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Lai A, Morgan A, Richardson J, Griffith LE, Kuspinar A, Smith-Turchyn J. Pre-Clinical Mobility Limitation (PCML) Outcomes in Rehabilitation Interventions for Middle-Aged and Older Adults: A Scoping Review. Can J Aging 2023:1-12. [PMID: 37981438 DOI: 10.1017/s0714980823000685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023] Open
Abstract
Individuals with pre-clinical mobility limitation (PCML) are at a high risk of future functional loss and progression to disability. The purpose of this scoping review was to provide a comprehensive understanding of PCML intervention studies in middle-aged and older adults. We present the interventions that have been tested or planned, describe how they have been conducted and reported, identify the knowledge gaps in current literature, and make recommendations about future research directions. An initial search of 2,291 articles resulted in 14 articles that met criteria for inclusion. Findings reveal that: (1) there is limited published work on PCML interventions, especially in middle-aged populations; and (2) the complexity and variety of PCML measures make it difficult to compare findings across PCML studies. Despite the diversity of measures, this review provides preliminary evidence that rehabilitation interventions on PCML help to delay or prevent disability progression.
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Affiliation(s)
- Aiping Lai
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Ashley Morgan
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Jenna Smith-Turchyn
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Rodrigues AAGDS, Peixoto Junior AA, Borges CL, Soares ES, Lima JWDO. Prevalence of sarcopenia components and associated socioeconomic factors among older adults living in rural areas in the state of Ceará, Brazil. CIENCIA & SAUDE COLETIVA 2023; 28:3159-3168. [PMID: 37971000 DOI: 10.1590/1413-812320232811.17642022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/10/2023] [Indexed: 11/19/2023] Open
Abstract
The aim is to determine the prevalence of sarcopenia components and associations with socioeconomic variables in older persons living in rural areas in the state of Ceará, Brazil. We conducted a cross-sectional study with 274 older adults. Muscle mass was assessed using muscle mass index (MMI), measured by bioelectrical impedance analysis and calf circumference. Muscle strength (MS) was assessed using the handgrip test. Physical performance was measured using the walk test to calculate gait speed (GS) and the timed up-and-go test. Probable sarcopenia was defined as the presence of low MS, while confirmed sarcopenia was defined as the presence of low MS and low MMI. Severe sarcopenia was defined as the presence of the latter two criteria and slow GS. We tested for associations between sociodemographic characteristics and lifestyle habits and the components of sarcopenia. The logistic regression produced the following results: i) prevalence of low MS was higher among men, individuals aged >69 years, and in those not working at the time of the study; ii) the prevalence of low MMI was higher in individuals aged >69 years, those not living with a spouse, and those with an inadequate level of physical activity; iii) the prevalence of slow GS was higher in individuals aged >69 years, those who had lived in rural areas for less than 30 years, and those not working at the time of the study.
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Affiliation(s)
- Antonia Alizandra Gomes Dos Santos Rodrigues
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade Estadual do Ceará. Av. Dr. Silas Munguba 1700, Campus do Itaperi. 60714-903 Fortaleza CE Brasil.
| | | | - Cíntia Lira Borges
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade Estadual do Ceará. Av. Dr. Silas Munguba 1700, Campus do Itaperi. 60714-903 Fortaleza CE Brasil.
- Curso de Medicina, Centro Universitário Christus. Fortaleza CE Brasil
| | - Edson Silva Soares
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade Estadual do Ceará. Av. Dr. Silas Munguba 1700, Campus do Itaperi. 60714-903 Fortaleza CE Brasil.
| | - José Wellington de Oliveira Lima
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade Estadual do Ceará. Av. Dr. Silas Munguba 1700, Campus do Itaperi. 60714-903 Fortaleza CE Brasil.
