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Wang W, Liu Y, Ji D, Xie K, Yang Y, Zhu X, Feng Z, Guo H, Wang B. The association between functional disability and depressive symptoms among older adults: Findings from the China Health and Retirement Longitudinal Study (CHARLS). J Affect Disord 2024; 351:518-526. [PMID: 38307133 DOI: 10.1016/j.jad.2024.01.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 01/14/2024] [Accepted: 01/27/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Previous research has shown that depressive symptoms in older adults was associated with functional disability, including basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs). However, little is known about the impact of different patterns of functional disability and new-onset functional disability on subsequent depressive symptoms. OBJECTIVE To determine the effect of various patterns of functional disability and new-onset functional disability on depressive symptoms among Chinese older adults aged 60 years and above. METHOD The study included 3242 older adults from the China Health and Retirement Longitudinal Study (CHARLS), which was conducted from 2011 to 2018. Cox proportional hazards models were used to investigate the associations between patterns of functional disability and depressive symptoms. The associations were also examined in the population with new-onset functional disability. RESULT During 15,321 person-years of follow-up, 946 depressive symptoms occurred. The hazard ratios (HRs) of depressive symptoms were 1.29 (95 % confidence intervals [CI]: 1.05-1.58) for IADLs disability, 1.22 (95 % CI: 0.75-1.55) for BADLs disability, and 1.78 (95 % CI: 1.41-2.22) for both IADLs and BADLs disabilities. In the analysis of new-onset functional disability, the HRs were 1.50 (95 % CI: 1.06-2.13) for onset IADLs disability, 1.28 (95 % CI: 0.85-1.91) for onset BADLs disability, and 1.69 (95 % CI: 1.03-2.76) for both onset BADLs and IADLs disabilities. LIMITATIONS Depressive symptoms were assessed using the Centre for Epidemiological Studies Depression Scale, which has limitations in diagnosing clinical depression. CONCLUSION Functional disability increases the risk of depressive symptoms, particularly impaired IADLs function. Psychological care for older adults with functional disability should be strengthened.
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Affiliation(s)
- Weihao Wang
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Yuxiang Liu
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Dakang Ji
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Kaihong Xie
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ying Yang
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Xiaoyue Zhu
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Zhuoyue Feng
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Haijian Guo
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China.
| | - Bei Wang
- School of Public Health, Southeast University, Nanjing, Jiangsu, China.
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Roquebert Q, Tenand M. Informal care at old age at home and in nursing homes: determinants and economic value. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:497-511. [PMID: 37296350 PMCID: PMC10972991 DOI: 10.1007/s10198-023-01601-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 05/24/2023] [Indexed: 06/12/2023]
Abstract
This paper provides a comprehensive analysis of informal care receipt by the French individuals aged 60 or older. The literature has focused on the community, leaving informal care in residential care settings in the shadow. We leverage data from a representative survey (CARE) conducted in 2015-2016 on both community-dwelling individuals and nursing home residents. Focusing on the 60+ with activity restrictions, we show that 76% of nursing home residents receive help with the activities of daily living from relatives, against 55% in the community. The number of hours conditional on receipt is yet 3.5 times higher in the community. Informal care represents 186 million hours per month and a value equivalent to 1.1% of GDP at least, care in the community representing 95% of the total. We investigate the determinants of informal care receipt. Using an Oaxaca-type approach, we disentangle between two mechanisms explaining that nursing home residents are more likely to receive informal care, namely the differences in population composition (endowments) and the differences in the association of individual characteristics with informal care (coefficients). Both are found to have a similar contribution. Our results imply that private costs make up for the majority (76%) of the costs associated with long-term care provision once informal care is taken into account. They also highlight that informal care is extremely common for nursing home residents. Existing evidence on the determinants of informal care receipt in the community has, however, limited relevance to understand informal care behaviors in nursing homes.
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Affiliation(s)
- Quitterie Roquebert
- Université de Strasbourg, Université de Lorraine, CNRS, BETA, 67000, Strasbourg, France
| | - Marianne Tenand
- Erasmus School of Health Policy & Management (ESHPM), Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam (EUR) and the Netherlands Bureau for Economic Policy Analysis (CPB), Rotterdam and The Hague, The Netherlands.
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Coste J, Pérès K, Robine JM, Carcaillon-Bentata L. Dimensionality and invariance of ADL, IADL, BI-M2/WG-SS, and GALI in large surveys in France (2008-2014) and implications for measuring disability in epidemiology. Arch Public Health 2023; 81:141. [PMID: 37544985 PMCID: PMC10405560 DOI: 10.1186/s13690-023-01164-6] [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: 09/24/2022] [Accepted: 07/27/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND The epidemiological investigation and surveillance of disability requires well-constructed, invariant, and, if possible, exchangeable measures. However, the current or recommended measures have not been thoroughly investigated with respect to these issues. Here we examined the dimensional structure and invariance of four measures across sociodemographic groups: Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Budapest Initiative Mark 2 (BI-M2) and Washington Group on Disability Statistics Short Set (WG-SS), and Global Activity Limitation Indicator (GALI). METHODS We used data from three large nationwide representative surveys conducted in France between 2008 and 2014. The surveys included these four measures and classical and modern approaches (correlations, principal component analysis, Rasch modeling) were used to assess their dimensional structure as well as their invariance through differential item functioning (DIF) for sociodemographic characteristics. Polytomous logistic regression models were used to assess gradients in health inequalities associated with these measures. RESULTS For many items of ADL, IADL, and BI-M2/WG-SS, we consistently observed disordered response thresholds, rejection of unidimensionality, and DIF evidence for sociodemographic characteristics across the survey samples. Health inequality gradients were erratic. In addition, it was impossible to identify a common continuum for GALI, ADL, IADL, and BI-M2/WG-SS or their constituent items. CONCLUSION This study warns against the current practice of investigating disability in epidemiology using measures that are unsuitable for epidemiological use, incommensurable, and inadequate regarding the basic requisites of dimensionality and invariance. Developing invariant measures and equating them along a common continuum to enlarge the common bases of measurement should therefore be a priority.
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Affiliation(s)
- Joël Coste
- Santé publique France (French national public health agency), Saint-Maurice, France.
| | - Karine Pérès
- University of Bordeaux, INSERM, Bordeaux Population Health, U1219, Bordeaux, France
| | - Jean-Marie Robine
- 3MMDN, University of Montpellier, EPHE, INSERM, Montpellier, France
- PSL Research University, Paris, France
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Zheng W, Huang Z. Onset of ADL and IADL limitation among Chinese middle-aged and older adults. PLoS One 2023; 18:e0287856. [PMID: 37459324 PMCID: PMC10351716 DOI: 10.1371/journal.pone.0287856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/14/2023] [Indexed: 07/20/2023] Open
Abstract
It is important to measure the prevalence and onset of limitations for older adults to take critical day-to-day activities in the population. However, too often, only very older people are covered, and too few activities are included in the studies. Using a nationally representative sample from 2011 to 2018 (N = 16, 381), this study characterizes the limitation pattern covering ADL and IADL activities among middle-aged and older adults in China. We use survival models to characterize the limitation transition. We find that half of the population become limited in activities including housekeeping, toileting, managing money, and cooking in their early 70s, followed by shopping, bathing, transferring and dressing in their late 70s, continence, and taking medications in their early 80s, and feeding in their early 90s. In addition, women show significantly younger age of limitation onsets for all activities except continence.
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Affiliation(s)
- Wenyuan Zheng
- Department of Insurance, School of Finance, Southwestern University of Finance and Economics, Chengdu, China
| | - Zhiyong Huang
- Department of Social Security, School of Public Administration, Southwestern University of Finance and Economics, Chengdu, China
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Galvin A, Amadéo B, Frasca M, Soubeyran P, Rondeau V, Delva F, Pérès K, Coureau G, Helmer C, Mathoulin-Pélissier S. Association between pre-diagnosis geriatric syndromes and overall survival in older adults with cancer (the INCAPAC study). J Geriatr Oncol 2023; 14:101539. [PMID: 37320933 DOI: 10.1016/j.jgo.2023.101539] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/25/2023] [Accepted: 05/26/2023] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Several population-based studies have reported disparities in overall survival (OS) among older patients with cancer. However, geriatric syndromes, known to be associated with OS in the geriatric population, were rarely studied. Thus, our aim was to identify the determinants of OS among French older adults with cancer, including geriatric syndromes before cancer diagnosis. MATERIALS AND METHODS Using cancer registries, we identified older subjects (≥65 years) with cancer in three French prospective cohort studies on aging from the Gironde department. Survival time was calculated from the date of diagnosis to the date of all-cause death or to the date of last follow-up, whichever came first. Demographic and socioeconomic characteristics, smoking status, self-rated health, cancer-related factors (stage at diagnosis, treatment), as well as geriatric syndromes (polypharmacy, activity limitation, depressive symptomatology, and cognitive impairment or dementia) were studied. Analyses were performed using Cox proportional hazard models for the whole population, then by age group (65-84 and 85+). RESULTS Among the 607 subjects included in the study, the median age at cancer diagnosis was 84 years. Smoking habits, activity limitations, cognitive impairment or dementia, advanced cancer stage and absence of treatment were significantly associated with lower OS in the analysis including the whole population. Women presented higher OS. Factors associated with OS differed by age group. Polypharmacy was inversely associated with OS in older adults aged 65-84 and 85 + . DISCUSSION Our findings support that geriatric assessment is needed to identify patients at higher risk of death and that an evaluation of activity limitation in older adults is essential. Improving early detection could enable interventions to address factors (activity limitations, cognitive impairment) associated with OS, potentially reducing disparities and lead to earlier palliative care.
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Affiliation(s)
- Angéline Galvin
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene Team, UMR 1219, Bordeaux F-33000, France.
| | - Brice Amadéo
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene Team, UMR 1219, Bordeaux F-33000, France
| | - Matthieu Frasca
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene Team, UMR 1219, Bordeaux F-33000, France
| | - Pierre Soubeyran
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Vinco team, UMR 1218, Bordeaux F-33000, France
| | - Virginie Rondeau
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Biostatistics team, UMR 1219, Bordeaux F-33000, France
| | - Fleur Delva
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene Team, UMR 1219, Bordeaux F-33000, France; Department of Public Health, Bordeaux University Hospital, Bordeaux F-3300, France
| | - Karine Pérès
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Sepia team, UMR 1219, Bordeaux F-33000, France
| | - Gaëlle Coureau
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene Team, UMR 1219, Bordeaux F-33000, France; Department of Public Health, Bordeaux University Hospital, Bordeaux F-3300, France
| | - Catherine Helmer
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Leha team, UMR 1219, Bordeaux F-33000, France
| | - Simone Mathoulin-Pélissier
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene Team, UMR 1219, Bordeaux F-33000, France; Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonie, Comprehensive Cancer Center, Bordeaux F-33000, France
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Marroig A. Transitions across states with and without difficulties in performing activities of daily living and death: a longitudinal comparison of ten European countries. Eur J Ageing 2023; 20:18. [PMID: 37202643 DOI: 10.1007/s10433-023-00763-0] [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: 04/28/2023] [Indexed: 05/20/2023] Open
Abstract
Ageing has been related to the onset of disability and dependency in older adults. There is a need to better understand the disability and dependency trajectories of older adults and their relationship with socio-demographic characteristics and institutional or cultural context. This study analyses the role of age, sex, education and self-perceived health in disability, dependency and death transitions, addressing the heterogeneity across European countries and inconsistencies when using different measures of disability. Multi-state models were adjusted to evaluate the role of risk and protective factors in the transitions to disability, dependency and death. Difficulties in performing activities of daily living (ADLs) assess disability and dependency states. Data were from the Survey of Health, Ageing and Retirement in Europe conducted in 2004-2013, considering individuals aged 65 and older at baseline from Austria, Belgium, Denmark, France, Germany, Italy, the Netherlands, Spain, Sweden and Switzerland. The results showed that transitions to disability and dependency varied with age, sex, education and self-perceived health. The probability of transition to disability and dependency states increases until the age of 70 for all countries. However, there was heterogeneity in the disability and dependency trajectories with ageing between men and women. In most countries, women live with difficulties and may need help for longer than men. Care policies should consider sex differences to decrease the burden of care of informal caregivers, particularly in countries where care systems are absent or partially developed and a high level of family obligations to care needs exist.
