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Singh S, Goodwin S, Zhong S, Avan A, Rogers K, Hachinski V, Frisbee S. Inequalities in health-related quality of life and functional health of an aging population: A Canadian community perspective. PLoS One 2024; 19:e0304457. [PMID: 38968188 PMCID: PMC11226017 DOI: 10.1371/journal.pone.0304457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/13/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Reducing health inequalities among older adults is crucial to ensuring healthy aging is within reach for all. The current study provides a timely update on demographic- and geographic-related inequalities in healthy aging among older adults residing in Canadian communities. METHODS Data was extracted from the Canadian Health Survey on Seniors [2019-2020] for ~6 million adults aged 65 years and older residing in 10 provinces of Canada. Healthy aging was defined by two indices: 1] health-related quality of life and 2] functional health. Poisson regression models and spatial mapping were used to demonstrate inequalities among age, race, and sex categories, and health regions. RESULTS Approximately 90.3% of individuals reported less than perfect quality of life and 18.8% reported less than perfect functional health. The prevalence of less than perfect quality of life was higher for females [PR 1.14, 95% CI;1.02-1.29] and for older adults aged ≥80 years as compared to males and older adults aged ≤79 years [PR 1.66, 95% CI;1.49-1.85]. Similarly, the prevalence of less than perfect functional health was higher for females [PR 1.58, 95% CI;1.32-1.89] and for older adults aged ≥80 years [PR 2.71, 95% CI;2.59-2.84]. Spatial mapping showed that regions of lower quality of life were concentrated in the Prairies and Western Ontario, whereas regions of higher quality of life were concentrated in Quebec. CONCLUSIONS Amongst older individuals residing in Canadian communities, less than perfect quality of life and functional health is unequally distributed among females, older adults aged ≥80 years, and those residing in the Prairie regions specifically. Newer policy should focus on interventions targeted at these subpopulations to ensure that healthy aging in within reach for all Canadians.
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Affiliation(s)
- Sarah Singh
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada
| | - Shane Goodwin
- Department of Sociology, University of Western Ontario, London, Ontario, Canada
| | - Shiran Zhong
- Department of Geography, University of Western Ontario, London, Ontario, Canada
| | - Abolfazl Avan
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada
| | - Kem Rogers
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Vladimir Hachinski
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada
- Department of Clinical Neurological Sciences, and Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Stephanie Frisbee
- Department of Pathology & Laboratory Medicine, and Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
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2
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Kim SY, Park J, Choi H, Loeser M, Ryu H, Seo K. Digital Marker for Early Screening of Mild Cognitive Impairment Through Hand and Eye Movement Analysis in Virtual Reality Using Machine Learning: First Validation Study. J Med Internet Res 2023; 25:e48093. [PMID: 37862101 PMCID: PMC10625097 DOI: 10.2196/48093] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/07/2023] [Accepted: 09/22/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND With the global rise in Alzheimer disease (AD), early screening for mild cognitive impairment (MCI), which is a preclinical stage of AD, is of paramount importance. Although biomarkers such as cerebrospinal fluid amyloid level and magnetic resonance imaging have been studied, they have limitations, such as high cost and invasiveness. Digital markers to assess cognitive impairment by analyzing behavioral data collected from digital devices in daily life can be a new alternative. In this context, we developed a "virtual kiosk test" for early screening of MCI by analyzing behavioral data collected when using a kiosk in a virtual environment. OBJECTIVE We aimed to investigate key behavioral features collected from a virtual kiosk test that could distinguish patients with MCI from healthy controls with high statistical significance. Also, we focused on developing a machine learning model capable of early screening of MCI based on these behavioral features. METHODS A total of 51 participants comprising 20 healthy controls and 31 patients with MCI were recruited by 2 neurologists from a university hospital. The participants performed a virtual kiosk test-developed by our group-where we recorded various behavioral data such as hand and eye movements. Based on these time series data, we computed the following 4 behavioral features: hand movement speed, proportion of fixation duration, time to completion, and the number of errors. To compare these behavioral features between healthy controls and patients with MCI, independent-samples 2-tailed t tests were used. Additionally, we used these behavioral features to train and validate a machine learning model for early screening of patients with MCI from healthy controls. RESULTS In the virtual kiosk test, all 4 behavioral features showed statistically significant differences between patients with MCI and healthy controls. Compared with healthy controls, patients with MCI had slower hand movement speed (t49=3.45; P=.004), lower proportion of fixation duration (t49=2.69; P=.04), longer time to completion (t49=-3.44; P=.004), and a greater number of errors (t49=-3.77; P=.001). All 4 features were then used to train a support vector machine to distinguish between healthy controls and patients with MCI. Our machine learning model achieved 93.3% accuracy, 100% sensitivity, 83.3% specificity, 90% precision, and 94.7% F1-score. CONCLUSIONS Our research preliminarily suggests that analyzing hand and eye movements in the virtual kiosk test holds potential as a digital marker for early screening of MCI. In contrast to conventional biomarkers, this digital marker in virtual reality is advantageous as it can collect ecologically valid data at an affordable cost and in a short period (5-15 minutes), making it a suitable means for early screening of MCI. We call for further studies to confirm the reliability and validity of this approach.