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Richardson J, Beauchamp M, Bean J, Brach J, Chaves PHM, Guralnik JM, Jette AM, Leveille SG, Hoenig H, Manini T, Marottoli R, Porter MM, Sinclair S, Letts L, Kuspinar A, Vrkljan B, Morgan A, Mirbaha S. Defining and Measuring Preclinical Mobility Limitation: An Expert Consensus Exercise Informed by a Scoping Review. J Gerontol A Biol Sci Med Sci 2023; 78:1641-1650. [PMID: 37300461 DOI: 10.1093/gerona/glad143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Early change in function in older adults has been termed preclinical disability (PCD). PCD has been understudied compared to other stages of disability because it is unlikely to receive comparative priority in clinical settings. It has major implications for prevention and population health as it may be the optimal time to intervene to prevent further decline. A standardized approach to research in PCD, including a common definition and measurement approaches, is needed to advance this work. METHODS The process to establish how PCD should be defined and measured was undertaken in 2 stages: (1) a scoping review of the literature, which was used to inform (2) a web-enabled consensus meeting with content experts. RESULTS The scoping review and the consensus meeting support the use of the term preclinical mobility limitation (PCML) and that it should be measured using both patient-reported and performance-based measures. It was agreed that the definition of PCML should include modification of frequency and/or method of task completion, without overt disability, and that requisite mobility tasks include walking (distance and speed), stairs, and transfers. CONCLUSIONS Currently, there are few standardized assessments that can identify PCML. PCML is the term that most clearly describes the stage where people experience a change in routine mobility tasks, without a perception of disability. Further evaluation into the reliability, validity, and responsiveness of outcome measures is needed to advance research on PCML.
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Affiliation(s)
- Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada
| | - Marla Beauchamp
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Jonathan Bean
- Faculty of Health Sciences, Department of PM&R, Harvard Medical School, Boston, Massachusetts, USA
- New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Bedford VAMC, Boston, Massachusetts, USA
| | - Jennifer Brach
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Paulo H M Chaves
- Benjamin Leon Center for Geriatric Research and Education, Florida International University, Miami, Florida, USA
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Jack M Guralnik
- Epidemiology & Public Health, School of Medicine, University of Maryland, Baltimore, Baltimore, Maryland, USA
| | - Alan M Jette
- Department of Physical Therapy & Athletic Training, College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts, USA
| | - Suzanne G Leveille
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Helen Hoenig
- Duke University School of Medicine, Physical Medicine and Rehabilitation Service, Durham VA Medical Center, Durham, North Carolina, USA
| | - Todd Manini
- Institute on Aging, Department of Aging & Geriatric Research, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Richard Marottoli
- Department of Geriatric Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Michelle M Porter
- Centre on Aging, University of Manitoba, Winnipeg, Manitoba, Canada
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Susanne Sinclair
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Lori Letts
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Brenda Vrkljan
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Ashley Morgan
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Shaghayegh Mirbaha
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Kyrönlahti SM, Stenholm S, Raitanen J, Neupane S, Koskinen S, Tiainen K. Educational Differences in Decline in Maximum Gait Speed in Older Adults Over an 11-Year Follow-up. J Gerontol A Biol Sci Med Sci 2020; 76:703-709. [DOI: 10.1093/gerona/glaa196] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
This study examined educational differences in decline in maximum gait speed over an 11-year follow-up in the general Finnish population aged 55 years and older and assessed the contribution of lifestyle factors, body mass index, physical workload, and chronic conditions on the association.
Method
Data from the nationally representative Health 2000 Survey and its 11-year follow-up were used. Participants aged 55 years and older with maximum gait speed measured at both time points were included (n = 1128). Information on education, age, sex, lifestyle factors, body mass index, physical workload, and chronic conditions was collected at baseline. General linear model was used to examine differences in decline in maximum gait speed between education groups. Mediation analyses using the product method was conducted to partition the total effect of education on decline in maximum gait speed into direct effect and indirect effect acting through mediators.
Results
Decline in maximum gait speed was greater in low and intermediate education groups in comparison to the high education group (0.24 m/s [95% confidence interval 0.21–0.26], 0.24 m/s [0.21–0.28], 0.10 m/s [0.07–0.14], respectively]. The most important mediators were higher body mass index and lifetime exposure to physical workload among the less educated, accounting for 10% and 11% of the total effect, respectively.
Conclusions
Education-based disparities in objectively measured mobility increase with age as lower education is associated with greater decline in gait speed. Higher body mass index and physical workload among less educated contributed most to the educational disparities in age-related decline in maximum gait speed.
