.78, 95% CI = 2.04-3.14) was significantly higher than that when the sample size was <1000 (RR = 1.91, 95% CI = 1.53-2.37) in the frailty group. Compared with a value adjusted for comorbidity, the unadjusted comorbidity was significantly higher in the prefrailty category (1.90 vs. 1.52). Compared with a value adjusted for education, the unadjusted education was significantly higher in the prefrailty category (1.81 vs. 1.46). No publication bias was observed. CONCLUSION The overall meta-analysis confirms that frailty has significantly increased the incident risk of disability. Frail, elderly people are at the highest risk of future disability and may be adequate candidates for taking part in prevention and intervention programs.
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Bernardes GM, Mambrini JVDM, Lima-Costa MF, Peixoto SV. [Multimorbidity profile associated with disability among the elderly living in the Metropolitan Region of Belo Horizonte, Brazil]. CIENCIA & SAUDE COLETIVA 2019; 24:1853-1864. [PMID: 31166518 DOI: 10.1590/1413-81232018245.17192017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 08/03/2017] [Indexed: 11/22/2022] Open
Abstract
The scope of this paper was to investigate the associations of disability in three domains (BADL, IADL and mobility) with cardiovascular diseases, diabetes and multimorbidity profile, among the elderly living in the Metropolitan Region of Belo Horizonte (MRBH). A cross-sectional study was conducted with a representative sample of 2,172 elderly persons (60 years and over). Disability, for each domain (BADL, IADL and mobility), was assessed as reporting great difficulty or need for help to perform at least one activity among those investigated, and self-reported diseases included arterial hypertension, myocardial infarction or angina, stroke, diabetes, and combinations of these diseases. Adjusted Poisson regression was used, and the attributable population fraction was also estimated. A major contribution of Cerebral Vascular Accidents (strokes) to disability in all domains was observed, especially BADLs, as well as the presence of infarction or angina in disability in IADLs and mobility, especially when combined with diabetes and hypertension. The multimorbidity profile can be used to identify vulnerable groups, which should be the target of prevention and rehabilitation, reducing the financial and social cost of this event among the elderly.
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Affiliation(s)
- Gabriella Marques Bernardes
- Programa de Pós-Graduação em Saúde Coletiva, Instituto René Rachou, Fiocruz. Av. Augusto de Lima 1715, Barro Preto. 30190-009 Belo Horizonte Brasil.
| | - Juliana Vaz de Melo Mambrini
- Programa de Pós-Graduação em Saúde Coletiva, Instituto René Rachou, Fiocruz. Av. Augusto de Lima 1715, Barro Preto. 30190-009 Belo Horizonte Brasil. .,Instituto René Rachou, Fiocruz. Belo Horizonte MG Brasil
| | - Maria Fernanda Lima-Costa
- Programa de Pós-Graduação em Saúde Coletiva, Instituto René Rachou, Fiocruz. Av. Augusto de Lima 1715, Barro Preto. 30190-009 Belo Horizonte Brasil. .,Instituto René Rachou, Fiocruz. Belo Horizonte MG Brasil
| | - Sérgio Viana Peixoto
- Programa de Pós-Graduação em Saúde Coletiva, Instituto René Rachou, Fiocruz. Av. Augusto de Lima 1715, Barro Preto. 30190-009 Belo Horizonte Brasil. .,Instituto René Rachou, Fiocruz. Belo Horizonte MG Brasil.,Escola de Enfermagem, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
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Wylie G, Torrens C, Campbell P, Frost H, Gordon AL, Menz HB, Skelton DA, Sullivan F, Witham MD, Morris J. Podiatry interventions to prevent falls in older people: a systematic review and meta-analysis. Age Ageing 2019; 48:327-336. [PMID: 30615052 PMCID: PMC6503946 DOI: 10.1093/ageing/afy189] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 10/16/2018] [Accepted: 11/14/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND foot problems are independent risk factors for falls in older people. Podiatrists diagnose and treat a wide range of problems affecting the feet, ankles and lower limbs. However, the effectiveness of podiatry interventions to prevent falls in older people is unknown. This systematic review examined podiatry interventions for falls prevention delivered in the community and in care homes. METHODS systematic review and meta-analysis. We searched multiple electronic databases with no language restrictions. Randomised or quasi-randomised-controlled trials documenting podiatry interventions in older people (aged 60+) were included. Two reviewers independently applied selection criteria and assessed methodological quality using the Cochrane Risk of Bias tool. TiDieR guidelines guided data extraction and where suitable statistical summary data were available, we combined the selected outcome data in pooled meta-analyses. RESULTS from 35,857 