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Affiliation(s)
- Alejandra Marroig
- Instituto de Estadística, Universidad de la República, Montevideo, Uruguay.
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Nanjo K, Ikeda T, Nagashio N, Sakai T, Jinno T. Psychological factors associated with instrumental activities of daily living disability in older adults with moderate to severe knee osteoarthritis. J Back Musculoskelet Rehabil 2023:BMR220197. [PMID: 36911929 DOI: 10.3233/bmr-220197] [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] [Indexed: 03/14/2023]
Abstract
BACKGROUND The population of older adults with knee osteoarthritis (OA)-related disabilities is increasing globally. However, studies regarding instrumental activities of daily living (IADL) in older adults with knee OA are limited. OBJECTIVE This study investigated the psychological factors associated with IADL disability in older adults with moderate to severe knee OA. METHODS A cross-sectional study was conducted on 179 patients with knee OA aged ⩾ 65 years. The six-item short form of the Pain Catastrophizing Scale (PCS-6), the four-item short form of the Pain Self-Efficacy Questionnaire (PSEQ-4), and the fifteen-item Geriatric Depression Scale (GDS-15) were used to assess psychological factors. The participants were divided into IADL disabled and non-disabled groups. Binary logistic regression analyses were performed with the IADL disability status as the dependent variable. The PCS-6, PSEQ-4, and GDS-15 tools were included as independent variables in the logistic regression model. RESULTS Of the 179 participants, 88 (49.1%) showed disability in conducting IADL. PSEQ-4 (odds ratio = 0.90, 95%; confidence interval = 0.82-0.99, p= 0.02) was a significant independent variable among all psychological factors. CONCLUSION Even after controlling for cofounders, our study found that self-efficacy, assessed using the PSEQ-4, was related to IADL disability in older adults with moderate to severe knee OA.
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Affiliation(s)
- Keigo Nanjo
- Department of Rehabilitation Medicine, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.,Department of Rehabilitation, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Takashi Ikeda
- Department of Rehabilitation Medicine, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.,School of Nursing and Rehabilitation Sciences, Showa University, Kanagawa, Japan.,Research Institute for Sport and Exercise Sciences, Showa University, Kanagawa, Japan
| | - Naoko Nagashio
- Department of Rehabilitation, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Tomoko Sakai
- Department of Rehabilitation Medicine, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Tetsuya Jinno
- Department of Orthopedic Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
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Andrade FMDD, Machado ÍE, Freitas MIDF, Souza MDFMD, Malta DC. Patterns of abuse of elderly people in Brazil: analysis of notifications. CAD SAUDE PUBLICA 2023; 39:e00075722. [PMID: 36790280 DOI: 10.1590/0102-311xen075722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 12/12/2022] [Indexed: 02/12/2023] Open
Abstract
This study aimed to describe the characteristics of elderly people abuse notifications by gender and to assess notification patterns according to gender. We analyzed data from the Brazilian Information System for Notificable Diseases (SINAN) in 2017. We carried out a descriptive analysis of victim characteristics, violence, and the probable perpetrator according to gender. Pearson's χ2 test was used to assess the significance between groups. Then, we verified the main relationships between the studied characteristics and the victim's gender by simple correspondence analysis (SCA). Thus, 17,311 cases/suspicions of elderly people abuse were notified, corresponding to 7.2% of the total number of violence notifications. Of these victims, 50.4% were white, 42.3% were married, and 17.2% had a disability/disorder; 76.9% occurred at home, 62.8% included physical violence, and 49.5% were cases of repeated violence. Most perpetrators were men (62%), and violence by two or more perpetrators was observed in 62.8% of the cases. SCA evidenced inequalities in older adults' gender, which proved to be higher among women. Physical violence was the most common among younger and old individuals, whereas neglect/abandonment tended to occur more frequently among the oldest individuals, and was most often committed by daughters. In sum, this study demonstrated evidence of gender-based violence, especially among older adults. Disability proved to be an essential characteristic for neglect/abandonment in older adults. In this context, policies are needed to reduce gender inequalities and implement a care network for older adults who are victims of violence.
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Affiliation(s)
| | - Ísis Eloah Machado
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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Li Y, Aierken A, Ding X, Pan Y, Chen Y. Dependency-associated individual, family, community, and social factors from a resilience framework among elderly people. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03670-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Sun Q, Jiang N, Lu N, Lou VWQ. Bidirectional relationship between cognitive function and loss hierarchy of activities of daily living among older adults with disabilities in urban China: a cross-lagged analysis. BMJ Open 2022; 12:e057211. [PMID: 36691162 PMCID: PMC9442490 DOI: 10.1136/bmjopen-2021-057211] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 08/11/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES The present study aimed to determine the bidirectional relationship between cognitive function and the loss hierarchy of activities of daily living (ADL) among older adults in China. DESIGN Data were derived from the Longitudinal Study on Family Caregivers for Frail Older Adults Aged 75 or Above in Shanghai (2010-2013). SETTING Community-dwelling older adults and their primary caregivers were invited to participate in this research. PARTICIPANTS The inclusion criteria for the older adults were as follows: (a) have a Shanghai urban household registration status, (b) be 75 years old or older, (c) have no fewer than two limitations in ADLs or equivalent, and (d) have one primary caregiver aged 18 years or older. 469 older adults cared by their spouses or children were included in the final analytical sample of this research. PRIMARY AND SECONDARY OUTCOME MEASURES Cognitive function was assessed using the Chinese version of the Short Portable Mental Status Questionnaire and ADLs were measured by self-reports of having difficulty or needing help with basic daily activities. RESULTS Cognitive function in 2010 was a significant predictor of intermediate loss of ADLs in 2013 (β=-0.13, p<0.05) and late loss of ADLs in 2013 (β=-0.17, p<0.01). The loss hierarchy of ADLs among older adults was not shown to be significant as a risk factor of cognitive function in 2013. CONCLUSIONS Practitioners are encouraged to adopt the ADL loss hierarchy as a supplementary needs assessment tool to make the social service delivery process more effective, economical and tailored. Cognitive function change monitoring programmes and services providing education on nutrition and encouraging social participation of older individuals were also helpful in promoting the quality of life of the older adults.
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Affiliation(s)
- Qian Sun
- Department of Social Security, Hebei University of Economics and Business, Shijiazhuang, People's Republic of China
- Hebei Collaborative Innovation Center On Urban-rural Integration, Shijiazhuang, People's Republic of China
- Sau Po Centre on Ageing, the University of Hong Kong, Hong Kong, People's Republic of China
| | - Nan Jiang
- Institute of Hospital Management, School of Medicine, Tsinghua University, Beijing, People's Republic of China
| | - Nan Lu
- Department of Social Work, Renmin University of China, Beijing, China
| | - Vivian W Q Lou
- Sau Po Centre on Ageing, the University of Hong Kong, Hong Kong, People's Republic of China
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, People's Republic of China
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Doroszkiewicz H. How the Cognitive Status of Older People Affects Their Care Dependency Level and Needs: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610257. [PMID: 36011890 PMCID: PMC9408506 DOI: 10.3390/ijerph191610257] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 05/30/2023]
Abstract
INTRODUCTION The decline in health and abilities as a result of the aging process leads to a growing need for care and various forms of support. The aim of this study was to find out the level and the main areas of care dependency among older persons with cognitive impairment versus those without cognitive impairment. MATERIALS AND METHODS A cross-sectional study was conducted among 200 older persons hospitalized in the years 2017-2018 at a geriatric ward in Poland. The research took into consideration the socio-demographic variables of the older people (age, sex, marital status, mode of dwelling, health self-evaluation, and loneliness) and the results of the assessment of their functional status, including their physical functional status according to the Barthel scale and the I-ADL, locomotion, the risk of falls and pressure sores, emotional state, cognitive function status, vision, hearing, and the Polish version of the Care Dependency Scale. RESULTS People with cognitive impairment significantly more often have poorer results in regard to ADL and I-ADL physical functions, locomotion, risk of depression, falls, pressure sores, as well as hearing and vision problems, than people with good cognitive status. The results of the study indicate that the advancing impairment of cognitive functions in older people has an impact on the level of care dependency. CONCLUSION The results of this original research show that persons with cognitive impairment are significantly more often dependent on external assistance in regard to all the needs assessed in the CDS than people without such impairment. The spectrum and number of needs in which the older person requires help grows significantly with the advancement of cognitive impairment. Older people with cognitive impairment who live alone require special support from formal caregivers in their home environment. Identification of the level of dependency and the needs of older people with cognitive impairment is of key importance for planning caregiving resources.
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Affiliation(s)
- Halina Doroszkiewicz
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland
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Fong JH, Youn Y. Assessing patterns and stability of ADL hierarchical scales for functional disability assessment. THE GERONTOLOGIST 2022; 63:773-782. [PMID: 35443060 DOI: 10.1093/geront/gnac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This study examined the stability over time of activities of daily living (ADL) items in three comparable longitudinal datasets and evaluated ADL loss sequences for older adults in the U.S., South Korea, and Japan. RESEARCH DESIGN AND METHODS Data from the U.S. Health and Retirement Study, and its two international sister surveys, were analyzed. Subjects were community-dwelling adults aged 60 and above. For each dataset, Rasch analysis was implemented to determine if the ordering of items remained stable across multiple waves (2006-2014), such that a single ADL hierarchy may be derived from multi-wave data. RESULTS Data fitted the Rasch model well. Item calibrations were sufficiently stable across measurement periods in each dataset, reflecting a stable frame of reference. Results were also robust to sample variations. The derived ADL hierarchies based on scaled logit scores revealed that "dressing" and "bathing" were relatively more difficult items for older adults in all study populations. DISCUSSION AND IMPLICATIONS Scale stability is essential when exploiting longitudinal data to analyze patterns in ADL disabilities. The consistency in ADL scales across measurement periods supports their use as screening tools and identifying those at risk for transitions in care. Interventions to reduce dependency in bathing and dressing can help improve independent functioning for community-dwelling elderly.