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Affiliation(s)
- Se Young Kim
- Department of Applied Artificial Intelligence, Seoul National University of Science and Technology, Seoul, Republic of Korea
| | - Jinseok Park
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hojin Choi
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Martin Loeser
- Department of Computer Science, Electrical Engineering and Mechatronics, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Hokyoung Ryu
- Graduate School of Technology and Innovation Management, Hanyang University, Seoul, Republic of Korea
| | - Kyoungwon Seo
- Department of Applied Artificial Intelligence, Seoul National University of Science and Technology, Seoul, Republic of Korea
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3
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Vlietstra L, Kirk B, Duque G, Qualls C, Vellas B, Andrieu S, Morley JE, Waters DL. Using minimal clinically important differences to measure long-term transitions of osteosarcopenia: The New Mexico Aging Process Study. Exp Gerontol 2023; 173:112106. [PMID: 36708751 DOI: 10.1016/j.exger.2023.112106] [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: 09/20/2022] [Revised: 01/16/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND/OBJECTIVE By having a better understanding of transitions in osteosarcopenia, interventions to reduce morbidity and mortality can be better targeted. The aim of this study was to show the rationale and method of using minimal clinically important differences (MCID's) to classify transitions, and the effects of demographic variables on transitions in a 9-year follow-up data from the New Mexico Aging Process Study (NMAPS). METHODS Transitions were identified in four aspects of osteosarcopenia: bone mineral density (BMD), appendicular skeletal muscle mass/body mass index ratio (ASM/BMI), grip strength and gait speed. Transitions were identified using a MCID score. As there is currently no available MCID for BMD and ASM/BMI, those were determined using a distribution-based and an anchor-based method. Total transitions were calculated for all four measures of osteosarcopenia in all transition categories (maintaining a health status, beneficial transition, harmful transitions). Poisson regression was used to test for effects of demographic variables, including age, sex, physical activity, medication, and health status, on transitions. RESULTS Over the 9-year follow-up, a total of 2163 MCID-derived BMD transitions were reported, 1689 ASM/BMI transitions, 2339 grip strength transitions, and 2151 gait speed transitions. Additionally, some MCID-derived transition categories were associated with sex, age, and health status. CONCLUSION Use of MCID-derived transitions reflected the fluctuation and the dynamic nature of health in older adults. Future research should focus on transitions of modifiable markers in osteosarcopenia to design intervention trials.
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Affiliation(s)
- Lara Vlietstra
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Ben Kirk
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia
| | - Gustavo Duque
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia; Research Institute of the McGill University Health Centre, McGill University, Montreal, QC H4A 3J1, Canada
| | - Clifford Qualls
- Department of Mathematics & Statistics and School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA
| | - Bruno Vellas
- Department of Internal and Geriatrics Medicine, Gerontopole, CHU de Toulouse, UMR 1295 INSERM, University Toulouse III, Toulouse, France; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA
| | - Sandrine Andrieu
- Department of Clinical Epidemiology and Public Health, CHU de Toulouse, UMR 1295 INSERM, University Toulouse III, Toulouse, France; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA
| | - John E Morley
- Division of Geriatric Medicine, Saint Louis University, 1402, South Grand Blvd, RoomM238, St. Louis, MO 63110-0250, USA
| | - Debra L Waters
- School of Physiotherapy, University of Otago, Dunedin, New Zealand; Department of Medicine, University of Otago, Dunedin, New Zealand; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA.
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Metzner G, Horstmeier LM, Bengel J, Bitzer EM, Dreher E, Frank F, Göhner A, Heimbach B, Himmelsbach I, Kaier K, Kiekert J, Kohler K, Laubner K, Lyssenko L, Maun A, Maurer C, Salm C, Seufert J, Voigt-Radloff S, Farin-Glattacker E. Local, collaborative, stepped, and personalized care management for older people with chronic diseases - results from the randomized controlled LoChro-trial. BMC Geriatr 2023; 23:92. [PMID: 36782119 PMCID: PMC9924193 DOI: 10.1186/s12877-023-03797-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 02/03/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND In the aging population of Western societies, an increasing number of older adults have multiple chronic diseases. As multifaceted health problems imply the involvement of several healthcare professionals, multimorbid older people frequently face a fragmentation of health care. Addressing these challenges, we developed a local, collaborative, stepped, and personalized care management approach (LoChro-Care) and evaluated its effectiveness. METHODS A two-group, parallel randomized controlled trial was conducted comparing LoChro-Care recipients (IG) to participants with usual care (CG). Patients aged 65 + with chronic conditions were recruited at inpatient and outpatient departments of the Medical Center, University of Freiburg. Participants were allocated using block randomization (nIG = 261, nCG = 263). LoChro-Care comprised individualized care provided by chronic care managers with 7 to 13 contacts over 12 months. Questionnaires were given at 3 time points (T0: baseline, T1: after 12 months, T2: after 18 months). The primary outcome was the physical, psychological, and social health status represented by a composite score of functional health and depressive symptoms. Secondary outcomes were the participants' evaluation of their health care situation, health-related quality of life (HRQL), and life-satisfaction (LS). The data were analyzed using linear mixed modelling. RESULTS We analyzed N = 491 participants (nIG = 244, nCG = 247), aged M = 76.78 years (SD = 6.35). For the composite endpoint, neither a significant difference between IG and CG (p = .88) nor a group-time interaction (p = .52; p = .88) could be observed. Participants in both groups showed a significant decline on the primary outcome between T0 and T2 (p < .001). Post hoc analyses revealed a decline in both functional health (p < .001) and depressive symptoms (p = .02). Both groups did not differ in their evaluation of their health care situation (p = .93), HRQL (p = .44) or LS (p = .32). Relevant confounding variables were female gender and multimorbidity. CONCLUSION Supporting patients' self-management in coordinating their individual care network through LoChro-Care did not result in any significant effect on the primary and secondary outcomes. A decline of functional health and depressive symptoms was observed among all participants. Potential future intervention adaptations are discussed, such as a more active case management through direct referral to (in-)formal support, an earlier treatment initiation, and the consideration of specific sociodemographic factors in care management planning. TRIAL REGISTRATION German Clinical Trials Register (DRKS): DRKS00013904 (02.02.2018), https://drks.de/search/de/trial/DRKS00013904.