titles and 5,201 screened abstracts, nine studies involving 6,502 participants (range 40-3,727) met the inclusion criteria. Interventions were single component podiatry (two studies), multifaceted podiatry (three studies), or multifactorial involving other components and referral to podiatry component (four studies). Seven studies were conducted in the community and two in care homes. Quality assessment showed overall low risk for selection bias, but unclear or high risk of detection bias in 4/9 studies. Combining falls rate data showed significant effects for multifaceted podiatry interventions compared to usual care (falls rate ratio 0.77 [95% CI 0.61, 0.99]); and multifactorial interventions including podiatry (falls rate ratio: 0.73 [95% CI 0.54, 0.98]). Single component podiatry interventions demonstrated no significant effects on falls rate. CONCLUSIONS multifaceted podiatry interventions and multifactorial interventions involving referral to podiatry produce significant reductions in falls rate. The effect of multi-component podiatry interventions and of podiatry within multifactorial interventions in care homes is unknown and requires further trial data. PROSPERO REGISTRATION NUMBER CRD42017068300.
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Affiliation(s)
- Gavin Wylie
- School of Nursing and Health Sciences, Section of Ageing and Health, and NHS Tayside Allied Health Professions Directoriate, University of Dundee, 11 Airlie Place, Dundee, UK
| | - Claire Torrens
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, Pathfoot, UK
| | - Pauline Campbell
- Nursing Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Cowcaddens Road, Glasgow, UK
| | - Helen Frost
- School of Health and Social Care, Edinburgh Napier University, 9 Sighthill Court, Edinburgh, UK
| | - Adam Lee Gordon
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Royal Derby Hospital, Uttoxeter Road, Derby, UK
| | - Hylton B Menz
- Musculoskeletal Reseach Centre, School of Physiotherapy, La Trobe University, Bundoora, Victoria, Australia
| | - Dawn A Skelton
- Institute of Applied Health Research, School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, UK
| | - Frank Sullivan
- Division of Population and Behavioural Science, Department of Medicine, University of St Andrews, St Andrews, UK
| | - Miles D Witham
- Section of Ageing and Health, University of Dundee, Ninewells Hospital, Dundee, UK
| | - Jacqui Morris
- School of Nursing and Health Sciences, University of Dundee, 11 Airlie Place, Dundee, UK
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Griffith LE, Gilsing A, Mangin D, Patterson C, van den Heuvel E, Sohel N, St John P, van den Akker M, Raina P. Multimorbidity Frameworks Impact Prevalence and Relationships with Patient-Important Outcomes. J Am Geriatr Soc 2019; 67:1632-1640. [PMID: 30957230 DOI: 10.1111/jgs.15921] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 03/02/2019] [Accepted: 03/13/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To explore how different frameworks and categories of chronic conditions impact multimorbidity (defined as two or more chronic conditions) prevalence estimates and associations with patient-important functional outcomes. DESIGN Baseline data from a population-based cohort study. SETTING National sample of Canadians. PARTICIPANTS A total of 51 338 community-living adults, aged 45 to 85 years. MAIN OUTCOME MEASURES Chronic conditions from three commonly recognized frameworks were categorized as: (1) diseases, (2) risk factors, or (3) symptoms. Estimates of multimorbidity prevalence were compared among frameworks by age and sex. Separate weighted logistic regression models were used to explore the impact of the different frameworks and categories of chronic conditions on odds ratios (ORs) for multimorbidity for four patient-important functional outcomes: disability, social participation restriction, and self-rated physical and mental health. RESULTS One framework included diseases and risk factors, and two frameworks included diseases, risk factors, and symptoms. The prevalence of multimorbidity differed among the frameworks, ranging from 33.5% to 60.6% having two or more chronic conditions. Including risk factors in frameworks increased prevalence estimates, while including symptoms increased prevalence estimates and associations with most patient-important outcomes. The two frameworks that included symptoms had the largest ORs for associations with disability, social participation restriction, and self-rated physical health but not self-rated mental health. Similar results were found when we compared ORs for patient-important outcome for multimorbidity based on three subframeworks: one including diseases only, one including diseases and risk factors, and one including diseases, risk factors, and symptoms. CONCLUSIONS Including risk factors appeared to increase only the prevalence of multimorbidity without significantly altering relationships to outcomes. The inclusion of symptoms increased prevalence and associations with patient-important outcomes. These findings underscore the importance of considering not only the number, but also the category, of conditions included in multimorbidity frameworks, as simply counting the number of diagnoses may reduce sensitivity to outcomes that are important to individuals. J Am Geriatr Soc 67:1632-1640, 2019.