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Affiliation(s)
- Joelle H Fong
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore
| | - Yongjoon Youn
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore
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Echeverría A, Astorga C, Fernández C, Salgado M, Villalobos Dintrans P. Funcionalidad y personas mayores: ¿dónde estamos y hacia dónde ir? Rev Panam Salud Publica 2022; 46:e34. [PMID: 35432502 PMCID: PMC9004688 DOI: 10.26633/rpsp.2022.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/29/2021] [Indexed: 11/24/2022] Open
Abstract
El proceso de envejecimiento poblacional llevará a un aumento en problemas de salud en personas mayores, principalmente relacionados a su funcionalidad. En esta línea, los países de la Región de las Américas deben comenzar a actuar para hacer frente a este desafío. Una de las tareas fundamentales en este reto tiene que ver con la capacidad de medir y monitorear la funcionalidad de la población. Los instrumentos utilizados para evaluarla están enfocados principalmente en las actividades básicas de la vida diaria, lo que limita su capacidad preventiva por ser las actividades instrumentales las que permiten un mejor pronóstico. Usando el caso de Chile identificamos desafíos para la Región, principalmente relacionados con las ventajas de incorporar nuevas metodologías de evaluación de la capacidad funcional que no solo permitan las estrategias actuales sino, también, detectar precozmente su deterioro y monitorear sus estadios a lo largo de la dependencia en las personas mayores. Ello permitirá, a la vez, evaluar las iniciativas de prevención y manejo de la pérdida de la funcionalidad.
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Affiliation(s)
| | - Constanza Astorga
- Establecimiento de Larga Estadía Acalis Las Tranqueras, Santiago, Chile
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14
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Zamudio-Rodríguez A, Avila-Funes JA, Tabue-Teguo M, Dartigues JF, Amieva H, Pérès K. Towards an approach of disability along a continuum from robustness, pre-frailty, frailty to disability. Age Ageing 2022; 51:6540135. [PMID: 35231091 DOI: 10.1093/ageing/afac025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND frailty and disability are very prevalent in older age and although both are distinct clinical entities, they are commonly used indistinctly in order to identify vulnerable older adults. OBJECTIVE to propose a hierarchical indicator between frailty and disability among older adults along a single continuum. DESIGN population-based cohort study. SETTING the Bordeaux Three-City Study and the Aging Multidisciplinary Investigation (AMI) cohort. SUBJECTS the sample included 1800 participants aged 65 and older. METHODS an additive hierarchical indicator was proposed by combining the phenotype of frailty (robustness, pre-frailty and frailty), instrumental activities of daily living (IADL) and basic activities of daily living (ADL). To test the relevance of this indicator, we estimated the 4-year mortality risk associated with each stage of the indicator. RESULTS in total, 34.0% were Robust (n = 612), 29.9% were Pre-frail (n = 538), 3.2% were Robust with IADL-disability (n = 58), 4.6% had pure Frailty (no disability) (n = 82), 11.9% were Pre-frail + IADL (n = 215), 8.6% were Frail + IADL (n = 154) and 7.8% Frail + IADL + ADL (n = 141). After grouping grades with similar mortality risks, we obtained a five-grade hierarchical indicator ranging from robustness to severe stage of the continuum. Each state presented a gradually increasing risk of dying compared to the robust group (from Hazard Ratio (HR) = 2.20 [1.49-3.25] to 15.10 [9.99-22.82]). CONCLUSIONS We confirmed that combining pre-frailty, frailty, IADL- and ADL-disability into a single indicator may improve our understanding of the aging process. Pre-frailty identified as the 'entry door' into the process may represent a key stage that could offer new opportunities for early, targeted, individualized and tailored interventions and care in clinical geriatrics.
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Affiliation(s)
| | - José Alberto Avila-Funes
- Inserm, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Maturin Tabue-Teguo
- Inserm, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
- CHU de Pointe-à-Pitre (Guadeloupe), Equipe LAMIA, Université des Antilles (Guadeloupe), Pointe-à-Pitre, France
| | - Jean-François Dartigues
- Inserm, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
| | - Hélène Amieva
- Inserm, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
| | - Karine Pérès
- Inserm, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
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15
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Saulnier T, Philipps V, Meissner WG, Rascol O, Traon APL, Foubert-Samier A, Proust-Lima C. Joint models for the longitudinal analysis of measurement scales in the presence of informative dropout. Methods 2022; 203:142-151. [DOI: 10.1016/j.ymeth.2022.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 11/29/2022] Open
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16
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Schüttengruber G, Halfens RJG, Lohrmann C. Care dependency of patients and residents at the end of life: A secondary data analysis of data from a cross-sectional study in hospitals and geriatric institutions. J Clin Nurs 2022; 31:657-668. [PMID: 34151486 PMCID: PMC9291881 DOI: 10.1111/jocn.15925] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 05/03/2021] [Accepted: 06/01/2021] [Indexed: 12/11/2022]
Abstract
AIMS AND OBJECTIVES The holistic care dependency concept can be applied to gain comprehensive insights into individuals' care needs in the end-of-life (EoL) phase. This study was carried out to measure and characterise the "care dependency" phenomenon in this phase and to obtain deeper knowledge about this phenomenon. BACKGROUND The end of a human life is often characterised by a physical decline, often implying that a high amount of care is needed. Non-malignant diseases can develop unpredictably; therefore, it is difficult to detect the onset of the EoL phase. DESIGN Data were collected in a cross-sectional multicentre study, using the Austrian Nursing Quality Measurement 2.0. METHODS Descriptive and multivariate statistical methods were used. Care dependency was measured with the Care Dependency Scale (CDS). The study follows the STROBE guideline. RESULTS Ten per cent (n = 389) of the sample (N = 3589) were allocated to "a pathway for management of patients at the end of life." The patients and residents in the EoL phase are significantly older and more often diagnosed with dementia, and circulatory system and musculoskeletal system diseases. Of these patients, 60% were care dependent completely or to a great extent. Dementia and age represent main influencing factors that affect the degree of care dependency at the end of life. CONCLUSION Our results show that the "typical" EoL patient or resident is female, old and affected by dementia and/or circulatory system diseases. Dementia and age were identified as main factors that contribute to very high care dependency. RELEVANCE TO CLINICAL PRACTICE The measurement of care dependency may support the identification of special care needs in the EoL phase. Gaining deeper knowledge about the care dependency phenomenon can also help healthcare staff better understand the needs of patients with non-malignant conditions in their last phase of life.
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Affiliation(s)
| | | | - Christa Lohrmann
- Institute of Nursing ScienceMedical University of GrazGrazAustria
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17
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The association of socio-economic and psychological factors with limitations in day-to-day activity over 7 years in newly diagnosed osteoarthritis patients. Sci Rep 2022; 12:943. [PMID: 35042904 PMCID: PMC8766461 DOI: 10.1038/s41598-022-04781-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/29/2021] [Indexed: 12/20/2022] Open
Abstract
Previous research has established links between chronic pain and impaired cognitive ability, as well as between chronic pain and anxiety, in osteoarthritis. Furthermore, there is evidence linking risk of osteoarthritis to lower educational attainment. However, the inter-play of these factors with key social factors (e.g., social deprivation) at the early stages of osteoarthritis are not understood. Here, we used data from waves 4, 5, 6 and 7 of the Survey of Health, Ageing and Retirement in Europe (SHARE) (n = 971) and selected a subsample of respondents who initially did not report a diagnosis of osteoarthritis until wave 6. We used path models to test how social deprivation, education and anxiety, before diagnosis (waves 4 and 5), affect the relationship between cognitive ability, pain and limitations in activities of daily living following diagnosis (waves 6 and 7). We show that high social deprivation before diagnosis predicts greater limitations in activities of daily living after diagnosis, with this effect partly mediated by impaired cognitive ability. We also find that higher educational attainment before diagnosis may protect against limitations in activities of daily living after diagnosis via better cognitive ability and lower anxiety. Therefore, improving cognitive ability and managing anxiety may mitigate the associations of social deprivation and low educational attainment with limitations in activities of daily living.
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Proust-Lima C, Philipps V, Perrot B, Blanchin M, Sébille V. Modeling repeated self-reported outcome data: a continuous-time longitudinal Item Response Theory model. Methods 2022; 204:386-395. [PMID: 35041926 DOI: 10.1016/j.ymeth.2022.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/03/2022] [Accepted: 01/10/2022] [Indexed: 12/28/2022] Open
Abstract
Item Response Theory (IRT) models have received growing interest in health science for analyzing latent constructs such as depression, anxiety, quality of life or cognitive functioning from the information provided by each individual's items responses. However, in the presence of repeated item measures, IRT methods usually assume that the measurement occasions are made at the exact same time for all patients. In this paper, we show how the IRT methodology can be combined with the mixed model theory to provide a longitudinal IRT model which exploits the information of a measurement scale provided at the item level while simultaneously handling observation times that may vary across individuals and items. The latent construct is a latent process defined in continuous time that is linked to the observed item responses through a measurement model at each individual- and occasion-specific observation time; we focus here on a Graded Response Model for binary and ordinal items. The Maximum Likelihood Estimation procedure of the model is available in the R package lcmm. The proposed approach is contextualized in a clinical example in end-stage renal disease, the PREDIALA study. The objective is to study the trajectories of depressive symptomatology (as measured by 7 items of the Hospital Anxiety and Depression scale) according to the time from registration on the renal transplant waiting list and the renal replacement therapy. We also illustrate how the method can be used to assess Differential Item Functioning and lack of measurement invariance over time.
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Affiliation(s)
- Cécile Proust-Lima
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR1219, F-33000 Bordeaux, France.
| | - Viviane Philipps
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR1219, F-33000 Bordeaux, France
| | - Bastien Perrot
- Université de Nantes, Université de Tours, INSERM, SPHERE U1246, Nantes, France; Methodology and Biostatistics Unit, CHU Nantes, Nantes, France
| | - Myriam Blanchin
- Université de Nantes, Université de Tours, INSERM, SPHERE U1246, Nantes, France
| | - Véronique Sébille
- Université de Nantes, Université de Tours, INSERM, SPHERE U1246, Nantes, France; Methodology and Biostatistics Unit, CHU Nantes, Nantes, France
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Costenoble A, Rossi G, Knoop V, Debain A, Smeys C, Bautmans I, Verté D, De Vriendt P, Gorus E. Does psychological resilience mediate the relation between daily functioning and prefrailty status? Int Psychogeriatr 2021; 34:1-10. [PMID: 34629136 DOI: 10.1017/s1041610221001058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Understanding of prefrailty's relationship with limitations in activities of daily living (ADLs) moderated by psychological resilience is needed, as resilience might support ADLs' maintenance and thus protect against frailty. Therefore, this study aims to analyze the influence of psychological resilience (using the Connor-Davidson Resilience Scale; CD-RISC) on the relation between ADLs and frailty status of older individuals (i.e. prefrail versus robust). DESIGN Cross-sectional design. SETTING UZ Brussels, Belgium. PARTICIPANTS Robust (Fried 0/4;n = 214; Age = 82.3 ± 2.1yrs) and prefrail (Fried 1-2/4; n = 191; Age = 83.8 ±3.2yrs) community-dwelling older individuals were included. MEASUREMENTS Frailty scores were obtained from weight loss, exhaustion, gait speed, and grip strength. A total Disability Index (DI) expressed dependency for basic (b-), instrumental (i-), and advanced (a-)ADLs. Mediation was investigated by estimating direct and indirect effects of all levels of ADLs and CD-RISC total score on prefrailty/robustness using a stepwise multiple regression approach. RESULTS Prefrailty/robustness significantly correlated with a-ADL-DI (point-biserial correlation (rpb) = 0.098; p<0.05). Adjusted for age and gender, the a-ADL-DI (p<0.05) had a significant protective direct effect against prefrailty. No effects were found with the CD-RISC total score. CONCLUSIONS Less limitation in a-ADLs is a directly correlated factor of prefrailty and might represent a higher likelihood of robustness.