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Affiliation(s)
- Gloria Metzner
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany.
| | - Lukas Maximilian Horstmeier
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany
| | - Jürgen Bengel
- Department of Rehabilitation Psychology and Psychotherapy, University of Freiburg, Engelbergerstr. 41, 79085, Freiburg, Germany
| | - Eva Maria Bitzer
- University of Education Freiburg, Public Health and Health Education, Kunzenweg 21, 79117, Freiburg, Germany
| | - Elena Dreher
- Center for Geriatric Medicine and Gerontology, University Medical Center Freiburg, Faculty of Medicine and Medical Center, University of Freiburg, Lehener Str. 88, 79106, Freiburg, Germany
| | - Fabian Frank
- Department of Social Work, Protestant University of Applied Sciences Freiburg, Bugginger Straße 38, 79114, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104, Freiburg, Germany
| | - Anne Göhner
- Center for Geriatric Medicine and Gerontology, University Medical Center Freiburg, Faculty of Medicine and Medical Center, University of Freiburg, Lehener Str. 88, 79106, Freiburg, Germany
| | - Bernhard Heimbach
- Center for Geriatric Medicine and Gerontology, University Medical Center Freiburg, Faculty of Medicine and Medical Center, University of Freiburg, Lehener Str. 88, 79106, Freiburg, Germany
| | - Ines Himmelsbach
- Catholic University of Applied Sciences Freiburg, Karlstraße 63, 79104, Freiburg, Germany
| | - Klaus Kaier
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Zinkmattenstr. 6a, 79108, Freiburg, Germany
| | - Jasmin Kiekert
- Catholic University of Applied Sciences Freiburg, Karlstraße 63, 79104, Freiburg, Germany
| | - Katharina Kohler
- Center for Geriatric Medicine and Gerontology, University Medical Center Freiburg, Faculty of Medicine and Medical Center, University of Freiburg, Lehener Str. 88, 79106, Freiburg, Germany
| | - Katharina Laubner
- Division of Endocrinology and Diabetology, Department of Medicine II, University Medical Center Freiburg, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Lisa Lyssenko
- University of Education Freiburg, Public Health and Health Education, Kunzenweg 21, 79117, Freiburg, Germany
| | - Andy Maun
- Institute of General Practice / Family Medicine, Medical Center - University of Freiburg, Faculty of Medicine, Elsässer Str. 2m, 79110, Freiburg, Germany
| | - Christoph Maurer
- Center for Geriatric Medicine and Gerontology, University Medical Center Freiburg, Faculty of Medicine and Medical Center, University of Freiburg, Lehener Str. 88, 79106, Freiburg, Germany
| | - Claudia Salm
- Institute of General Practice / Family Medicine, Medical Center - University of Freiburg, Faculty of Medicine, Elsässer Str. 2m, 79110, Freiburg, Germany
| | - Jochen Seufert
- Division of Endocrinology and Diabetology, Department of Medicine II, University Medical Center Freiburg, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Sebastian Voigt-Radloff
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany.,Center for Geriatric Medicine and Gerontology, University Medical Center Freiburg, Faculty of Medicine and Medical Center, University of Freiburg, Lehener Str. 88, 79106, Freiburg, Germany
| | - Erik Farin-Glattacker
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany
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Charlton RA, McQuaid GA, Wallace GL. Social support and links to quality of life among middle-aged and older autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:92-104. [PMID: 35362329 PMCID: PMC9806477 DOI: 10.1177/13623613221081917] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
LAY ABSTRACT Social support can take many forms, such as practical help, time spent socially with others, or the satisfaction with personal relationships. Social support is known to affect quality of life (QoL) in both non-autistic older and autistic young adults. QoL reflects how satisfied an individual is with their life either overall or in a certain area. We know little about middle-aged and older autistic adults' experiences of social support or QoL. In this study, 388 adults aged 40-83 years old, completed online questionnaires asking about background such as age and sex, depression and anxiety symptoms, QoL (physical, psychological, social, environmental, and autism-specific), and different types of social support. Even after taking into account background, depression, and anxiety, social support was important for individuals' QoL. To our knowledge this is the first paper to examine the relationship between social support and QoL in middle-aged and older autistic adults. Improving social support may have a significant impact on the QoL of older autistic adults. Future studies should examine whether age-related changes in social support (size, content, and arrangement of social networks) that are common in non-autistic aging, also occur among older autistic adults.
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Affiliation(s)
- Rebecca A Charlton
- Goldsmiths, University of London,
UK,Rebecca A Charlton, Department of
Psychology, Goldsmiths University of London, New Cross, London SE14 6NW, UK.