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Affiliation(s)
- Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Anne Gilsing
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Dee Mangin
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Edwin van den Heuvel
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Nazmul Sohel
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Philip St John
- Section of Geriatric Medicine, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Marjan van den Akker
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands.,Department of Public Health and Primary Care, Academic Center for General Practice - KU Leuven, Leuven, Belgium
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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Petty LS, Foster JEG, Rigby P. Identifying community-dwelling older adults' vision loss during mobility assessments: A scoping review. Can J Occup Ther 2019; 86:95-105. [PMID: 30862231 DOI: 10.1177/0008417419831800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND. Co-occurring mobility issues and vision loss are prevalent in older adults. Vision loss can cause ambulation difficulties and falls. Community-dwelling older adults frequently require mobility-aids assessment by occupational therapists. However, therapists often lack access to medical documentation on vision or training in vision assessment to ensure that clients have adequate vision for safe mobility-aid use. PURPOSE. This study aimed to identify screening and assessment approaches to identify functional vision loss to guide mobility-aid prescription. METHOD. A scoping review following Arksey and O'Malley's five stages was undertaken using Medline and CINAHL databases. A data-charting form was used for extraction of information about each article, including the population, vision diagnosis, and the methodology for vision screening. The data regarding vision loss and mobility of older adults were summarized for each article. FINDINGS. Twenty-three papers were included in the study, describing screening questions and questionnaires or assessment tools to screen for vision loss in community settings. IMPLICATIONS. The various tools identified can better prepare therapists to prescribe mobility aids appropriate for seniors' level of functional vision and to refer clients for further assessment and intervention if warranted.
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Jerliu N, Burazeri G, Toçi E, Philp I, Czabanowska K, Ramadani N, Brand H. Application of EASY-Care Standard 2010 instrument in a population-based survey in transitional Kosovo. Eur J Public Health 2019; 29:367-371. [PMID: 30169678 DOI: 10.1093/eurpub/cky172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The aim of this study was to assess the health needs and priorities of older people in Kosovo, the newest state in Europe striving for a functional democracy after the breakdown of former Yugoslavia and the following war in the region. METHODS A cross-sectional study was conducted in Kosovo in 2011 including a nationwide representative sample of 1890 individuals aged ≥65 years (949 men, mean age: 73 ± 6 years; 941 women, mean age: 74 ± 7 years; overall response rate: 84%). All individuals were administered the full version of EASY-Care Standard 2010 instrument, inquiring about the need for support in activities of daily living ('independence'), the 'risk of breakdown in care' (leading to emergency admission to hospital) and the 'risk of falls'. RESULTS The degree of 'independence' was lower, whereas the 'risk of breakdown in care' and the 'risk of falls' were significantly higher in: older women; the oldest individuals (≥85 years); rural residents; participants living alone; those perceiving themselves as poor; participants who could not access medical care; those who perceived their general health status as poor; and older people who reported at least one chronic condition. CONCLUSIONS This is one of the very few reports from Southeast European region informing about the health needs and priorities of older people in a large and representative population-based sample of older men and women. The poor health status of older people, especially evident in the socio-demographic disadvantaged categories, should raise the awareness of policymakers and decision-makers for appropriate health and social care of elderly in Kosovo and in other European countries.