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Affiliation(s)
- Axelle Costenoble
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
| | - Gina Rossi
- Personality and Psychopathology Research Group, Faculty of Psychology and Educational Sciences, VUB, Brussels, Belgium
| | - Veerle Knoop
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
| | - Aziz Debain
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
- Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090Brussels, Belgium
| | - Celeste Smeys
- Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090Brussels, Belgium
| | - Ivan Bautmans
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
- Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090Brussels, Belgium
| | - Dominique Verté
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Belgian Ageing Studies Research Group, VUB, Brussels, Belgium
| | - Patricia De Vriendt
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
- Arteveldehogeschool, Ghent, Belgium
| | - Ellen Gorus
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090Brussels, Belgium
- Gerontology Department, VUB, Laarbeeklaan 103, B-1090Brussels, Belgium
- Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090Brussels, Belgium
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20
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Han Y, Xue J, Pei W, Fang Y. Hierarchical structure in the activities of daily living and trajectories of disability prior to death in elderly Chinese individuals. BMC Geriatr 2021; 21:522. [PMID: 34600493 PMCID: PMC8487510 DOI: 10.1186/s12877-021-02460-y] [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: 06/01/2021] [Accepted: 09/10/2021] [Indexed: 11/29/2022] Open
Abstract
Background The global burden of disability continues to increase. Understanding the hierarchical structure of activities of daily living (ADL) and the trajectories of disability of elderly individuals is pivotal to developing early interventions. Purpose To determine the hierarchical structure of the ability of Chinese elderly individuals to perform ADL and further describe the trajectories of disability prior to death. Methods Longitudinal item response theory model (LIRT) was constructed for 28,345 elderly participants in the Chinese Longitudinal Healthy Longevity Survey, in which ADL were measured using the Katz scale from 1998 to 2018, until the participants’ death. Two difficulty parameters (κ−partial and κ−total) were used in the LIRT defining the thresholds for hierarchical structure in ADL (κ−partial: no limitation to partial limitation, κ−total: partial limitation to totally limited). Disability values estimated from the LIRT were fitted to a mixed-effects model to examine the manner in which the trajectories of disability varied with different subject characteristics. Results The findings confirmed the earliest loss in the capability to perform ADL (bathing(κ-partial = − 1.396), toileting(κ-partial = − 0.904)) at the level of partial limitation, with an overlap of partial and totally limited (total bathing, partial dressing, partial transferring, total dressing, partial feeding, partial continence), and finally a total loss of capability for toileting, feeding, transferring, and continence (κ-total = 3.647). Disability trajectories varied with sex (β = 0.041, SE = 0.001), place of residence (β = 0.010, SE = 0.001), and marital status (β = 0.144, SE = 0.001). Females, individuals living in urban areas, and those who lived without a spouse had a poorer disability status. Conclusion The loss in the ability to perform ADL has a hierarchical structure. Subject characteristics affect trajectories of disability in the elderly Chinese population. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02460-y.
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Affiliation(s)
- Yaofeng Han
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China.,Center for Aging and Health Research School of Public Health, Xiamen University, Xiamen, China
| | - Jihui Xue
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Wei Pei
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Ya Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China.
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21
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Carles S, Taddé BO, Berr C, Helmer C, Jacqmin-Gadda H, Carrière I, Proust-Lima C. Dynamic reciprocal relationships between cognitive and functional declines along the Alzheimer's disease continuum in the prospective COGICARE study. Alzheimers Res Ther 2021; 13:148. [PMID: 34479648 PMCID: PMC8418020 DOI: 10.1186/s13195-021-00887-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 08/09/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Thoroughly understanding the temporal associations between cognitive and functional dimensions along the dementia process is fundamental to define preventive measures likely to delay the disease's onset. This work aimed to finely describe the trajectories of cognitive and functional declines, and assess their dynamic bidirectional relationships among subjects at different stages of the dementia process. METHODS We leveraged extensive repeated data of cognition and functional dependency from the French prospective COGICARE study, designed to better characterize the natural history of cognitive and functional declines around dementia diagnosis. Cognition was measured by the Mini-Mental State Examination, the Isaacs Set Test for verbal fluency, the Benton Visual Retention Test for visuo-spatial memory, and Trail Making Test Part B for executive functioning. Functional dependency was measured by basic and instrumental activities of daily living. The study included 102 cognitively normal, 123 mildly cognitively impaired, and 72 dementia cases with a median of 5 repeated visits over up to 57 months. We used a dynamic causal model which addresses the two essential issues in temporal associations assessment: focusing on intra-individual change and accounting for time. RESULTS Better cognitive abilities were associated with lower subsequent decline of the functional level among the three clinical stages with an intensification over time but no reciprocity of the association whatever the clinical status. CONCLUSION This work confirms that the progressive functional dependency could be induced by cognitive impairment. Subjects identified as early as possible with clinically significant cognitive impairments could benefit from preventive measures before the deterioration of activities of daily living and the appearance of dementia clinical signs.
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Affiliation(s)
- Sophie Carles
- Institute for Neurosciences of Montpellier INM, Univ. Montpellier, INSERM, F-34091, Montpellier, France
| | | | - Claudine Berr
- Institute for Neurosciences of Montpellier INM, Univ. Montpellier, INSERM, F-34091, Montpellier, France
| | | | | | - Isabelle Carrière
- Institute for Neurosciences of Montpellier INM, Univ. Montpellier, INSERM, F-34091, Montpellier, France
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Shim Y, Choe K, Kim KS, Kim JS, Ha J. The applicability of the interpersonal-psychological theory of suicide among community-dwelling older persons. Suicide Life Threat Behav 2021; 51:816-823. [PMID: 33870547 DOI: 10.1111/sltb.12757] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 07/03/2020] [Accepted: 03/05/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study examined the application of the interpersonal-psychological theory of suicide to community-dwelling older persons in South Korea. METHODS A cross-sectional study design was used. The data were collected by surveying 200 older persons (117 female, 83 male) aged over 65 years at welfare centers for older persons. The Interpersonal Needs Questionnaire, the Suicidal Ideation Scale, and the Acquired Capability for Suicide Scale were used to assess participants' thwarted belongingness, perceived burdensomeness, suicidal ideation, attempts, and the capability for suicide. Structural equation modeling was used to examine the fitness of a model based on the interpersonal-psychological theory of suicide. This theory described that perceived burdensomeness and thwarted belongingness lead to suicidal ideation, which is transformed into suicide attempts through an acquired capability for suicide. RESULTS Perceived burdensomeness was significantly associated with suicidal ideation among older persons, whereas thwarted belongingness was not. Furthermore, suicidal ideation influenced suicide attempts. The acquired capability for suicide moderated the relationship between suicidal ideation and suicide attempts. CONCLUSIONS To prevent suicidal ideation and suicide attempts among older persons, it is important to prevent them from feeling that they are a burden.
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Affiliation(s)
- Yuhwa Shim
- Department of Nursing, Chung-Ang University, Seoul, Korea
| | - Kwisoon Choe
- Department of Nursing, Chung-Ang University, Seoul, Korea
| | - Ki-Sook Kim
- Department of Nursing, Chung-Ang University, Seoul, Korea
| | - Ji-Su Kim
- Department of Nursing, Chung-Ang University, Seoul, Korea
| | - Jeongmin Ha
- Department of Nursing, Chung-Ang University, Seoul, Korea
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Nanjo K, Ikeda T, Nagashio N, Masuda T, Sakai T, Okawa A, Jinno T. Gait speed and pain status as discriminatory factors for instrumental activities of daily living disability in older adults with knee osteoarthritis. Geriatr Gerontol Int 2021; 21:683-688. [PMID: 34219332 DOI: 10.1111/ggi.14229] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/31/2021] [Accepted: 06/16/2021] [Indexed: 11/28/2022]
Abstract
AIM Factors related to instrumental activities of daily living disability in older adults with knee osteoarthritis are unclear. This study aimed to examine the discriminatory accuracy for the presence of instrumental activities of daily living disability in older adults with knee osteoarthritis by combining two factors of gait ability and pain status. METHODS A cross-sectional study was conducted on 114 patients with knee osteoarthritis aged ≥ 65 years. Participants were divided into instrumental activities of daily living disabled or non-disabled groups. A logistic regression model was created with usual gait speed and knee injury and osteoarthritis outcome score-pain subscale as independent variables for discriminating the presence of instrumental activities of daily living disability. The area under the receiver operating characteristic curve was inspected to determine discriminatory accuracy of the logistic regression model, usual gait speed, knee injury and osteoarthritis outcome score-pain subscale. RESULTS Of the 114 patients, 26 (22.8%) had instrumental activities of daily living disability. The area under the curves was 0.91 (95% confidence interval: 0.85-0.96) for the logistic regression model, 0.78 (95% confidence interval: 0.68-0.89) for usual gait speed, and 0.73 (95% confidence interval: 0.61-0.84) for knee injury and osteoarthritis outcome score-pain subscale. CONCLUSIONS This study showed that gait speed and pain status were independent discriminatory factors and combining these factors to discriminate more accurately the presence or absence of instrumental activities of daily living disability in older adults with knee osteoarthritis was important. Geriatr Gerontol Int 2021; 21: 683-688.
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Affiliation(s)
- Keigo Nanjo
- Department of Rehabilitation Medicine, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.,Department of Rehabilitation, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Takashi Ikeda
- Department of Rehabilitation Medicine, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.,School of Nursing and Rehabilitation Sciences, Showa University, Yokohama, Japan.,Research Institute for Sport and Exercise Sciences, Showa University, Yokohama, Japan
| | - Naoko Nagashio
- Department of Rehabilitation, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Tadashi Masuda
- Faculty of Symbiotic Systems Science, Fukushima University, Fukushima, Japan
| | - Tomoko Sakai
- Department of Rehabilitation Medicine, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Atsushi Okawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuya Jinno
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
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Echeverría A, Cauas R, Díaz B, Sáez C, Cárcamo M. Herramientas de evaluación de actividades de la vida diaria instrumentales en población adulta: revisión sistemática. REVISTA MÉDICA CLÍNICA LAS CONDES 2021. [DOI: 10.1016/j.rmclc.2021.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Madero-Cabib I, Villalobos Dintrans P, Browne Salas J. Extending the analysis of functional ability trajectories to unexplored national contexts: The case of Chile. J Gerontol B Psychol Sci Soc Sci 2021; 77:1280-1293. [PMID: 34181007 DOI: 10.1093/geronb/gbab116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Despite the enormous advances in the field, most evidence about functional ability trajectories in old age comes from studies conducted in developed and high-income countries. This research aims to build on these previous advances to examine functional ability trajectories in Chile. METHODS Drawing on a robust, publicly available 15-years panel dataset (2004-2018), and using sequence analysis, we examine functional ability trajectories types among four age groups (people aged 46-50, 51-55, 56-60, and 61-64 at baseline). Then, we analyze trajectories' dynamics looking at intra-individual health-declining and health-recovery transitions between functional ability statuses, within each trajectory type. Finally, we assess how multiple baseline individual characteristics predict the likelihood of following a functional ability trajectory type, using multinomial regression models. RESULTS Across all age groups, an important fraction (between 26%-50%) reports stable healthy trajectories, and between 10%-20% follow equivocal-declining trajectories (i.e., exhibiting both health-declining and health-recovery intra-individual transitions), suggesting that age might not be the main source of heterogeneity in functional ability trajectories. Overall, women, lower educated people, nonworking individuals, and people with a higher burden of chronic conditions at baseline, are more prevalent among health-declining trajectory types; however, these results are not constant across the age groups analyzed. DISCUSSION This nationally focused study reinforces the feasibility and usefulness of an in-depth analysis of functional ability trajectories in old age. The study findings can be crucial to define different prevention strategies according to the functional ability path that an individual might follow, especially in countries like Chile that currently navigates the challenges of population aging.