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Affiliation(s)
- Saila M Kyrönlahti
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Jani Raitanen
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Finland
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Subas Neupane
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Finland
| | - Seppo Koskinen
- Department of Public Health Solutions, National Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kristina Tiainen
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Finland
- Gerontology Research Center, Tampere University, Finland
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Binder N, Blümle A, Balmford J, Motschall E, Oeller P, Schumacher M. Cohort studies were found to be frequently biased by missing disease information due to death. J Clin Epidemiol 2019; 105:68-79. [DOI: 10.1016/j.jclinepi.2018.09.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/25/2018] [Accepted: 09/07/2018] [Indexed: 02/08/2023]
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Thorpe RJ, Wynn AJ, Walker JL, Smolen JR, Cary MP, Szanton SL, Whitfield KE. Relationship Between Chronic Conditions and Disability in African American Men and Women. J Natl Med Assoc 2018; 108:90-8. [PMID: 26928493 DOI: 10.1016/j.jnma.2015.12.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Race differences in chronic conditions and disability are well established; however, little is known about the association between specific chronic conditions and disability in African Americans. This is important because African Americans have higher rates and earlier onset of both chronic conditions and disability than white Americans. METHODS We examined the relationship between chronic conditions and disability in 602 African Americans aged 50 years and older in the Baltimore Study of Black Aging. Disability was measured using self-report of difficulty in activities of daily living (ADL). Medical conditions included diagnosed self-reports of asthma, depressive symptoms, arthritis, cancer, diabetes, cardiovascular disease (CVD), stroke, and hypertension. RESULTS After adjusting for age, high school graduation, income, and marital status, African Americans who reported arthritis (women: odds ratio (OR)=4.87; 95% confidence interval(CI): 2.92-8.12; men: OR=2.93; 95% CI: 1.36-6.30) had higher odds of disability compared to those who did not report having arthritis. Women who reported major depressive symptoms (OR=2.59; 95% CI: 1.43-4.69) or diabetes (OR=1.83; 95% CI: 1.14-2.95) had higher odds of disability than women who did not report having these conditions. Men who reported having CVD (OR=2.77; 95% CI: 1.03-7.41) had higher odds of disability than men who did not report having CVD. CONCLUSIONS These findings demonstrate the importance of chronic conditions in understanding disability in African Americans and how it varies by gender. Also, these findings underscore the importance of developing health promoting strategies focused on chronic disease prevention and management to delay or postpone disability in African Americans. PUBLICATION INDICES Pubmed, Pubmed Central, Web of Science database.
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Affiliation(s)
- Roland J Thorpe
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Center for Biobehavioral Health Disparities Research, Duke University.
| | - Anastasia J Wynn
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health
| | | | - Jenny R Smolen
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health
| | | | - Sarah L Szanton
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Center for Biobehavioral Health Disparities Research, Duke University, Johns Hopkins School of Nursing, Johns Hopkins University
| | - Keith E Whitfield
- Center for Biobehavioral Health Disparities Research, Duke University, Department of Psychology and Neuroscience, Duke University
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Rantakokko M, Portegijs E, Viljanen A, Iwarsson S, Rantanen T. Task Modifications in Walking Postpone Decline in Life-Space Mobility Among Community-Dwelling Older People: A 2-year Follow-up Study. J Gerontol A Biol Sci Med Sci 2017; 72:1252-1256. [PMID: 28329074 DOI: 10.1093/gerona/glw348] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 12/22/2016] [Indexed: 11/13/2022] Open
Abstract
Background Task modification refers to performing a task differently than before. While task modification in walking may be a sign of looming walking difficulty, it may also be adaptive in and postpone the decline in life-space mobility. However, this has not been studied. This study examined whether changes in life-space mobility over a 2-year period differ between people who at baseline report no walking difficulty and no task modification, those who report no walking difficulty but task modification, and those who report walking difficulty. Methods Community-dwelling people aged 75-90 years were interviewed face-to-face at baseline (N = 848), and over phone one (n = 816) and two (n = 761) years later. Life-space mobility was assessed annually with the Life-Space Assessment (range 0-120, higher scores indicate better life-space mobility). Self-reported ability to walk 2 km was assessed at baseline and categorized into "no difficulty," "no difficulty but task modifications" (reduced frequency, given up walking, walking slower or resting during walking) and "difficulty." The analyses were adjusted for age, gender, number of chronic conditions, cognitive impairment, lower extremity performance and education. Results The life-space mobility score was highest and remained stable over 2-years among those with no walking difficulties at baseline and lowest and showing a steady decline among those with walking difficulties. Those with task modifications formed the middle group. They showed no marked changes in life-space mobility during the first year, but significant decline during the second year. Conclusion Task modifications in walking may help community-dwelling older people to postpone life-space mobility decline.