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Affiliation(s)
- Naim Jerliu
- National Institute of Public Health of Kosovo, Prishtina, Kosovo.,Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
| | - Genc Burazeri
- Department of International Health, School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Department of Public Health, Faculty of Medicine, University of Medicine, Tirana, Albania
| | - Ervin Toçi
- Department of Public Health, Faculty of Medicine, University of Medicine, Tirana, Albania
| | - Ian Philp
- Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Katarzyna Czabanowska
- Department of International Health, School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Naser Ramadani
- National Institute of Public Health of Kosovo, Prishtina, Kosovo.,Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
| | - Helmut Brand
- Department of International Health, School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
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Does place matter? A multilevel analysis of victimization and satisfaction with personal safety of seniors in Canada. Health Place 2018; 53:17-25. [DOI: 10.1016/j.healthplace.2018.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 07/05/2018] [Accepted: 07/12/2018] [Indexed: 11/22/2022]
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41
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Multiple chronic conditions: Implications for cognition - Findings from the Wisconsin Registry for Alzheimer's Prevention (WRAP). Appl Nurs Res 2018; 42:56-61. [PMID: 30029715 DOI: 10.1016/j.apnr.2018.06.004] [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: 02/01/2018] [Revised: 06/12/2018] [Accepted: 06/14/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Several chronic illnesses have demonstrated relationships to cognitive decline in the context of aging. However, researchers have largely ignored the effects of multi-morbidity in the context of Alzheimer's disease and related dementias (ADRD) risk. The purpose of this study is to examine the relationship between multiple chronic conditions (MCC) and cognitive decline. METHODS Latent class analysis (LCA) was completed to identify different subgroups of the 1285 participants from the Wisconsin Registry for Alzheimer's Prevention who were recognized based on their self-reported chronic illnesses. Differences between variables of interest (i.e., biomarkers and depressive symptom scores) and each of the individual classes were then explored. Chi-square tests were used to examine the association between MCC and cognitive status. RESULTS LCA revealed a four-class model best fit solution. Participants in the sleep class had the highest incidence of new onset cognitive decline. DISCUSSION Findings offer evidence of an association between specific MCC groups and the development of cognitive decline. Nurses should monitor and screen for cognitive decline in the presence of MCC in order to better target self-management interventions.
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42
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Ge L, Yap CW, Heng BH. Sex differences in associations between multimorbidity and physical function domains among community-dwelling adults in Singapore. PLoS One 2018; 13:e0197443. [PMID: 29758072 PMCID: PMC5951575 DOI: 10.1371/journal.pone.0197443] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 05/02/2018] [Indexed: 12/21/2022] Open
Abstract
Objectives The aims of the study were to identify the associations between multimorbidity and specific physical function domains among community-dwelling adults in Singapore, and to examine sex differences in the associations. Methods This study was conducted using baseline data of 1,940 participants in the Population Health Index Survey conducted in the Central Region of Singapore from November 2015 to November 2016. Physical function was assessed using the Function Component of the Late-life Function and Disability Instrument and compared between men and women. Multiple linear regressions were conducted to examine associations between multimorbidity and different physical function domains for all participants, and in men and women separately. Results The prevalence of multimorbidity in the study population was 35.0% for adults aged 21 years and above, with no differences between men and women. Multimorbidity was associated with reduced upper extremity function, basic and advanced lower extremity function, and overall function in men and women after adjusting for demographic factors. Multimorbidity had a stronger association with advanced lower extremity function and overall physical function in women than in men. Conclusions The findings of this study indicate that multimorbidity is associated with physical function domains in men and women, and in particular advanced lower extremity for women. Effective community-based interventions need to be implemented to preserve physical function in individuals with multimorbidity to keep them functionally independent and physically active in the community. Additional focus on advanced lower extremity function for women is needed.