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Affiliation(s)
- Ignacio Madero-Cabib
- Instituto de Sociología & Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile.,Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Santiago, Chile
| | - Pablo Villalobos Dintrans
- Programa Centro Salud Pública, Facultad de Ciencias Médicas, Universidad de Santiago, Santiago, Chile
| | - Jorge Browne Salas
- Sección de Geriatría, División de Medicina Interna, Facultad de Medicina, Pontificia, Universidad Católica de Chile, Santiago, Chile
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Hucteau E, Noize P, Pariente A, Helmer C, Pérès K. ADL-dependent older adults were identified in medico-administrative databases. J Clin Epidemiol 2021; 139:297-306. [PMID: 34166754 DOI: 10.1016/j.jclinepi.2021.06.014] [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: 02/01/2021] [Revised: 05/31/2021] [Accepted: 06/17/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We aimed to develop an algorithm for the identification of basic Activities of Daily Living (ADL)-dependency in health insurance databases. STUDY DESIGN AND SETTING We used the AMI (Aging Multidisciplinary Investigation) population-based cohort including both individual face-to-face assessment of ADL-dependency and merged health insurance data. The health insurance factors associated with ADL-dependency were identified using a LASSO logistic regression model in 1000 bootstrap samples. An external validation on a 1/97 representative sample of the French Health Insurance general population of Affiliates has been performed. RESULTS Among 995 participants of the AMI cohort aged ≥ 65y, 114 (11.5%) were ADL-dependent according to neuropsychologists individual assessments. The final algorithm developed included: age, sex, four drug classes (dopaminergic antiparkinson drugs, antidepressants, antidiabetic agents, lipid modifying agents), three type of medical devices (medical bed, patient lifter, incontinence equipment), four medical acts (GP's consultations at home, daily and non-daily nursing at home, transport by ambulance) and four long-term diseases (stroke, heart failure, coronary heart disease, Alzheimer and other dementia). Applying this algorithm, the estimated prevalence of ADL-dependency was 12.3% in AMI and 9.5% in the validation sample. CONCLUSION This study proposes a useful algorithm to identify ADL-dependency in the health insurance data.
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Affiliation(s)
- Emilie Hucteau
- Univ. Bordeaux, Inserm UMR 1219, Bordeaux Population Health Research Center, team Lifelong Exposure, Health and Aging, Bordeaux, France; DRUGS-SAFE National Platform of Pharmacoepidemiology, Bordeaux, France.
| | - Pernelle Noize
- DRUGS-SAFE National Platform of Pharmacoepidemiology, Bordeaux, France; Univ. Bordeaux, Inserm UMR 1219, Bordeaux Population Health Research Center, team Pharmacoepidemiology, Bordeaux, France; Bordeaux University Hospital, Public Health department, Medical pharmacoepidemiology, Bordeaux, France
| | - Antoine Pariente
- DRUGS-SAFE National Platform of Pharmacoepidemiology, Bordeaux, France; Univ. Bordeaux, Inserm UMR 1219, Bordeaux Population Health Research Center, team Pharmacoepidemiology, Bordeaux, France; Bordeaux University Hospital, Public Health department, Medical pharmacoepidemiology, Bordeaux, France
| | - Catherine Helmer
- Univ. Bordeaux, Inserm UMR 1219, Bordeaux Population Health Research Center, team Lifelong Exposure, Health and Aging, Bordeaux, France; DRUGS-SAFE National Platform of Pharmacoepidemiology, Bordeaux, France
| | - Karine Pérès
- DRUGS-SAFE National Platform of Pharmacoepidemiology, Bordeaux, France; Univ. Bordeaux, Inserm UMR 1219, Bordeaux Population Health Research Center, team Psychoepidemiology of aging and chronic diseases, France
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Marroig A, Machado M, Muniz-Terrera G. Dependency Change with Aging and Associated Factors in Uruguay: A Cohort Study. J Aging Health 2021; 33:886-895. [PMID: 33966467 DOI: 10.1177/08982643211017726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To assess the heterogeneity of transitions toward dependency in older adults and to explore the robustness of results to different operationalizations of dependency. METHOD Using data from people aged 60 years and older from a national representative study in Uruguay (Encuesta Longitudinal de Protección Social, N = 5071), we fitted multinomial regressions adjusted by sociodemographic and health characteristics to model transitions into dependency and death. We used a harder operationalization with basic activities of daily living (Katz-dependency) and Comprehensive-dependency with basic, instrumental, and advanced activities. RESULTS Increasing age (RRR = 1.08, CI = [1.05; 1.12], p < .001) and having comorbidities (RRR = 2.16, CI = [1.31; 3.57], p = .003) increased the risk of transition from nondependent to dependent using Katz-dependency. Women with at least two chronic conditions have increased risk of Comprehensive-dependency (RRR = 1.79, CI = [1.15; 2.80], p = .010). DISCUSSION Inconsistencies in findings emerged when evaluating transitions into dependency with the different measures, which may have social care implications.
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Cui P, Chen Y, Li Y, Wali N, Li Y. The role of social support in the association between dependency and important risk factors among the elderly. Psychogeriatrics 2021; 21:317-323. [PMID: 33749093 DOI: 10.1111/psyg.12671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/14/2020] [Accepted: 02/08/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study aimed to assess the association between social resources and dependency, and explored the effect of social support in modifying important risk factors for dependency among the elderly. METHODS This was a population-based cross-sectional study. A total of 950 participants aged ≥60 years were selected using a complex multistage sampling design from 22 locations in China. All data were collected using questionnaires by face-to-face interviews. Dependency was assessed using the Minnesota Multiphasic Personality Inventory-II, and social resource status with the Chinese version of the Older American Resources and Services (OARS) questionnaire. Logistic regression analysis was used to evaluate the association between dependency and social resources. Analysis of covariance was performed to evaluate the effect of social support on modifications of important risk factors for dependency. RESULTS A total of 913 participants were included in the analysis, and 10.3% of the males and 14.4% of the females were identified as in dependency. The results of logistic regression analysis showed a significant negative association between the levels of social resources and dependency. The odds ratio was 0.78 (95% confidence interval, 0.73-0.84) after adjusting for important confounding factors. The results of analysis of covariance showed differences in the mean dependency scores between different groups defined by chronic disease status and social support level. CONCLUSIONS Levels of social resources were negatively associated with dependency. Our results suggest that social support has both a direct effect on dependency and an indirect effect through modifying chronic disease status and individual income.
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Affiliation(s)
- PingYu Cui
- Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, China
| | - Yuan Chen
- Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, China
| | - YaXing Li
- Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, China
| | - Nuremaguli Wali
- Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, China
| | - Ying Li
- Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, China
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Pérès K, Zamudio-Rodriguez A, Dartigues JF, Amieva H, Lafitte S. Prospective pragmatic quasi-experimental study to assess the impact and effectiveness of an innovative large-scale public health intervention to foster healthy ageing in place: the SoBeezy program protocol. BMJ Open 2021; 11:e043082. [PMID: 33926977 PMCID: PMC8094369 DOI: 10.1136/bmjopen-2020-043082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION With the accelerating pace of ageing, healthy ageing has become a major challenge for all societies worldwide. Based on that Healthy Ageing concept proposed by the WHO, the SoBeezy intervention has been designed through an older person-centred and integrated approach. The programme creates the environments that maximise functional ability to enable people to be and do what they value and to stay at home in best possible conditions. METHODS AND ANALYSIS Five levers are targeted: tackling loneliness, restoring feeling of usefulness, finding solutions to face material daily life difficulties, promoting social participation and combating digital divide. Concretely, the SoBeezy programme relies on: (1) a digital intelligent platform available on smartphone, tablet and computer, but also on a voice assistant specifically developed for people with digital divide; (2) a large solidarity network which potentially relies on everyone's engagement through a participatory intergenerational approach, where the older persons themselves are not only service receivers but also potential contributors; (3) an engagement of local partners and stakeholders (citizens, associations, artisans and professionals). Organised as a hub, the system connects all the resources of a territory and provides to the older person the best solution to meet his demand. Through a mixed, qualitative and quantitative (before/after analyses and compared to controls) approach, the research programme will assess the impact and effectiveness on healthy ageing, the technical usage, the mechanisms of the intervention and conditions of transferability and scalability. ETHICS AND DISSEMINATION Inserm Ethics Committee and the Comité Éthique et Scientifique pour les Recherches, les Études et les Évaluations dans le domaine de la Santé approved this research and collected data will be deposited with a suitable data archive.
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Affiliation(s)
- Karine Pérès
- Univ. Bordeaux, INSERM, Bordeaux Population Health, U1219, Bordeaux, France
| | | | | | - Hélène Amieva
- Univ. Bordeaux, INSERM, Bordeaux Population Health, U1219, Bordeaux, France
| | - Stephane Lafitte
- University Hospital Centre Bordeaux Cardiology Hospital Anaesthesiology and Reanimation, Pessac, Nouvelle-Aquitaine, France
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Edjolo A, Dartigues JF, Pérès K, Proust-Lima C. Heterogeneous Long-Term Trajectories of Dependency in Older Adults: The PAQUID Cohort, a Population-Based Study over 22 years. J Gerontol A Biol Sci Med Sci 2021; 75:2396-2403. [PMID: 32115657 DOI: 10.1093/gerona/glaa057] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A critical step toward successful aging is to identify opportunities for prevention of functional decline. Our aim was to describe the heterogeneity in trajectories of dependency preceding death in elders and to identify factors associated with this heterogeneity. METHODS The study relied on 3,238 participants of the prospective population-based PAQUID cohort aged 65+ at baseline in 1988. Dependency was defined from an 11-item scale of basic and instrumental activities of daily living (ADL: bathing, dressing, toileting, continence, eating, and transferring; instrumental activities of daily living (IADL): telephoning, shopping, using transport, handling medication, and managing finances) collected over 22 years. Heterogeneous trajectories were estimated using a longitudinal item response theory model including latent classes. RESULTS Five distinct profiles of functional dependency were identified over the two last decades of life: persistently high (12%), moderate (26%), persistently low (40%), and accelerated high dependency (15%), and no dependency (8%). Main factors associated with heterogeneity included age at death, sex, education, initial cognition (Mini-Mental State Examination [MMSE] score and dementia), initial disability, and poly-medication. CONCLUSIONS In the two last decades of life, more than 9 elders in 10 were characterized as functional decliners. On average, around half of the elders died with no or mild dependency, while 27% live several years with a high level of limitations and would need assistance in activities of daily living, at least for 2-4 years preceding death. The identified factors associated with these trajectories are important to understand functional heterogeneity in elders and to propose interventions to postpone or prevent "chronic" disability.