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Affiliation(s)
- Merja Rantakokko
- Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Finland
| | - Erja Portegijs
- Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Finland
| | - Anne Viljanen
- Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Finland
| | | | - Taina Rantanen
- Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Finland
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Santos VRD, Christofaro DGD, Gomes IC, Freitas Júnior IF, Gobbo LA. Factors associated with mobility of the oldest old. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.001.ao07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: Several factors can be associated to the reduction of mobility among the elderly. Early identification of these factors is crucial, since it may lead to prevention of functional dependencies. Objective: To analyze the association between mobility, sociodemographic factors and the prevalence of noncommunicable chronic diseases (NCDs) in oldest old. Methods: The sample consisted of 120 elderly persons aged (80 and 95 years), with 76 of them being women (83 ± 3 years) and 44 of them men (83 ± 3 years). Sociodemographic factors and NCDs which we studied were: age, gender, marital status, education, nutritional status, ethnicity, hypertension, diabetes and osteoarticular diseases. Mobility was analyzed using a battery of Physical Performance Tests. For statistical analysis we used the chi-square test and binary logistic regression to examine the relationship between sociodemographic factors, NCDs and mobility. SPSS (17.0) software was used for this and the significance level was set at 5%. Results: Level of education (p ≤ 0.001) and age (p = 0.034) are the two factors related to low mobility. However, the model built by multiple logistic regression analysis revealed that age is independently related to limited mobility in oldest old people (OR 3.29; 95% CI 1.09 to 9.87). Conclusion: Thus, oldest old >85 years are at a greater risk of decreased mobility independent of their education, marital and nutritional statuses and gender. We encourage further studies in this area. Studies which will not only address those facts considered in this study but that also examine family-related aspects, especially using longitudinal studies.
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Rantakokko M, Portegijs E, Viljanen A, Iwarsson S, Rantanen T. Mobility Modification Alleviates Environmental Influence on Incident Mobility Difficulty among Community-Dwelling Older People: A Two-Year Follow-Up Study. PLoS One 2016; 11:e0154396. [PMID: 27104750 PMCID: PMC4841513 DOI: 10.1371/journal.pone.0154396] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 04/11/2016] [Indexed: 11/24/2022] Open
Abstract
Background Environmental barriers increase risk for mobility difficulties in old age. Mobility difficulty is preceded by a phase where people try to postpone a difficulty through mobility modification. We studied whether perceived environmental mobility barriers outdoors correlate with mobility modification and mobility difficulty, predict development of mobility difficulty over a two-year follow-up, and whether mobility modification alleviates the risk for difficulty. Methods At baseline, 848 people aged 75–90 were interviewed face-to-face. Telephone follow-up interviews were conducted one (n = 816) and two years (n = 761) later. Environmental barriers to mobility were self-reported using a15-item structured questionnaire at baseline, summed and divided into tertiles (0, 1 and 2 or more barriers). Mobility difficulty was assessed as self-reported ability to walk 2 km at all assessment points and categorized into ‘no difficulty’, ‘no difficulty but mobility modifications’ (reducing frequency, stopping walking, using an aid, slowing down or resting during the performance) and ‘difficulty’. Results At baseline, 212 participants reported mobility modifications and 356 mobility difficulties. Those reporting one or multiple environmental barriers had twice the odds for mobility modifications and up to five times the odds for mobility difficulty compared to those reporting no environmental barriers. After multiple adjustments for health and functioning, reporting multiple environmental barriers outdoors continued to predict the development of incident mobility difficulty over the two-year follow-up. Mobility modifications attenuated the association. Conclusion For older people who successfully modify their performance, environmental influence on incident mobility difficulty can be diminished. Older people use mobility modification to alleviate environmental press on mobility.