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Nygaard NPB, Thomsen GF, Rasmussen J, Skadhauge LR, Gram B. Ergonomic and individual risk factors for musculoskeletal pain in the ageing workforce. BMC Public Health 2022; 22:1975. [PMID: 36303167 PMCID: PMC9615169 DOI: 10.1186/s12889-022-14386-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/10/2022] [Indexed: 11/24/2022] Open
Abstract
Background The present study aimed to investigate the possible association between specific ergonomic and individual risk factors and musculoskeletal pain (MSP) in the back, shoulder, hip and knee region in workers aged 50-65y. Methods The study was a population based cross-sectional survey. The study population comprised citizens born between 1952–1966, living in Esbjerg municipality, Denmark, ultimo 2016 (n = 23,463). A questionnaire was sent electronically or by mail. The analysis included the working population only. A multivariate logistic regression was used for each of the following dependent variables; musculoskeletal pain for the past 3 months in the back, shoulder, hip and knee, where independent variables included ergonomic exposure, age, sex, body mass index (BMI) and leisure time physical activity (LTPA). Results The overall response rate was 58% and the data of individuals at work (n = 9,263) demonstrated several ergonomic exposures with increased odds for pain in specific regions. Exposure to back twisted or bend, squatting or lying on knees and to carrying or lifting were associated with musculoskeletal pain in the back, whereas exposure to back twisted or bend, arms above shoulder and repeated arm movement were associated with pain in the shoulder. Exposure to back twisted or bend, repeated arm movement, squatting or lying on knees and to carrying or lifting were associated with musculoskeletal pain in the hip. Important individual risk factors were also identified. Increasing age was significantly associated with increased pain in the hip but associated with less risk for pain in the back and shoulder. Males had higher odds for pain in the back and knee compared to females but lower odds for pain in the hip. BMI was particularly important for knee pain. The level of LTPA did not have an important association with MSP in any region. Conclusion There is a significant positive association between ergonomic exposures and musculoskeletal pain, which were specific for the back, shoulder, hip and knee. In addition, the data demonstrated a differential association with age, sex and BMI. This needs to be considered for the treatment and classification of musculoskeletal pain and for future preventive initiatives.
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Affiliation(s)
- Niels-Peter Brøchner Nygaard
- Research Unit of Health Science, Hospital of South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark. .,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - Gert Frank Thomsen
- Department of Occupational Medicine, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Jesper Rasmussen
- Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lars Rauff Skadhauge
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Occupational Medicine, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Bibi Gram
- Research Unit of Health Science, Hospital of South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Angel B, Ajnakina O, Albala C, Lera L, Márquez C, Leipold L, Bilovich A, Dobson R, Bendayan R. Grip Strength Trajectories and Cognition in English and Chilean Older Adults: A Cross-Cohort Study. J Pers Med 2022; 12:1230. [PMID: 36013179 PMCID: PMC9410389 DOI: 10.3390/jpm12081230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 11/27/2022] Open
Abstract
Growing evidence about the link between cognitive and physical decline suggests the early changes in physical functioning as a potential biomarker for cognitive impairment. Thus, we compared grip-strength trajectories over 12-16 years in three groups classified according to their cognitive status (two stable patterns, normal and impaired cognitive performance, and a declining pattern) in two representative UK and Chilean older adult samples. The samples consisted of 7069 UK (ELSA) and 1363 Chilean participants (ALEXANDROS). Linear Mixed models were performed. Adjustments included socio-demographics and health variables. The Declined and Impaired group had significantly lower grip-strength at baseline when compared to the Non-Impaired. In ELSA, the Declined and Impaired showed a faster decline in their grip strength compared to the Non-Impaired group but differences disappeared in the fully adjusted models. In ALEXANDROS, the differences were only found between the Declined and Non-Impaired and they were partially attenuated by covariates. Our study provides robust evidence of the association between grip strength and cognitive performance and how socio-economic factors might be key to understanding this association and their variability across countries. This has implications for future epidemiological research, as hand-grip strength measurements have the potential to be used as an indicator of cognitive performance.
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Affiliation(s)
- Bárbara Angel
- Public Health Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago 7830490, Chile; (B.A.); (L.L.); (C.M.)
| | - Olesya Ajnakina
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK; (O.A.); (L.L.); (R.D.); (R.B.)
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London WC1E 6BT, UK
| | - Cecilia Albala
- Public Health Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago 7830490, Chile; (B.A.); (L.L.); (C.M.)
| | - Lydia Lera
- Public Health Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago 7830490, Chile; (B.A.); (L.L.); (C.M.)
- Latin Division, Keiser University eCampus, Fort Lauderdale, FL 33409, USA
| | - Carlos Márquez
- Public Health Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago 7830490, Chile; (B.A.); (L.L.); (C.M.)
| | - Leona Leipold
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK; (O.A.); (L.L.); (R.D.); (R.B.)
- NIHR Biomedical Research Centre at South London and Maudsley, NHS Foundation Trust and King’s College London, London SE5 8AF, UK
| | - Avri Bilovich
- Centre for the Study of Decision-Making Uncertainty, University College London, London WC1E 6BT, UK;
| | - Richard Dobson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK; (O.A.); (L.L.); (R.D.); (R.B.)
- NIHR Biomedical Research Centre at South London and Maudsley, NHS Foundation Trust and King’s College London, London SE5 8AF, UK
- Health Data Research UK London, University College London, London WC1E 6BT, UK
- Institute of Health Informatics, University College London, London WC1E 6BT, UK
- NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK
| | - Rebecca Bendayan
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK; (O.A.); (L.L.); (R.D.); (R.B.)