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Affiliation(s)
- Lixia Ge
- Health Services and Outcomes Research, National Healthcare Group Pte Ltd, Singapore, Singapore
- * E-mail:
| | - Chun Wei Yap
- Health Services and Outcomes Research, National Healthcare Group Pte Ltd, Singapore, Singapore
| | - Bee Hoon Heng
- Health Services and Outcomes Research, National Healthcare Group Pte Ltd, Singapore, Singapore
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43
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Calderón-Larrañaga A, Santoni G, Wang HX, Welmer AK, Rizzuto D, Vetrano DL, Marengoni A, Fratiglioni L. Rapidly developing multimorbidity and disability in older adults: does social background matter? J Intern Med 2018; 283:489-499. [PMID: 29415323 DOI: 10.1111/joim.12739] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Multimorbidity is among the most disabling geriatric conditions. In this study, we explored whether a rapid development of multimorbidity potentiates its impact on the functional independence of older adults, and whether different sociodemographic factors play a role beyond the rate of chronic disease accumulation. METHODS A random sample of persons aged ≥60 years (n = 2387) from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) was followed over 6 years. The speed of multimorbidity development was estimated as the rate of chronic disease accumulation (linear mixed models) and further dichotomized into the upper versus the three lower rate quartiles. Binomial negative mixed models were used to analyse the association between speed of multimorbidity development and disability (impaired basic and instrumental activities of daily living), expressed as the incidence rate ratio (IRR). The effect of sociodemographic factors, including sex, education, occupation and social network, was investigated. RESULTS The risk of new activity impairment was higher among participants who developed multimorbidity faster (IRR 2.4, 95% CI 1.9-3.1) compared with those who accumulated diseases more slowly overtime, even after considering the baseline number of chronic conditions. Only female sex (IRR for women vs. men 1.6, 95% CI 1.2-2.0) and social network (IRR for poor vs. rich social network 1.7, 95% CI 1.3-2.2) showed an effect on disability beyond the rate of chronic disease accumulation. CONCLUSIONS Rapidly developing multimorbidity is a negative prognostic factor for disability. However, sociodemographic factors such as sex and social network may determine older adults' reserves of functional ability, helping them to live independently despite the rapid accumulation of chronic conditions.
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Affiliation(s)
- A Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - G Santoni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - H X Wang
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.,Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - A K Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - D Rizzuto
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - D L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.,Department of Geriatrics, Catholic University of Rome, Italy
| | - A Marengoni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - L Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
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Amegbor PM, Kuuire VZ, Robertson H, Kuffuor OA. Predictors of basic self-care and intermediate self-care functional disabilities among older adults in Ghana. Arch Gerontol Geriatr 2018; 77:81-88. [PMID: 29684742 DOI: 10.1016/j.archger.2018.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/05/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
Abstract
The number of older adults in Ghana is growing rapidly. Associated with this growth, is the rise in age-related chronic diseases such as cardiovascular and musculoskeletal conditions. However, there is limited knowledge in the Ghanaian context on the effect of chronic diseases on functional disabilities among older adults. In this study, we examine the association between chronic diseases, socioeconomic status, and functional disabilities. Data from 4107 Ghanaian older adults (persons aged 50 years and above) who participated in the World Health Organization's Global Ageing and Adult Health survey (SAGE-Wave 1) were used to fit random effect multivariate logistic and complementary log-log regression. Stroke was significantly associated with difficulty in performing both basic self-care functions and intermediate self-care functions. Hypertension and arthritis, on the other hand, were associated with basic self-care functional disability only. Socioeconomically vulnerable groups such as females, those with less education and low-incomes were more likely to have functional disabilities associated with basic self-care and intermediate self-care activities. In order to reduce functional disabilities among older persons in Ghana, efforts should be aimed at reducing chronic conditions as well as improving socioeconomic status.