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Affiliation(s)
- Arlette Edjolo
- Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR, France
| | | | - Karine Pérès
- Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR, France
| | - Cécile Proust-Lima
- Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR, France
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Feger DM, Willis SL, Thomas KR, Marsiske M, Rebok GW, Felix C, Gross AL. Incident Instrumental Activities of Daily Living Difficulty in Older Adults: Which Comes First? Findings From the Advanced Cognitive Training for Independent and Vital Elderly Study. Front Neurol 2020; 11:550577. [PMID: 33192982 PMCID: PMC7642324 DOI: 10.3389/fneur.2020.550577] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 09/09/2020] [Indexed: 01/19/2023] Open
Abstract
Introduction: Instrumental activities of daily living (IADLs) are complex daily tasks important for independent living. Many older adults experience difficulty with IADLs as their physical and/or cognitive function begins to decline. However, it is unknown in what order IADLs become difficult. Methods: Participants from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study who were free of IADL difficulty at baseline (N = 1,277) were followed up to 10 years until first reported IADL difficulty. A total of 19 IADL tasks were grouped into seven task categories. A discrete-time multiple-event process survival mixture model (MEPSUM) was used to generate hazard estimates of incident IADL difficulty in seven groups from ages 65 to 80. Hazard estimates were compared in the three intervention groups (memory, inductive reasoning, and speed of information processing) vs. the no-contact control group. Results: A total of 887 (69.5%) participants reported incident difficulty in at least one IADL task category. Compared to individuals who remained free of IADL difficulty, those who reported incident difficulty were more likely to be older, female, and have lower Short Form 36 general health scores. The IADL task categories to first become difficult were housework, managing health care, and phone use. There were no differences by intervention group in the hazard estimates of incident IADL difficulty. Conclusion: Managing health care and phone use are more cognitively demanding IADLs, and individuals who experience difficulty in these tasks first may be more likely to experience cognitive decline. Recognizing early difficulty in managing health care may allow for implementation of compensation strategies to minimize unintentional medication misuse, increased adverse medical events, and unnecessary hospitalization. Training of a specific cognitive domain may not influence ordering of IADL difficulty because IADL tasks require proficiency in, and integration of, multiple cognitive domains.
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Affiliation(s)
- Danielle M Feger
- Center on Aging and Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Sherry L Willis
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
| | - Kelsey R Thomas
- Veterans Affairs San Diego Healthcare System, San Diego, CA, United States.,Department of Psychiatry, University of California San Diego School of Health Sciences, La Jolla, CA, United States
| | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, FL, United States
| | - George W Rebok
- Center on Aging and Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Cynthia Felix
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States
| | - Alden L Gross
- Center on Aging and Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
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Zamudio-Rodríguez A, Letenneur L, Féart C, Avila-Funes JA, Amieva H, Pérès K. The disability process: is there a place for frailty? Age Ageing 2020; 49:764-770. [PMID: 32365166 DOI: 10.1093/ageing/afaa031] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/21/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND frailty and disability are very common in older adults; they share some risk factors and pathophysiological mechanisms. Yet, they are different clinical entities. OBJECTIVES this study aimed to explore a potential hierarchical relationship between frailty and disability along the continuum of the disablement process. DESIGN prospective cohort study. SETTING the French Three-City (3C) study. SUBJECTS the sample included 943 participants aged 75 and older. METHODS the Fried frailty phenotype, Instrumental Activities of Daily Living (IADL) and basic Activities of Daily Living (ADL) were used. We distinguished between four mutually excluding groups: (i) robust (no frailty and no disability); (ii) pure frailty (no disability); (iii) frailty with IADL disability (no ADL disability) and (iv) frailty with IADL and ADL disabilities. We used Cox's regression models to study the 4-year mortality risk associated with each status. RESULTS Eight-two per cent of participants were classified according to the assumed hierarchy: 61.3% was robust, 5.4% frail, 10.5% frail and IADL-disabled and 4.8% frail, IADL and ADL-disabled. An extra group of 17% was identified with IADL-disabled individuals without frailty. This extra group was similar to pure frailty in terms of characteristics and risk of death, placing them along the continuum at an intermediate stage between robustness and the two most disabled sub-groups. CONCLUSIONS our findings suggest that including frailty along the continuum could be relevant to describe the whole disablement process. Frailty would occur upstream of the process and might be relevant to identify an opportune time window, where specific monitoring and clinical interventions could be implemented in order to interrupt the process at a potentially more reversible stage.
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Affiliation(s)
- Alfonso Zamudio-Rodríguez
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Luc Letenneur
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Catherine Féart
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - José Alberto Avila-Funes
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Hélène Amieva
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Karine Pérès
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
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Shin JH, Shin IS. Investigation of Longitudinal Data Analysis: Hierarchical Linear Model and Latent Growth Model Using a Longitudinal Nursing Home Dataset. Res Gerontol Nurs 2020; 12:275-283. [PMID: 31755964 DOI: 10.3928/19404921-20191024-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 06/19/2019] [Indexed: 01/11/2023]
Abstract
The appropriate use of the data analysis method in a longitudinal design remains controversial in gerontological nursing research. The objective of the current study is to compare statistical approaches between a hierarchical-linear model (HLM) and a latent-growth model (LGM) in random effects, variance explained, growth trajectory, and model fitness. Secondary analysis of longitudinal data was used. Two variables were chosen to demonstrate the comparison between statistical methods. The HLM was superior in addressing unbalanced data in repeated-measures analysis of variance (ANOVA) and multivariate ANOVA because its nested data structure and random effects could be estimated. The LGM had advantages in modeling growth trajectories and model-fit comparisons. Superior to the HLM, the LGM reported more acceptable data fit, reporting a quadratic model, and successfully differentiated between and within components. The current research provides some evidence for applying appropriate statistical methods when addressing longitudinal datasets in gerontological nursing research. [Research in Gerontological Nursing, 12(6), 275-283.].
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Soriano G, De Souto Barreto P, Virecoulon Giudici K, Cantet C, Guyonnet S, Vellas B, Rolland Y, Andrieu S. Meal-related difficulties and weight loss in older people: Longitudinal data from MAPT study. Clin Nutr 2020; 39:3483-3488. [PMID: 32241710 DOI: 10.1016/j.clnu.2020.03.011] [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: 11/22/2018] [Revised: 02/08/2020] [Accepted: 03/08/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Difficulties with meal-related activities (preparing meals and food shopping) may influence food intake, and contribute to nutritional risk among elderly people. All known studies on this topic had a cross-sectional design, thereby no causal relationships could be derived. We aim to investigate if difficulties with meal-related activities can contribute to subsequent weight loss in community-dwelling older people. METHODS We used data of older subjects from the MAPT Study (n = 1531, median age = 74 years, 64% women), who provided prospective data on weight every 6 months and cognitive, physical condition, and functional capacities every year during a 3-year period. Difficulties preparing meals and shopping were evaluated each year with the Alzheimer's Disease Cooperative Study-Activities of Daily Living Prevention Instrument (ADCS ADL-PI) Scale. The risk of losing weight (≥5% or ≥ 3 kg in the following year) was estimated using a time-dependent Cox regression model. RESULTS During the 3-year follow-up, a total of 851 subjects experienced at least a 5% or 3 kg weight loss. Two hundred thirty-seven subjects declared having difficulties with meal preparation at least once, and 133 declared having difficulties shopping. Subjects reporting any meal-related difficulties were older (p < 0.001), had more depressive symptoms (p < 0.001), and a lower physical function (p < 0.001) compared to those without difficulties. They also had a lower cognitive score (preparing meals: p < 0.001; shopping: p = 0.005) and a lower body mass index (preparing meals: p = 0.005; shopping: p = 0.023) at the end of the study. Meal-related activities were not associated with weight loss in unadjusted analysis and after adjustment for sex, age, depression, physical and cognitive status. CONCLUSION Difficulties preparing meals and shopping had no effect on weight loss in community-dwelling older people, despite their association with advanced age, functional decline, and depressive symptoms.
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Affiliation(s)
- Gaëlle Soriano
- INSERM UMR1027, Université de Toulouse, Université de Toulouse III Paul Sabatier, Institut Du Vieillissement, 37 Allées Jules Guesde, Toulouse Cedex 9, 31062, Toulouse, France; Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Cité de La Santé, 20 Rue Du Pont Saint Pierre, TSA 60033, Toulouse Cedex 9, 31059, Toulouse, France.
| | - Philippe De Souto Barreto
- INSERM UMR1027, Université de Toulouse, Université de Toulouse III Paul Sabatier, Institut Du Vieillissement, 37 Allées Jules Guesde, Toulouse Cedex 9, 31062, Toulouse, France; Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Cité de La Santé, 20 Rue Du Pont Saint Pierre, TSA 60033, Toulouse Cedex 9, 31059, Toulouse, France.
| | - Kelly Virecoulon Giudici
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Institut Du Vieillissement, 37 Allées Jules Guesde, Toulouse Cedex 9, 31062, Toulouse, France.
| | - Christelle Cantet
- Inserm UMR 1027, Université de Toulouse III Paul Sabatier, Faculté de Médecine Toulouse Purpan, 37 Allées Jules Guesde, Toulouse Cedex 9, 31 000, Toulouse, France.
| | - Sophie Guyonnet
- INSERM UMR1027, Université de Toulouse, Université de Toulouse III Paul Sabatier, Institut Du Vieillissement, 37 Allées Jules Guesde, Toulouse Cedex 9, 31062, Toulouse, France; Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Cité de La Santé, 20 Rue Du Pont Saint Pierre, TSA 60033, Toulouse Cedex 9, 31059, Toulouse, France.
| | - Bruno Vellas
- INSERM UMR1027, Université de Toulouse, Université de Toulouse III Paul Sabatier, Institut Du Vieillissement, 37 Allées Jules Guesde, Toulouse Cedex 9, 31062, Toulouse, France; Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Cité de La Santé, 20 Rue Du Pont Saint Pierre, TSA 60033, Toulouse Cedex 9, 31059, Toulouse, France.
| | - Yves Rolland
- INSERM UMR1027, Université de Toulouse, Université de Toulouse III Paul Sabatier, Institut Du Vieillissement, 37 Allées Jules Guesde, Toulouse Cedex 9, 31062, Toulouse, France; Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Cité de La Santé, 20 Rue Du Pont Saint Pierre, TSA 60033, Toulouse Cedex 9, 31059, Toulouse, France.
| | - Sandrine Andrieu
- Inserm UMR 1027, Université de Toulouse III Paul Sabatier, Faculté de Médecine Toulouse Purpan, 37 Allées Jules Guesde, Toulouse Cedex 9, 31 000, Toulouse, France; Unité de Soutien Méthodologique à La Recherche CHU de Toulouse, Faculté de Médecine Toulouse Purpan, 37 Allées Jules Guesde, Toulouse Cedex 9, 31 000 Toulouse, France.