- NIHR Biomedical Research Centre at South London and Maudsley, NHS Foundation Trust and King’s College London, London SE5 8AF, UK
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8
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Ip EH, Chen SH, Rejeski WJ, Bandeen-Roche K, Hayden KM, Hugenschmidt CE, Pierce J, Miller ME, Speiser JL, Kritchevsky SB, Houston DK, Newton RL, Rapp SR, Kitzman DW. Gradient and Acceleration of Decline in Physical and Cognitive Functions in Older Adults: A Disparity Analysis. J Gerontol A Biol Sci Med Sci 2022; 77:1603-1611. [PMID: 35562076 PMCID: PMC9373944 DOI: 10.1093/gerona/glac109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Substantive previous work has shown that both gait speed and global cognition decline as people age. Rates of their decline, as opposed to cross-sectional measurements, could be more informative of future functional status and other clinical outcomes because they more accurately represent deteriorating systems. Additionally, understanding the sex and racial disparity in the speed of deterioration, if any, is also important as ethnic minorities are at an increased risk of mobility disability and dementia. METHOD Data from 2 large longitudinal intervention studies were integrated. Rates of decline were derived from individual-level measures of gait speed of 400-m walk and scores on the Modified Mini Mental State Examination (3MSE). We also assessed age-associated declines and accelerations in changes across the ages represented in the studies (age range 53-90). RESULTS The mean rate of decline in 400-m gait speed across individuals was 0.03 m/s per year, and multivariable analysis showed a significant acceleration in decline of -0.0013 m/s/y2 (p < .001). Both race and sex moderated the rate of decline. For global cognition, the mean rate of decline was 0.05 of a point per year on the 3MSE scale, and acceleration in the rate of decline was significant (-0.017 point/y2, p < .001), but neither sex nor race moderated the decline. CONCLUSION Rate of decline in physical but not cognitive function appears moderated by sex and race. This finding, as well as rates and accelerations of decline estimated herein, could inform future intervention studies. CLINICAL TRIALS REGISTRATION NUMBER NCT00017953 (Look AHEAD); NCT01410097 (Look AHEAD ancillary); NCT00116194 (LIFE).
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Affiliation(s)
- Edward H Ip
- Address correspondence to: Edward H. Ip, Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, North Carolina 27157, USA. E-mail:
| | - Shyh-Huei Chen
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Karen Bandeen-Roche
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kathleen M Hayden
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Christina E Hugenschmidt
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - June Pierce
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Michael E Miller
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Jaime L Speiser
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Stephen B Kritchevsky
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Denise K Houston
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Robert L Newton
- Population and Public Health, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Dalane W Kitzman
- Sections of Cardiovascular and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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9
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Gyasi RM, Aboderin I, Asiki G. Prevalence and Social Risk Factors of Functional Limitations Among Slum-Dwelling Older Adults: Findings From the Nairobi Urban Health and Demographic Surveillance System. Gerontol Geriatr Med 2022; 8:23337214221088700. [PMID: 35573080 PMCID: PMC9102122 DOI: 10.1177/23337214221088700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 11/15/2022] Open
Abstract
Objective: In this study, we investigate the patterns and the risk factors of functional limitations in a sample of 1323 slum-dwelling older adults in Kenya who participated in the Nairobi Urban Health and Demographic Surveillance Systems. Methods: We conducted crude and adjusted logistic regression analyses to evaluate the associations. Results: The prevalence of activities of daily living (ADL) and instrumental ADL (IADL) limitations were approximately 5% and 8%, respectively; some 4.5% reported both limitations. Estimates varied significantly between sexes and age (p < .001). After adjustments, age, female, and Garre ethnic group were associated with ADL and IADL limitations. ADL decline was determined by co-residence (aOR = 0.93, 95% CI = 0.34–0.95), household size (aOR = 1.19, 95% CI = 1.04–1.37) and educational level (aOR = 0.45, 95% CI = 0.05–0.72). Conclusions: Older slum-dwellers in Nairobi experience functional impairments with marked age and sex differences. These findings may encourage salient policy planning and public health interventions to promote healthy aging in informal settlements.