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Affiliation(s)
- Prince M Amegbor
- Department of Geography and Planning, Queen's University, Mackintosh-Corry Hall, Room E208, Kingston, Ontario, K7L 3N6, Canada.
| | - Vincent Z Kuuire
- Department of Geography, University of Toronto Mississauga, William Davis Building, Room 3278, Mississauga, ON, L5L 1C6, Canada
| | | | - Oscar A Kuffuor
- Department of Geography and Planning, Queen's University, Mackintosh-Corry Hall, Room E208, Kingston, Ontario, K7L 3N6, Canada
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45
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Simões D, Araújo FA, Monjardino T, Severo M, Cruz I, Carmona L, Lucas R. The population impact of rheumatic and musculoskeletal diseases in relation to other non-communicable disorders: comparing two estimation approaches. Rheumatol Int 2018; 38:905-915. [PMID: 29423535 DOI: 10.1007/s00296-018-3990-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 01/29/2018] [Indexed: 12/16/2022]
Abstract
The aim of this study was to quantify the population impact of rheumatic and musculoskeletal diseases (RMDs) with other non-communicable diseases (NCDs), using two complementary strategies: standard multivariate models based on global burden of disease (GBD)-defined groups vs. empirical mutually exclusive patterns of NCDs. We used cross-sectional data from the Portuguese Fourth National Health Survey (n = 23,752). Six GBD-defined groups were included: RMDs, chronic obstructive pulmonary disease or asthma, cancer, depression, diabetes or renal failure, and stroke or myocardial infarction. The empirical approach comprised the patterns "low disease probability", "cardiometabolic conditions", "respiratory conditions" and "RMDs and depression". As recommended by the outcome measures in rheumatology (OMERACT) initiative, health outcomes included life impact, pathophysiological manifestations, and resource use indicators. Population attributable fractions (PAF) were computed for each outcome and bootstrap confidence intervals (95% CI) were estimated. Among GBD-defined groups, RMDs had the highest impact across all the adverse health outcomes, from frequent healthcare utilization (PAF 7.8%, 95% CI 6.2-9.3) to negative self-rated health (PAF 18.1%, 95% CI 15.4-20.6). In the empirical approach, patterns "cardiometabolic conditions" and "RMDs and depression" had similar PAF estimates across all adverse health outcomes, but "RMDs and depression" showed significantly higher impact on chronic pain (PAF 8.9%, 95% CI 7.6-10.3) than the remaining multimorbidity patterns. RMDs revealed the greatest population impact across all adverse health outcomes tested, using both approaches. Empirical patterns are particularly interesting to evaluate the impact of RMDs in the context of their co-occurrence with other NCDs.