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Affiliation(s)
- Merja Rantakokko
- Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
- * E-mail:
| | - Erja Portegijs
- Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Anne Viljanen
- Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | | | - Taina Rantanen
- Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
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Batsis JA, Germain CM, Vásquez E, Zbehlik AJ, Bartels SJ. Physical Activity Predicts Higher Physical Function in Older Adults: The Osteoarthritis Initiative. J Phys Act Health 2016; 13:6-16. [PMID: 25831551 PMCID: PMC4596795 DOI: 10.1123/jpah.2014-0531] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Physical activity reduces mobility impairments in elders. We examined the association of physical activity on risk of subjective and objective physical function in adults with and at risk for osteoarthritis (OA). METHODS Adults aged ≥ 60 years from the longitudinal Osteoarthritis Initiative, a prospective observational study of knee OA, were classified by sex-specific quartiles of Physical Activity Score for the Elderly scores. Using linear mixed models, we assessed 6-year data on self-reported health, gait speed, Late-Life Function and Disability Index (LLFDI) and chair stand. RESULTS Of 2252 subjects, mean age ranged from 66 to 70 years. Within each quartile, physical component (PCS) of the Short Form-12 and gait speed decreased from baseline to follow-up in both sexes (all P < .001), yet the overall changes across PASE quartiles between these 2 time points were no different (P = .40 and .69, males and females, respectively). Decline in PCS occurred in the younger age group, but rates of change between quartiles over time were no different in any outcomes in either sex. LLFDI scores declined in the 70+ age group. Adjusting for knee extensor strength reduced the strength of association. CONCLUSIONS Higher physical activity is associated with maintained physical function and is mediated by muscle strength, highlighting the importance of encouraging physical activity in older adults with and at risk for OA.
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Affiliation(s)
- John A Batsis
- Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH
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Lorenz RA, Budhathoki CB, Kalra GK, Richards KC. The relationship between sleep and physical function in community-dwelling adults: a pilot study. FAMILY & COMMUNITY HEALTH 2014; 37:298-306. [PMID: 25167070 PMCID: PMC4286147 DOI: 10.1097/fch.0000000000000046] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
More than 50% of community-dwelling adults have sleep complaints. Because aging is associated with decline in physical function, coexistent sleep difficulties may exacerbate functional decline. This pilot study explored the relationships between sleep, age, chronic disease burden, and physical function among 50 community-dwelling older adults. Findings revealed significant relationships between total sleep time and preclinical disability (r = -0.33, P ≤ .05) and mobility difficulty (r = -0.36, P ≤ .05). A regression analysis showed that total sleep time was significantly associated with mobility difficulty and preclinical disability, even after controlling for chronic disease burden. These findings suggest that total sleep time may be a catalyst for functional decline.
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12
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Pirkle CM, de Albuquerque Sousa ACP, Alvarado B, Zunzunegui MV. Early maternal age at first birth is associated with chronic diseases and poor physical performance in older age: cross-sectional analysis from the International Mobility in Aging Study. BMC Public Health 2014; 14:293. [PMID: 24684705 PMCID: PMC3977880 DOI: 10.1186/1471-2458-14-293] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 03/28/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early maternal age at first birth and elevated parity may have long-term consequences for the health of women as they age. Both are known risk factors for obstetrical complications with lifelong associated morbidities. They may also be related to diabetes and cardiovascular disease development. METHODS We examine the relationship between early maternal age at first birth, defined as ≤18 years of age, multiparity (>2 births), and poor physical performance (Short Physical Performance Battery≤8) in community samples of women between 65 and 74 years of age from Canada, Albania, Colombia, and Brazil (N=1040). Data were collected in 2012 to provide a baseline assessment for a longitudinal cohort called the International Mobility in Aging Study. We used logistic regression and general linear models to analyse the data. RESULTS Early maternal age at first birth is significantly associated with diabetes, chronic lung disease, high blood pressure, and poor physical performance in women at older ages. Parity was not independently associated with chronic conditions and physical performance in older age. After adjustment for study site, age, education, childhood economic adversity and lifetime births, women who gave birth at a young age had 1.75 (95% CI: 1.17-2.64) the odds of poor SPPB compared to women who gave birth>18 years of age. Adjustment for chronic diseases attenuated the association between early first birth and physical performance. Results were weaker in Colombia and Brazil, than Canada and Albania. CONCLUSIONS This study provides evidence that adolescent childbirth may increase the risk of developing chronic diseases and physical limitations in older age. Results likely reflect both the biological and social consequences of early childbearing and if the observed relationship is causal, it reinforces the importance of providing contraception and sex education to young women, as the consequences of early pregnancy may be life-long.
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Affiliation(s)
- Catherine M Pirkle
- Department of Population Health and Environment, Research Center CHUQ, Laval University, 2875, Boulevard Laurier, Édifice Delta II; Bureau 600, 6e étage, Québec, QC G1V 2M2, Canada.