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Affiliation(s)
- Razak M. Gyasi
- African Population and Health Research Center (APHRC), Nairobi, Kenya
- Faculty of Health, Southern Cross University, Lismore, NSW, Australia
| | - Isabella Aboderin
- Africa Research and Partnerships, Perivoli Africa Research Centre (PARC), School for Policy Studies, University of Bristol, Bristol, UK
| | - Gershim Asiki
- African Population and Health Research Center (APHRC), Nairobi, Kenya
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10
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Fohner AE, Sitlani CM, Buzkova P, Doyle MF, Liu X, Bis JC, Fitzpatrick A, Heckbert SR, Huber SA, Kuller L, Longstreth WT, Feinstein MJ, Freiberg M, Olson NC, Seshadri S, Lopez O, Odden MC, Tracy RP, Psaty BM, Delaney JA, Floyd JS. Association of Peripheral Lymphocyte Subsets with Cognitive Decline and Dementia: The Cardiovascular Health Study. J Alzheimers Dis 2022; 88:7-15. [PMID: 35527553 PMCID: PMC9277688 DOI: 10.3233/jad-220091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Alison E. Fohner
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Colleen M. Sitlani
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
| | - Petra Buzkova
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Margaret F. Doyle
- Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Xiaojuan Liu
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA
| | - Joshua C. Bis
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
| | - Annette Fitzpatrick
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
- Department of Family Medicine and Global Health, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Susan R. Heckbert
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Sally A. Huber
- Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Lewis Kuller
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - William T. Longstreth
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Matthew J. Feinstein
- Departments of Medicine, Preventive Medicine and Pathology, Northwestern University, Evanston, IL, USA
| | - Matthew Freiberg
- Department of Cardiovascular Medicine, Vanderbilt University, Nashville, TN, USA
| | - Nels C. Olson
- Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, TX, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Oscar Lopez
- Departments of Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michelle C. Odden
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA
| | - Russell P. Tracy
- Department of Biochemistry, Larner College of Medicine, University of Vermont, Burlington, VT, USA
- Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Joseph A. Delaney
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
- College of Pharmacy, University of Manitoba, Winnipeg, MB, Canada
| | - James S. Floyd
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
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11
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Sefcik JS, Petrovsky DV, Huang L, Behrens LL, Naylor MD, Hodgson NA, Hirschman KB. Predictors of change over time in satisfaction with outdoor activities ratings among long-term care services and supports recipients. Geriatr Nurs 2022; 45:153-159. [PMID: 35472750 PMCID: PMC9353871 DOI: 10.1016/j.gerinurse.2022.03.007] [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: 01/19/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To identify predictors of change in older adults' satisfaction with outdoor activities ratings over the first two years of enrollment in long-term services and supports (LTSS). METHODS Self-rated satisfaction with outdoor activities (not at all satisfied to extremely satisfied) was the primary outcome of this secondary data analysis. Mixed-effects linear regression modeling with a backward elimination process was used for analyses. RESULTS In the final model (N = 453) older LTSS recipients at baseline had lower ratings of satisfaction with outdoor activities over time, whereas younger recipients had higher ratings over time. Those who moved into a residential facility at baseline had an increase in outdoor activity satisfaction ratings over time compared to older adults who received home and community-based services that had a decrease. DISCUSSION LTSS clinicians can use these findings to support older adults with decision-making around enrollment into LTSS, address preferences, and develop person-centered care interventions for outdoor activity.
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Affiliation(s)
- Justine S Sefcik
- Drexel University College of Nursing and Health Professions, 1601 Cherry St., Room 377, Philadelphia, PA 19102, United States.
| | - Darina V Petrovsky
- Rutgers University School of Nursing and Institute for Health, Health Care Policy, and Aging Research, 112 Paterson St, New Brunswick, NJ, 08901, United States
| | - Liming Huang
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, United States
| | - Liza L Behrens
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, 201 Nursing Sciences Building, University Park, PA 16803, United States
| | - Mary D Naylor
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, United States
| | - Nancy A Hodgson
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, United States
| | - Karen B Hirschman
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, United States
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12
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García-Castro FJ, Bendayan R, Dobson RJB, Blanca MJ. Cognition in informal caregivers: evidence from an English population study. Aging Ment Health 2022; 26:507-518. [PMID: 33719753 DOI: 10.1080/13607863.2021.1893270] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVES The relationship between caregiving and cognition remains unclear. We investigate this association comparing four cognitive tasks and exploring the role of potential explanatory pathways such as healthy behaviours (healthy caregiver hypothesis) and depression (stress process model). RESEARCH DESIGN AND METHODS Respondents were from English Longitudinal Study of Ageing (ELSA) (N = 8910). Cognitive tasks included immediate and delayed word recall, verbal fluency and serial 7 subtraction. Series of hierarchical linear regressions were performed. Adjustments included socio-demographics, health related variables, health behaviours and depression. RESULTS Being a caregiver was positively associated with immediate and delayed recall, verbal fluency but not with serial 7. For immediate and delayed recall, these associations were partially attenuated when adjusting for health behaviours, and depression. For verbal fluency, associations were partially attenuated when adjusting for depression but fully attenuated when adjusting for health behaviours. No associations were found for serial 7. DISCUSSION AND IMPLICATIONS Our findings show that caregivers have higher level of memory and executive function compared to non-caregivers. For memory, we found that although health behaviours and depression can have a role in this association, they do not fully explain it. However, health behaviours seem to have a clear role in the association with executive function. Public health and policy do not need to target specifically cognitive function but other areas as the promotion of healthy behaviours and psychological adjustment such as preventing depression and promoting physical activity in caregivers.