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Affiliation(s)
- Daniela Simões
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135-139, 4050-600, Porto, Portugal.,Escola Superior de Saúde de Santa Maria, Porto, Portugal
| | - Fábio Azevedo Araújo
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135-139, 4050-600, Porto, Portugal
| | - Teresa Monjardino
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135-139, 4050-600, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135-139, 4050-600, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Ivo Cruz
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135-139, 4050-600, Porto, Portugal.,Unidade de Saúde Pública do ACeS Grande Porto V-Porto Ocidental, Porto, Portugal
| | | | - Raquel Lucas
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135-139, 4050-600, Porto, Portugal. .,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
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Mace RA, Mansbach WE. Validity of Brief Cognitive Assessment Tool modifications for older adults with visual and motor limitations. J Clin Exp Neuropsychol 2018; 40:715-721. [DOI: 10.1080/13803395.2017.1423041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ryan A. Mace
- Mansbach Health Tools, LLC, Simpsonville, MD, USA
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Hou C, Ping Z, Yang K, Chen S, Liu X, Li H, Liu M, Ma Y, Van Halm-Lutterodt N, Tao L, Luo Y, Yang X, Wang W, Li X, Guo X. Trends of Activities of Daily Living Disability Situation and Association with Chronic Conditions among Elderly Aged 80 Years and Over in China. J Nutr Health Aging 2018; 22:439-445. [PMID: 29484359 DOI: 10.1007/s12603-017-0947-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES In China, few studies reported the disability situation and the association between disabilities with chronic conditions in aged people. This study investigates the cross-sectional trends of prevalence and severity of activities of daily living disability (ADL) in Chinese oldest-old people from 1998 to 2008, and identified the potential risk factors of disability. DESIGN A combination of population-based longitudinal prospective study and probabilistically sampling cross-sectional studies. SETTING The Chinese Longitudinal Healthy Longevity Survey (CLHLS) was based on a random sampling of aged people from twenty-two provinces in China. PARTICIPANTS A total of 52,667 participants aged from 80 years old to 105 years old sampled in the year of 1998 (n=8,768), 2000 (n=10,940), 2002 (n=10,905), 2005 (n=10,396) and 2008 (n=11,658) were analyzed respectively. RESULTS The prevalence of ADL disability decreased from the year of 1998 (18%) to 2008 (12%). The disability prevalence significantly increased in 2002 and decreased in 2008 (P<0.001) in total participants than the year of 1998. The prevalence trends of low ADL disability level were almost identical with that of the total ADL disability. Stroke/cerebrovascular disease (CVD) and cognitive impairment were the strongest risk factors of disability. Vision impairment became less associated with ADL disability (P=0.045), while the association between multimorbidity and ADL disability became stronger (P=0.033). CONCLUSIONS The prevalence of ADL disability declined among the oldest-old population in China from the year of 1998 to 2008 without obeying a linear pattern. Temporal trends of ADL disability mainly attributed to the change of low disability level prevalence. Stroke/CVD and cognitive impairment were the most common risk factors of disability. Vision impairment caused disability has become less common, while risks of multimorbidity related disability increased.
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Affiliation(s)
- C Hou
- Xiuhua Guo, PhD, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China. E-mail:
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48
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Tomioka K, Kurumatani N, Hosoi H. Beneficial effects of working later in life on the health of community-dwelling older adults. Geriatr Gerontol Int 2017; 18:308-314. [PMID: 29094489 DOI: 10.1111/ggi.13184] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/14/2017] [Accepted: 08/27/2017] [Indexed: 01/14/2023]
Abstract
AIM Evidence regarding the health effects of working lack coherence. This study seeks to determine if continuing to work into older age benefits or damages one's health. METHODS Baseline questionnaires were mailed to 15 058 individuals aged ≥65 years living in two municipalities in Nara Prefecture, Japan. Of these, 11 183 were returned. Analyses were limited to those who maintained each health index at baseline. We followed the participants for 3 years, and examined three health outcomes: long-term care need, cognitive decline and instrumental activities of daily living (IADL) decline. Participants were divided into four groups according to their baseline working status and follow-up status: non-working, retired, initiating work and continuing to work. RESULTS After covariate adjustments, older men who initiated work had a decreased likelihood for long-term care (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.17-0.98) and IADL decline (OR 0.44, 95% CI 0.23-0.84), older men who continued working prevented the onset of long-term care (OR 0.22, 95% CI 0.09-0.54) and cognitive decline (OR 0.69, 95% CI 0.50-0.96), older women who initiated working were less likely to require long-term care (OR 0.24, 95% CI 0.09-0.66) and IADL decline (OR 0.38, 95% CI 0.16-0.88), and older women who continued working had a significantly lower risk of IADL decline (OR 0.39, 95% CI 0.16-0.99), compared with the non-working group. Retirees did not differ from the non-working group in any of the health outcomes. CONCLUSIONS Although beneficial effects vary by sex and type of health outcomes, the present findings suggest that policies encouraging older people to participate in the workforce contribute to extending healthy life expectancy. Geriatr Gerontol Int 2018; 18: 308-314.