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Deshpande N, Metter JE, Guralnik J, Bandinelli S, Ferrucci L. Sensorimotor and psychosocial determinants of 3-year incident mobility disability in middle-aged and older adults. Age Ageing 2014; 43:64-9. [PMID: 24042004 DOI: 10.1093/ageing/aft135] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE to identify sensorimotor and psychosocial determinants of 3-year incident mobility disability. DESIGN prospective. SETTING population-based sample of community-dwelling older persons. PARTICIPANTS community-living middle-aged and older persons (age: 50-85 years) without baseline mobility disability (n = 622). MEASUREMENTS mobility disability, defined as self-reported inability to walk a quarter mile without resting or inability to walk up a flight of stairs unsupported, was ascertained at baseline and 3-year follow-up. Potential baseline determinant characteristics included demographics, education, social support, financial condition, knee extensor strength, visual contrast sensitivity, cognition, depression, presence of chronic conditions and history of falls. RESULTS a total of 13.5% participant reported 3-year incident mobility disability. Age ≥75 years, female sex, knee extensor strength in the lowest quartile, visual contrast sensitivity <1.7 on the Pelli-Robson chart or significant depressive symptoms (CESD score >16) were independent determinants of 3-year incident mobility disability (ORs 1.84-16.51). CONCLUSIONS low visual contrast sensitivity, poor knee extensor strength and significant depressive symptoms are independent determinants of future onset of mobility disability.
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Affiliation(s)
- Nandini Deshpande
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
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Palazzo C, Ravaud JF, Trinquart L, Dalichampt M, Ravaud P, Poiraudeau S. Respective contribution of chronic conditions to disability in France: results from the national Disability-Health Survey. PLoS One 2012; 7:e44994. [PMID: 23024781 PMCID: PMC3443206 DOI: 10.1371/journal.pone.0044994] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Accepted: 08/15/2012] [Indexed: 11/30/2022] Open
Abstract
Background Representative national data on disability are becoming increasingly important in helping policymakers decide on public health strategies. We assessed the respective contribution of chronic health conditions to disability for three age groups (18–40, 40–65, and >65 years old) using data from the 2008–2009 Disability-Health Survey in France. Methods Data on 12 chronic conditions and on disability for 24,682 adults living in households were extracted from the Disability-Health Survey results. A weighting factor was applied to obtain representative estimates for the French population. Disability was defined as at least one restriction in activities of daily living (ADL), severe disability as the inability to perform at least one ADL alone, and self-reported disability as a general feeling of being disabled. To account for co-morbidities, we assessed the contribution of each chronic disorder to disability by using the average attributable fraction (AAF). Findings We estimated that 38.8 million people in France (81.7% [95% CI 80.9;82.6]) had a chronic condition: 14.3% (14.0;14.6) considered themselves disabled, 4.6% (4.4;4.9) were restricted in ADL and 1.7% (1.5;1.8) were severely disabled. Musculoskeletal and sensorial impairments contributed the most to self-reported disability (AAF 15.4% and 12.3%). Neurological and musculoskeletal diseases had the largest impact on disability (AAF 17.4% and 16.4%, respectively). Neurological disorders contributed the most to severe disability (AAF 31.0%). Psychiatric diseases contributed the most to disability categories for patients 18–40 years old (AAFs 23.8%–40.3%). Cardiovascular conditions were also among the top four contributors to disability categories (AAFs 8.5%–11.1%). Conclusions Neurological, musculoskeletal, and cardiovascular chronic disorders mainly contribute to disability in France. Psychiatric impairments have a heavy burden for people 18–40 years old. These findings should help policymakers define priorities for health-service delivery in France and perhaps other developed countries.
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Woods NF, Cochrane BB, LaCroix AZ, Seguin RA, Zaslavsky O, Liu J, Beasley JM, Brunner RL, Espeland MA, Goveas JS, Lane DS, Manson JE, Mouton CP, Robinson JG, Tinker LF. Toward a positive aging phenotype for older women: observations from the women's health initiative. J Gerontol A Biol Sci Med Sci 2012; 67:1191-6. [PMID: 22518819 DOI: 10.1093/gerona/gls117] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To develop a positive aging phenotype, we undertook analyses to describe multiple dimensions of positive aging and their relationships to one another in women 65 years of age and older and evaluate the performance of individual indicators and composite factors of this phenotype as predictors of time to death, years of healthy living, and years of independent living. METHODS Data from Women's Health Initiative clinical trial and observational study participants ages 65 years and older at baseline, including follow-up observations up to 8 years later, were analyzed using descriptive statistics and principal components analysis to identify the factor structure of a positive aging phenotype. The factors were used to predict time to death, years of healthy living (without hospitalization or diagnosis of a serious health condition), and years of independent living (without nursing home admission or use of special services). RESULTS We identified a multidimensional phenotype of positive aging that included two factors: Physical-Social Functioning and Emotional Functioning. Both factors were predictive of each of the outcomes, but Physical-Social Functioning was the strongest predictor. Each standard deviation of increase in Physical-Social Functioning was accompanied by a 23.7% reduction in mortality risk, a 19.4% reduction in risk of major health conditions or hospitalizations, and a 26.3% reduction in risk of dependent living. CONCLUSIONS Physical-Social Functioning and Emotional Functioning constitute important components of a positive aging phenotype. Physical-Social Functioning was the strongest predictor of outcomes related to positive aging, including years of healthy living, years of independent living, and time to mortality.