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Edjolo A, Pérès K, Guerchet M, Pilleron S, Ndamba-Bandzouzi B, Mbelesso P, Clément JP, Dartigues JF, Preux PM. Development of the Central Africa Daily Functioning Interference Scale for Dementia Diagnosis in Older Adults: The EPIDEMCA Study. Dement Geriatr Cogn Disord 2019; 47:29-41. [PMID: 30630171 DOI: 10.1159/000492782] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 08/08/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND There are a few validated tools capable of assessing the dimensions essential for the diagnosis of dementia and cognitive disorders in sub-Saharan Africa. OBJECTIVES Our aim was to develop an adapted tool, the Central African - Daily Functioning Interference (DFI) scale. METHODS An initial 16-item scale of activity limitations and participation restrictions was completed by 301 participants with low cognitive performances to assess their level of DFI. A psychometric evaluation was performed using Item Response Theory. RESULTS A unidimensional 10-item scale emerged with a reasonable coverage of DFI (thresholds range: -1.067 to 1.587) with good item discrimination properties (1.397-4.076) and a high reliability (Cronbach's al pha = 0.92). The cutoff for detecting 96% of those with dementia was with a latent score ≥0.035 that corresponds to the LAUNDRY limitation. CONCLUSIONS These results provide valuable support for the reliability and internal validity of an operational 10-item scale for DFI assessment used in Central Africa for the diagnosis of dementia in the elderly.
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Affiliation(s)
- Arlette Edjolo
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France, .,INSERM UMR 1094, Tropical Neuroepidemiology, Faculty of Medicine, Limoges, France,
| | - Karine Pérès
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Maëlenn Guerchet
- University Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France.,INSERM UMR 1094, Tropical Neuroepidemiology, Faculty of Medicine, Limoges, France.,King's College London, Centre for Global Mental Health, Institute of Psychiatry, Health Service and Population Research Department, London, United Kingdom
| | - Sophie Pilleron
- University Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France.,INSERM UMR 1094, Tropical Neuroepidemiology, Faculty of Medicine, Limoges, France
| | | | - Pascal Mbelesso
- University Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France.,INSERM UMR 1094, Tropical Neuroepidemiology, Faculty of Medicine, Limoges, France.,Department of Neurology, Brazzaville University Hospital, Brazzaville, Congo
| | - Jean-Pierre Clément
- University Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France.,INSERM UMR 1094, Tropical Neuroepidemiology, Faculty of Medicine, Limoges, France.,Hospital and University Federation of Adult and Geriatric Psychiatry, Limoges, France
| | - Jean-François Dartigues
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Pierre-Marie Preux
- University Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France.,INSERM UMR 1094, Tropical Neuroepidemiology, Faculty of Medicine, Limoges, France.,CHU, Department of Medical Information and Evaluation, Clinical Research and Biostatistics Unit, Limoges, France
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Hajduk AM, Murphy TE, Geda ME, Dodson JA, Tsang S, Haghighat L, Tinetti ME, Gill TM, Chaudhry SI. Association Between Mobility Measured During Hospitalization and Functional Outcomes in Older Adults With Acute Myocardial Infarction in the SILVER-AMI Study. JAMA Intern Med 2019; 179:1669-1677. [PMID: 31589285 PMCID: PMC6784755 DOI: 10.1001/jamainternmed.2019.4114] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 07/28/2019] [Indexed: 12/17/2022]
Abstract
Importance Many older survivors of acute myocardial infarction (AMI) experience functional decline, an outcome of primary importance to older adults. Mobility impairment has been proposed as a risk factor for functional decline but has not been evaluated to date in older patients hospitalized for AMI. Objective To examine the association of mobility impairment, measured during hospitalization, as a risk marker for functional decline among older patients with AMI. Design, Setting, and Participants Prospective cohort study among 94 academic and community hospitals in the United States. Participants were 2587 hospitalized patients with AMI who were 75 years or older. The study dates were January 2013 to June 2017. Main Outcomes and Measures Mobility was evaluated during AMI hospitalization using the Timed "Up and Go," with scores categorized as preserved mobility (≤15 seconds to complete), mild impairment (>15 to ≤25 seconds to complete), moderate impairment (>25 seconds to complete), and severe impairment (unable to complete). Self-reported function in activities of daily living (ADLs) (bathing, dressing, transferring, and walking around the home) and walking 0.4 km (one-quarter mile) was assessed at baseline and 6 months after discharge. The primary outcomes were worsening of 1 or more ADLs and loss of ability to walk 0.4 km from baseline to 6 months after discharge. The association between mobility impairment and risk of functional decline was evaluated with multivariable-adjusted logistic regression. Results Among 2587 hospitalized patients with AMI, the mean (SD) age was 81.4 (4.8) years, and 1462 (56.5%) were male. More than half of the cohort exhibited mobility impairment during AMI hospitalization (21.8% [564 of 2587] had mild impairment, 16.0% [414 of 2587] had moderate impairment, and 15.2% [391 of 2587] had severe impairment); 12.8% (332 of 2587) reported ADL decline, and 16.7% (431 of 2587) reported decline in 0.4-km mobility. Only 3.8% (30 of 800) of participants with preserved mobility experienced any ADL decline compared with 6.9% (39 of 564) of participants with mild impairment (adjusted odds ratio [aOR], 1.24; 95% CI, 0.74-2.09), 18.6% (77 of 414) of participants with moderate impairment (aOR, 2.67; 95% CI, 1.67-4.27), and 34.7% (136 of 391) of participants with severe impairment (aOR, 5.45; 95% CI, 3.29-9.01). Eleven percent (90 of 800) of participants with preserved mobility declined in ability to walk 0.4 km compared with 15.2% (85 of 558) of participants with mild impairment (aOR, 1.51; 95% CI, 1.04-2.20), 19.0% (78 of 411) of participants with moderate impairment (aOR, 2.03; 95% CI, 1.37-3.02), and 24.6% (95 of 386) of participants with severe impairment (aOR, 3.25; 95% CI, 2.02-5.23). Conclusions and Relevance This study's findings suggest that mobility impairment assessed during hospitalization may be a potent risk marker for functional decline in older survivors of AMI. These findings also suggest that brief, validated assessments of mobility should be part of the care of older hospitalized patients with AMI to identify those at risk for this important patient-centered outcome.
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Affiliation(s)
- Alexandra M. Hajduk
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Terrence E. Murphy
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Mary E. Geda
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - John A. Dodson
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Sui Tsang
- Department of Medicine, NYU Langone Health, New York, New York
| | - Leila Haghighat
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Mary E. Tinetti
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Thomas M. Gill
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Sarwat I. Chaudhry
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
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Disability for basic and instrumental activities of daily living in older individuals. PLoS One 2019; 14:e0220157. [PMID: 31348797 PMCID: PMC6660130 DOI: 10.1371/journal.pone.0220157] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 07/09/2019] [Indexed: 01/10/2023] Open
Abstract
AIMS To know the prevalence, associated factors and temporal trends of disabilities for basic and instrumental activities of daily living in older people in Spain from 2009 to 2017. BACKGROUND Disability in older people is associated with health problems, increased health costs and low quality of life. There are no updated data in Spain with a representative sample about disability. METHODS Cross-sectional study with 25,465 non-institutionalized older people who participated in the European Health Survey in 2009 and 2014 and the National Health Survey in 2011/12 and 2017 in Spain. The prevalence rates of disability were evaluated using the Katz Scale and Lawton and Brody Scale. Logistic regression was used to determine if there was an association between basic and instrumental activities of daily living and sociodemographic characteristics. RESULTS More individuals had disability for instrumental activities of daily living (31.9%) than disability for basic activities of daily living (11.1%). The most predominant disability for instrumental activities of daily living was performing severe housework (34%). The prevalence of disabilities decreased from 2009 to 2017. In general, disability was associated with female gender, advanced age, lower education, restricted daily activity, being bedridden and higher pain levels. CONCLUSION There is a considerable prevalence of disabilities for basic and instrumental activities of daily living in older people in Spain. Although the disability prevalence has decreased slowly from 2009 to 2017, it continues to remain a health problem. Gender may influence the disabilities for basic and instrumental activities of daily living. Health policymakers should establish prevention strategies and effective interventions (e.g., physical exercise) for prevention and reduction of the disabilities for basic and instrumental activities of daily living, particularly in older females.
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Galvin A, Helmer C, Coureau G, Amadeo B, Rainfray M, Soubeyran P, Dartigues JF, Pérès K, Bellera C, Delva F, Mathoulin-Pélissier S. Determinants of functional decline in older adults experiencing cancer (the INCAPAC study). J Geriatr Oncol 2019; 10:913-920. [PMID: 30902591 DOI: 10.1016/j.jgo.2019.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/28/2019] [Accepted: 03/11/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Previous studies have reported on the higher risk of functional decline among older patients with cancer. However, few have focused on factors of functional decline in older persons with cancer and are mainly hospital-based and focus on consequences of cancer treatment. The aim of the study was to identify determinants of functional decline in older subjects with cancer in a population-based study. METHODS Using cancer registries, we identified older subjects (age ≥ 65 years) with cancer in three prospective cohort studies from Gironde, a French department. Functional status was measured using the Instrumental Activities of Daily Living (IADL) and the basic Activities of Daily Living (ADL) scales, and functional decline was measured between cancer pre- and post-diagnosis visits. Studied variables were demographic and socioeconomic (age at diagnosis, sex, living alone, education), cancer-related (stage at diagnosis, treatment received), smoking status, health-related (polypharmacy, depressive symptomatology), and geriatric-specific (cognitive impairment or dementia). Analyses were performed using logistic regression models. RESULTS Age (≥85 years), cognitive impairment or dementia, and advanced stage at diagnosis were associated with a higher risk of ADL limitations, whether considering death or not. Age (≥85 years), education and polypharmacy were associated with a higher risk of ADL and/or IADL limitations. CONCLUSIONS We identified factors that could impact on ADL and/or IADL limitations in older patients with cancer. The information on these determinants is useful in clinical settings to identify patients with cancer at high risk of functional decline.