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Affiliation(s)
- Kimiko Tomioka
- Nara Prefectural Health Research Center, Nara Medical University, Nara, Japan
| | - Norio Kurumatani
- Nara Prefectural Health Research Center, Nara Medical University, Nara, Japan
| | - Hiroshi Hosoi
- Nara Prefectural Health Research Center, Nara Medical University, Nara, Japan
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Wister AV, Coatta KL, Schuurman N, Lear SA, Rosin M, MacKey D. A Lifecourse Model of Multimorbidity Resilience: Theoretical and Research Developments. Int J Aging Hum Dev 2017; 82:290-313. [PMID: 27076489 DOI: 10.1177/0091415016641686] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this article is to advance a Lifecourse Model of Multimorbidity Resilience. It focuses on the ways in which individuals face adversities associated with multimorbidity and regain a sense of wellness through a complex, dynamic phenomenon termed resilience. A comprehensive review of 112 publications (between 1995 and 2015) was conducted using several comprehensive electronic data bases. Two independent researchers extracted and synthesized resilience literature with specific applications to chronic illness. The article outlines five stages of theoretical development of resilience, synthesizes these with the aging and chronic illness literature, builds a rationale for a lifecourse approach to resilience, and applies the model to multimorbidity. Cultivating and maintaining resilience is fundamental to functioning and quality of life for those with multimorbidity. We found that there are a number of gaps in both basic and applied research that need to be filled to advance knowledge and practice based on resilience approaches.
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Affiliation(s)
- Andrew V Wister
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | | | - Nadine Schuurman
- Department of Geography, Simon Fraser University, Burnaby, BC, Canada
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Healthy Heart Program, St. Paul's Hospital, Vancouver, BC, Canada
| | - Miriam Rosin
- Department of Biomedical Physiology & Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Dawn MacKey
- Department of Biomedical Physiology & Kinesiology, Simon Fraser University, Burnaby, BC, Canada
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50
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Awale A, Dufour AB, Katz P, Menz HB, Hannan MT. Link Between Foot Pain Severity and Prevalence of Depressive Symptoms. Arthritis Care Res (Hoboken) 2017; 68:871-6. [PMID: 26555319 DOI: 10.1002/acr.22779] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 09/24/2015] [Accepted: 10/27/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Associations between pain and depression are well known, yet foot pain, common in populations, has been understudied. This cross-sectional study examined foot pain and severity of foot pain with depressive symptoms in adults. METHODS Framingham Foot Study (2002-2008) participants completed questionnaires that included questions about foot pain (yes/no; none, mild, moderate, or severe pain) and the Center for Epidemiologic Studies Depression Scale (scores ≥16 indicated depressive symptoms). Age and body mass index (BMI) were also assessed. Sex-specific logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) for associations of foot pain with depressive symptoms, adjusting for age and BMI. In a subset, further models adjusted for leg pain, back pain, or other joint pain. RESULTS Of 1,464 men and 1,857 women, the mean ± SD age was 66 ± 10 years. Depressive symptoms were reported in 21% of men and 27% of women. Compared to those with no foot pain and independent of age and BMI, both men and women with moderate foot pain had approximately a 2-fold increased odds of depressive symptoms (men with severe foot pain OR of 4 [95% CI 2.26-8.48], women with severe foot pain OR of 3 [95% CI 2.02-4.68]). Considering other pain regions attenuated ORs, but the pattern of results remained unchanged. CONCLUSION Even after we adjusted for age, BMI, and other regions of pain, those reporting worse foot pain were more likely to report depressive symptoms. These findings suggest that foot pain may be a part of a broader pain spectrum, with an impact beyond localized pain and discomfort.
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Affiliation(s)
| | - Alyssa B Dufour
- Hebrew SeniorLife, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | | | | | - Marian T Hannan
- Hebrew SeniorLife, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, Massachusetts
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