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Affiliation(s)
- Nancy Fugate Woods
- Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA.
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McLaughlin SJ, Jette AM, Connell CM. An examination of healthy aging across a conceptual continuum: prevalence estimates, demographic patterns, and validity. J Gerontol A Biol Sci Med Sci 2012; 67:783-9. [PMID: 22367432 DOI: 10.1093/gerona/glr234] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although the notion of healthy aging has gained wide acceptance in gerontology, measuring the phenomenon is challenging. Guided by a prominent conceptualization of healthy aging, we examined how shifting from a more to less stringent definition of healthy aging influences prevalence estimates, demographic patterns, and validity. METHODS Data are from adults aged 65 years and older who participated in the Health and Retirement Study. We examined four operational definitions of healthy aging. For each, we calculated prevalence estimates and examined the odds of healthy aging by age, education, gender, and race-ethnicity in 2006. We also examined the association between healthy aging and both self-rated health and death. RESULTS Across definitions, the prevalence of healthy aging ranged from 3.3% to 35.5%. For all definitions, those classified as experiencing healthy aging had lower odds of fair or poor self-rated health and death over an 8-year period. The odds of being classified as "healthy" were lower among those of advanced age, those with less education, and women than for their corresponding counterparts across all definitions. CONCLUSIONS Moving across the conceptual continuum--from a more to less rigid definition of healthy aging--markedly increases the measured prevalence of healthy aging. Importantly, results suggest that all examined definitions identified a subgroup of older adults who had substantially lower odds of reporting fair or poor health and dying over an 8-year period, providing evidence of the validity of our definitions. Conceptualizations that emphasize symptomatic disease and functional health may be particularly useful for public health purposes.
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Affiliation(s)
- Sara J McLaughlin
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Room 3814 SPH I, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
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Murray ET, Hardy R, Strand BH, Cooper R, Guralnik JM, Kuh D. Gender and life course occupational social class differences in trajectories of functional limitations in midlife: findings from the 1946 British birth cohort. J Gerontol A Biol Sci Med Sci 2011; 66:1350-9. [PMID: 21860018 PMCID: PMC3210957 DOI: 10.1093/gerona/glr139] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 07/16/2011] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Older women and those of lower socioeconomic position (SEP) consistently constitute a larger portion of the disabled population than older men or those of higher SEP, yet no studies have examined when in the life course these differences emerge. METHODS Prevalence of self-reported limitations in the upper body (gripping or reaching) and lower body (walking or stair climbing) at 43 and 53 years were utilized from 1,530 men and 1,518 women from the British 1946 birth cohort. Generalized linear models with a binomial distribution were used to examine the effects of gender, childhood and adult SEP, and the differences in the SEP effects by gender on the prevalence of limitations at age 43 years and changes in prevalence from 43 to 53 years. RESULTS For both genders, the prevalence of upper and lower body limitations were reported at 3%-5% at age 43 years. However, by age 53 years, women's upper body limitations had increased to 28% and lower body limitations to 21%, whereas men's limitations had only increased to 12% and 11%, respectively. Men and women whose father's occupation was manual or whose adult head of household occupation was manual had higher prevalence of both limitations compared with those with non-manual backgrounds. These differences widened with age, especially in women. The effect of adult SEP on the prevalence of limitations was stronger than that of childhood SEP and was partly mediated by educational attainment. CONCLUSION Our findings provide the first evidence that prevention of disability in old age should begin early in midlife, especially for women from manual occupation households.
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Affiliation(s)
- Emily T Murray
- MRC Unit for Lifelong Health and Ageing, Division of Population Health, University College London, UK.
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