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Affiliation(s)
- Angéline Galvin
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, F-33000 Bordeaux, France.
| | - Catherine Helmer
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Leha team, UMR 1219, F-33000 Bordeaux, France
| | - Gaëlle Coureau
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, F-33000 Bordeaux, France; Department of Public Health, Bordeaux University Hospital, F-3300 Bordeaux, France
| | - Brice Amadeo
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, F-33000 Bordeaux, France
| | - Muriel Rainfray
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, F-33000 Bordeaux, France; Department of Clinical Gerontology, Bordeaux University Hospital, F-33604 Pessac, France
| | - Pierre Soubeyran
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Vinco team, UMR 1218, F-33000 Bordeaux, France; Department of Medical Oncology, SIRIC Bordeaux Research Integrate Oncology, Institut Bergonié, F-33000 Bordeaux, France
| | - Jean-François Dartigues
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Leha team, UMR 1219, F-33000 Bordeaux, France
| | - Karine Pérès
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Sepia team, UMR 1219, F-33000 Bordeaux, France
| | - Carine Bellera
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, F-33000 Bordeaux, France; Clinical and Epidemiological Research Unit, INSERM CIC1401, Institut Bergonie, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Fleur Delva
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, F-33000 Bordeaux, France; Department of Public Health, Bordeaux University Hospital, F-3300 Bordeaux, France
| | - Simone Mathoulin-Pélissier
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, F-33000 Bordeaux, France; Clinical and Epidemiological Research Unit, INSERM CIC1401, Institut Bergonie, Comprehensive Cancer Center, F-33000 Bordeaux, France
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Fong JH, Feng J. Comparing the loss of functional independence of older adults in the U.S. and China. Arch Gerontol Geriatr 2018; 74:123-127. [DOI: 10.1016/j.archger.2017.10.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 10/24/2017] [Accepted: 10/24/2017] [Indexed: 10/18/2022]
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Tabue-Teguo M, Grasset L, Avila-Funes JA, Genuer R, Proust-Lima C, Péres K, Féart C, Amieva H, Harmand MGC, Helmer C, Salles N, Rainfray M, Dartigues JF. Prevalence and Co-Occurrence of Geriatric Syndromes in People Aged 75 Years and Older in France: Results From the Bordeaux Three-city Study. J Gerontol A Biol Sci Med Sci 2017; 73:109-116. [PMID: 28541397 DOI: 10.1093/gerona/glx068] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 04/10/2017] [Indexed: 11/13/2022] Open
Abstract
Background Geriatric syndromes (GSs) are often the result of cumulative insults to multiple organ systems and are considered common in older adults. However, their frequency and co-occurrence are not well known in the elderly population. This study aimed to determine the prevalence of several GSs and to analyze the co-occurrence of these syndromes in a general population of elderly individuals. Methods A cross-sectional analysis of 630 adults aged 75 years or older participating in the 10-year follow-up of the Bordeaux sample of the French Three-City Study was conducted. The following 10 GSs were assessed: physical frailty, dementia and cognitive impairment, depressive symptoms, polymedication, social isolation, thinness, falls, dependence, sensory deficit, and incontinence. The prevalence of the 10 GSs was estimated, and multiple correspondence analysis (MCA) models were used to explore the mutual associations between these GSs. Results The mean age of the participants was 83.3 years; 69% were women, and 80.5% [95% confidence interval (CI) = 76.3-82.7] had at least one GS. The most frequent GSs were polymedication (50.6% 95%CI = 46.7-54.5) and falls (43.1% 95%CI = 38.4-46.1). The MCA models identified two major dimensions of the 10 GSs: "Dementia-Dependence-Incontinence" and "Frailty-Depression-Isolation." Conclusions GSs were very common in this French elderly population and were grouped into two major dimensions: the "Dementia-Dependence-Incontinence" and "Frailty-Depression-Isolation."
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Affiliation(s)
- Maturin Tabue-Teguo
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France.,Institut des Maladies Neurodégénératives Clinique, Centre Hospitalier Universitaire de Bordeaux, France.,Centre Hospitalier Villeneuve-sur-Lot, France
| | - Leslie Grasset
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France
| | - José Alberto Avila-Funes
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France.,Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Robin Genuer
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France
| | - Cecile Proust-Lima
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France
| | - Karine Péres
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France
| | - Catherine Féart
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France
| | - Hélène Amieva
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France.,Institut des Maladies Neurodégénératives Clinique, Centre Hospitalier Universitaire de Bordeaux, France
| | - Magali González-Colaço Harmand
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France
| | - Catherine Helmer
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France
| | - Nathalie Salles
- Pôle gérontologie clinique, Centre Hospitalier Universitaire de Bordeaux, France
| | - Muriel Rainfray
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France.,Pôle gérontologie clinique, Centre Hospitalier Universitaire de Bordeaux, France
| | - Jean François Dartigues
- INSERM U 1219, Université de Bordeaux, France.,Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, France.,Institut des Maladies Neurodégénératives Clinique, Centre Hospitalier Universitaire de Bordeaux, France
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Franse CB, van Grieken A, Qin L, Melis RJF, Rietjens JAC, Raat H. Socioeconomic inequalities in frailty and frailty components among community-dwelling older citizens. PLoS One 2017; 12:e0187946. [PMID: 29121677 PMCID: PMC5679620 DOI: 10.1371/journal.pone.0187946] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 10/27/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND So far, it has not yet been studied whether socioeconomic status is associated with distinct frailty components and for which frailty component this association is the strongest. We aimed to examine the association between socioeconomic status and frailty and frailty components. In addition we assessed the mediating effect of the number of morbidities on the association between socioeconomic status and other frailty components. METHODS This is a cross-sectional study of pooled data of The Older Persons and Informal Caregivers Survey Minimum DataSet in the Netherlands among community-dwelling persons aged 55 years and older (n = 26,014). Frailty was measured with a validated Frailty Index that consisted of 45 items. The Frailty Index contained six components: morbidities, limitations in activities of daily living (ADL), limitations in instrumental ADL (IADL), health-related quality of life, psychosocial health and self-rated health. Socioeconomic indicators used were education level and neighbourhood socioeconomic status. RESULTS Persons with primary or secondary education had higher overall frailty and frailty component scores compared to persons with tertiary education (P < .001). Lower education levels were most consistently associated with higher overall frailty, more morbidities and worse self-rated health (P < .05 in all age groups). The strongest association was found between primary education and low psychosocial health for persons aged 55-69 years and more IADL limitations for persons aged 80+ years. Associations between neighborhood socioeconomic status and frailty (components) also showed inequalities, although less strong. The number of morbidities moderately to strongly mediated the association between socioeconomic indicators and other frailty components. CONCLUSION There are socioeconomic inequalities in frailty and frailty components. Inequalities in frailty, number of morbidities and self-rated health are most consistent across age groups. The number of morbidities a person has play an important role in explaining socioeconomic inequalities in frailty and should be taken into account in the management of frailty.
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Affiliation(s)
- Carmen B. Franse
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
- * E-mail:
| | - Amy van Grieken
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Li Qin
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - René J. F. Melis
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Judith A. C. Rietjens
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
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Pérès K, Matharan F, Daien V, Nael V, Edjolo A, Bourdel-Marchasson I, Ritchie K, Tzourio C, Delcourt C, Carrière I. Visual Loss and Subsequent Activity Limitations in the Elderly: The French Three-City Cohort. Am J Public Health 2017; 107:564-569. [PMID: 28207341 DOI: 10.2105/ajph.2016.303631] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate the relationship between vision and disability in the elderly. METHODS We used a baseline visual indicator (combining near acuity with Snellen equivalent < 20/30 and self-reported distance visual loss) to explore the association between visual loss and subsequent disability (mobility, instrumental activities of daily living [IADLs], ADLs, and participation restriction) from 1999 to 2007 in 8491 elderly participants of the French Three-City Cohort (Bordeaux, Dijon, and Montpellier). RESULTS In multiadjusted analyses, near visual impairment, alone or associated with distance visual function loss, was associated with greater risk of developing ADL limitations (P = .027), IADL limitations (P = .002), and participation restriction (P < .001), but not mobility (P = .848). The disabling impact of visual loss was significant for 11 of the 15 activities, when analyzed one by one. CONCLUSIONS Both near and distance visual loss was associated with greater functional decline over time, and the combination of the two could be even worse. Public Health Implications. In the context of rapid aging of the population, maintaining good vision in the elderly represents a promising prevention track, visual impairment being common in the elderly, largely undermanaged, and mostly reversible. Further research, especially trials, is necessary to estimate the public health impact of such interventions.
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Affiliation(s)
- Karine Pérès
- Karine Pérès, Fanny Matharan, Virginie Nael, Arlette Edjolo, Christophe Tzourio, and Cécile Delcourt are with Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France. Vincent Daien, Karen Ritchie, and Isabelle Carrière are with INSERM, U1061, Montpellier, France. Isabelle Bourdel-Marchasson I is with Pole de gérontologie clinique, CHU Bordeaux, Bordeaux, France
| | - Fanny Matharan
- Karine Pérès, Fanny Matharan, Virginie Nael, Arlette Edjolo, Christophe Tzourio, and Cécile Delcourt are with Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France. Vincent Daien, Karen Ritchie, and Isabelle Carrière are with INSERM, U1061, Montpellier, France. Isabelle Bourdel-Marchasson I is with Pole de gérontologie clinique, CHU Bordeaux, Bordeaux, France
| | - Vincent Daien
- Karine Pérès, Fanny Matharan, Virginie Nael, Arlette Edjolo, Christophe Tzourio, and Cécile Delcourt are with Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France. Vincent Daien, Karen Ritchie, and Isabelle Carrière are with INSERM, U1061, Montpellier, France. Isabelle Bourdel-Marchasson I is with Pole de gérontologie clinique, CHU Bordeaux, Bordeaux, France
| | - Virginie Nael
- Karine Pérès, Fanny Matharan, Virginie Nael, Arlette Edjolo, Christophe Tzourio, and Cécile Delcourt are with Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France. Vincent Daien, Karen Ritchie, and Isabelle Carrière are with INSERM, U1061, Montpellier, France. Isabelle Bourdel-Marchasson I is with Pole de gérontologie clinique, CHU Bordeaux, Bordeaux, France
| | - Arlette Edjolo
- Karine Pérès, Fanny Matharan, Virginie Nael, Arlette Edjolo, Christophe Tzourio, and Cécile Delcourt are with Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France. Vincent Daien, Karen Ritchie, and Isabelle Carrière are with INSERM, U1061, Montpellier, France. Isabelle Bourdel-Marchasson I is with Pole de gérontologie clinique, CHU Bordeaux, Bordeaux, France
| | - Isabelle Bourdel-Marchasson
- Karine Pérès, Fanny Matharan, Virginie Nael, Arlette Edjolo, Christophe Tzourio, and Cécile Delcourt are with Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France. Vincent Daien, Karen Ritchie, and Isabelle Carrière are with INSERM, U1061, Montpellier, France. Isabelle Bourdel-Marchasson I is with Pole de gérontologie clinique, CHU Bordeaux, Bordeaux, France
| | - Karen Ritchie
- Karine Pérès, Fanny Matharan, Virginie Nael, Arlette Edjolo, Christophe Tzourio, and Cécile Delcourt are with Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France. Vincent Daien, Karen Ritchie, and Isabelle Carrière are with INSERM, U1061, Montpellier, France. Isabelle Bourdel-Marchasson I is with Pole de gérontologie clinique, CHU Bordeaux, Bordeaux, France
| | - Christophe Tzourio
- Karine Pérès, Fanny Matharan, Virginie Nael, Arlette Edjolo, Christophe Tzourio, and Cécile Delcourt are with Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France. Vincent Daien, Karen Ritchie, and Isabelle Carrière are with INSERM, U1061, Montpellier, France. Isabelle Bourdel-Marchasson I is with Pole de gérontologie clinique, CHU Bordeaux, Bordeaux, France
| | - Cécile Delcourt
- Karine Pérès, Fanny Matharan, Virginie Nael, Arlette Edjolo, Christophe Tzourio, and Cécile Delcourt are with Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France. Vincent Daien, Karen Ritchie, and Isabelle Carrière are with INSERM, U1061, Montpellier, France. Isabelle Bourdel-Marchasson I is with Pole de gérontologie clinique, CHU Bordeaux, Bordeaux, France
| | - Isabelle Carrière
- Karine Pérès, Fanny Matharan, Virginie Nael, Arlette Edjolo, Christophe Tzourio, and Cécile Delcourt are with Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France. Vincent Daien, Karen Ritchie, and Isabelle Carrière are with INSERM, U1061, Montpellier, France. Isabelle Bourdel-Marchasson I is with Pole de gérontologie clinique, CHU Bordeaux, Bordeaux, France
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