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Affiliation(s)
- F Javier García-Castro
- Department of Psychobiology and Behavioral Sciences Methodology, University of Malaga, Malaga, Spain
| | - Rebecca Bendayan
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Biomedical Research Centre at South London and Maudsley, NHS Foundation Trust and King's College London, London, UK
| | - Richard J B Dobson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Biomedical Research Centre at South London and Maudsley, NHS Foundation Trust and King's College London, London, UK
- Institute of Health Informatics, University College London, London, UK
- Health Data Research UK London, University College London, London, UK
- NIHR Biomedical Research Centre at University College London Hospitals NHS Foundation Trust, London, UK
| | - María J Blanca
- Department of Psychobiology and Behavioral Sciences Methodology, University of Malaga, Malaga, Spain
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13
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Wakida M, Asai T, Kubota R, Kuwabara T, Fukumoto Y, Sato H, Nakano J, Mori K, Ikezoe T, Hase K. Longitudinal effects of physical exercise on health-related outcomes based on frailty status in community-dwelling older adults. Geriatr Gerontol Int 2022; 22:213-218. [PMID: 35080094 DOI: 10.1111/ggi.14346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/02/2021] [Accepted: 12/27/2021] [Indexed: 12/23/2022]
Abstract
AIM To clarify the difference in the longitudinal effects of physical exercise on health-related outcomes according to the baseline frailty status (frail or non-frail) in community-dwelling older adults. METHODS Participants included 177 adults aged ≥65 years who carried out multicomponent physical exercises (strength, aerobic, gait and balance) for 40 min, one to three times per week, for 1 year at a day-care center. Bodyweight, comfortable walking speed, 6-min walking distance and Mini-Mental State Examination were measured at baseline and every 3 months. For longitudinal trend, we analyzed the change in scores from baseline for each outcome using the linear mixed effects model. Fixed effects included "group" (frail or non-frail), "time" (4 time points every 3 months, from 3 to 12 months) and "interaction between group and time." RESULTS The effect sizes from baseline showed almost all positive values for each outcome. The linear mixed effects model showed significant effects on "interaction between group and time" in changes in bodyweight (P = 0.033), "group" in changes in walking speed (P = 0.013) and "time" in changes in the Mini-Mental State Examination (P < 0.001). Bodyweight showed a decreasing trend in the non-frail group after 3 months, unlike in the frail group. For walking speed, moderate effect sizes (d = 0.67-0.74) were sustained over time in the frail group, as did lesser effect sizes (d = 0.26-0.40) in the non-frail group. CONCLUSIONS Exercise-based multicomponent interventions were effective for both groups. The longitudinal effects on walking speed and bodyweight were greater in the frail group. Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Masanori Wakida
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan.,KMU Day-Care Center Kori, Kansai Medical University Kori Hospital, Osaka, Japan
| | - Tsuyoshi Asai
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Ryo Kubota
- KMU Day-Care Center Kori, Kansai Medical University Kori Hospital, Osaka, Japan.,Department of Physical Medicine and Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Takayuki Kuwabara
- Department of Rehabilitation, Kansai Medical University Hospital, Osaka, Japan.,Department of Physical Medicine and Rehabilitation, Kansai Medical University, Osaka, Japan
| | | | - Haruhiko Sato
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Jiro Nakano
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Kimihiko Mori
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Tome Ikezoe
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Kimitaka Hase
- Department of Rehabilitation, Kansai Medical University Hospital, Osaka, Japan.,Department of Physical Medicine and Rehabilitation, Kansai Medical University, Osaka, Japan
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14
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Christofoletti M, Del Duca GF, Benedetti TRB, Malta DC. Sociodemographic determinants of multimorbidity in Brazilian adults and older adults: a cross-sectional study. SAO PAULO MED J 2022; 140:115-122. [PMID: 35043867 PMCID: PMC9623826 DOI: 10.1590/1516-3180.2021.0105.r1.31052021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/31/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Multimorbidity due to non-communicable chronic diseases (NCDs) constitutes a significant challenge for healthcare systems. To attenuate its impacts, it is essential to identify the sociodemographic determinants of this condition, which can discriminate against population segments that are more exposed. OBJECTIVE To identify associations between multimorbidity conditions and sociodemographic indicators among Brazilian adults and older adults. DESIGN AND SETTING Cross-sectional telephone-based survey in 26 Brazilian state capitals and the federal district. METHODS The Vigitel 2013 survey was used, with data collected via a questionnaire. The outcome was multimorbidity (2, 3 or 4 NCDs), and the exposures were sociodemographic indicators (age, sex, skin color, marital status and education). The analysis consisted of multinomial logistic regression (odds ratio), stratified by age. RESULTS Among adults, multimorbidity comprising two, three or four diseases was associated with advancing age (P < 0.001); two and three diseases, with having a partner (P = 0.004 and P < 0.001, respectively); and two, three or four diseases, with lower education (P < 0.001). Among older adults, two, three or four diseases were associated with female sex (P < 0.001); three diseases, with living with a partner (P = 0.018); two diseases, with black skin color (P = 0.016); and two or three diseases, with lower education (P < 0.001). CONCLUSIONS To control and prevent multimorbidity, strategies for individuals with existing chronic diseases, with partners and with lower education levels are needed. Particularly for adults, advancing age should be considered; and for older adults, being a woman and having black skin color.
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Affiliation(s)
- Marina Christofoletti
- MSc. Doctoral Student, Department of Physical Education, Universidade Federal de Santa Catarina (UFSC), Florianópolis (SC), Brazil.
| | - Giovani Firpo Del Duca
- PhD. Full Professor, Department of Physical Education, Universidade Federal de Santa Catarina (UFSC), Florianópolis (SC), Brazil.
| | - Tânia Rosane Bertoldo Benedetti
- PhD. Full Professor, Department of Physical Education, Universidade Federal de Santa Catarina (UFSC), Florianópolis (SC), Brazil.
| | - Deborah Carvalho Malta
- PhD. Full Professor, Department of Maternal and Child Nursing and Public Health, Universidade Federal de Minas Gerais, Minas Gerais (MG), Brazil.
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15
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Longitudinal and Cross-Sectional Association Between Gait Speed, Ankle Proprioception, and LE Numbness—Results From the Baltimore Longitudinal Study of Aging. J Aging Phys Act 2022; 31:453-457. [DOI: 10.1123/japa.2022-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 08/29/2022] [Accepted: 08/31/2022] [Indexed: 11/09/2022]
Abstract
Mobility declines in older adults can be determined through monitoring longitudinal changes in gait speed. We examined longitudinal changes [in] ankle proprioception among those with and without baseline lower extremity numbness to develop a better understanding of mobility declines in healthy older adults. Participants included 568 adults (52.8% women) aged 60–98 years from the Baltimore Longitudinal Study of Aging. Larger ankle proprioception decreases during plantar flexion were found in the participants with lower extremity numbness compared with those without numbness (p = .034). Among participants with lower extremity numbness, slower baseline speeds from both usual and fast pace gait were associated with performance decline in ankle proprioception measured during ankle dorsiflexion (p = .039 and p = .004, respectively). Assisting older adults, especially those with lower extremity numbness, to maintain and improve ankle proprioception may help prevent mobility declines that have previously been considered age related.
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16
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Sleep and Risk for Metabolic Syndrome, Hypertension, Diabetes and Obesity Among Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2022; 15:88-102. [PMID: 36895436 PMCID: PMC9987437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
Older adults often face a variety of health problems that are found less frequently in younger populations. Metabolic syndrome and other related diseases are common due to a variety of age and lifestyle factors. Sleep, often operationalized only as duration, quality, or apnea diagnosis, is associated with worse health outcomes across the lifespan. However, sleep is multi-faceted and may require a collection of measures in order to reflect this. This study examined a suite of self-reported sleep habits (risk for sleep apnea, night time duration, nap duration, quality, timing, and consistency of duration and timing) and physiological data in a sample of 144 older adults. Sleep-related variables as a group predicted risk for metabolic syndrome, hypertension, and diabetes but was not a clear predictor of obesity. Of the individual measures, risk for apnea and consistency of sleep duration throughout the week predicted risk for metabolic syndrome (apnea b = .64, p < .05; duration inconsistencies b = .22, p < .05). The findings of the study suggest that greater consistency in sleep schedules may benefit the health of older adult populations' risk for these disorders.
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17
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Nygaard NPB, Thomsen GF, Rasmussen J, Skadhauge LR, Gram B. Workability in the Ageing Workforce-A Population-Based Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312656. [PMID: 34886382 PMCID: PMC8656594 DOI: 10.3390/ijerph182312656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/21/2021] [Accepted: 11/29/2021] [Indexed: 12/20/2022]
Abstract
Background: The purpose of this study was to investigate the impact of age, musculoskeletal pain and ergonomic exposure on workability in the oldest group of workers. Methods: The study was a population based cross-sectional survey. The study population comprised citizens born between 1952–1966, living in Esbjerg municipality ultimo 2016 (n = 23,463). A questionnaire was sent electronically or by mail. The analysis included the working population only. A stereotype logistic regression was used with the primary dependent variable being workability and independent variables included age, musculoskeletal pain, and ergonomic exposure. Results: The response rate was 58% and the data demonstrated a significant negative association between age and workability. With excellent workability as a reference, the odds for poor workability increased by 97% being 60+ y compared to 50–55 y. Both moderate intensity and severe musculoskeletal pain in the back, shoulder and knee/hip all showed significantly higher odds for poor workability. Ergonomic exposures, such as standing/walking, working with back bent or twisted and carrying or lifting had a significant negative impact on workability. Conclusion: Age, musculoskeletal pain and ergonomic exposures showed a significant negative impact on workability in the oldest group of workers and should be targeted with preventive initiatives.
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Affiliation(s)
- Niels-Peter Brøchner Nygaard
- Research Unit of Health Science, Hospital of South West Jutland, University Hospital of Southern Denmark, 6700 Esbjerg, Denmark;
- Department of Regional Health Research, University of Southern Denmark, 5230 Odense, Denmark;
- Correspondence: ; Tel.: +45-20612033
| | - Gert Frank Thomsen
- Department of Occupational Medicine, Hospital of South West Jutland, University Hospital of Southern Denmark, 6700 Esbjerg, Denmark;
| | - Jesper Rasmussen
- Department of Occupational and Environmental Medicine, Odense University Hospital, 5000 Odense, Denmark;
- Department of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark
| | - Lars Rauff Skadhauge
- Department of Regional Health Research, University of Southern Denmark, 5230 Odense, Denmark;
- Department of Occupational Medicine, Hospital of South West Jutland, University Hospital of Southern Denmark, 6700 Esbjerg, Denmark;
| | - Bibi Gram
- Research Unit of Health Science, Hospital of South West Jutland, University Hospital of Southern Denmark, 6700 Esbjerg, Denmark;
- Department of Regional Health Research, University of Southern Denmark, 5230 Odense, Denmark;
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18
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Choi SL, Men F. Food insecurity associated with higher COVID-19 infection in households with older adults. Public Health 2021; 200:7-14. [PMID: 34653739 PMCID: PMC8433037 DOI: 10.1016/j.puhe.2021.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/16/2021] [Accepted: 09/03/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES As a well-documented social determinant of health, food insecurity may be associated with COVID-19 infection in households with older adults. We examined whether older adults were vulnerable to COVID-19 infection during the early pandemic if they were food insecure versus food secure. STUDY DESIGN A cross-sectional study using a nationally representative population-based survey of US older adults. METHODS We used a random subsample of Health and Retirement Study (HRS) drawn in June 2020 (N = 3212). We compared the odds of reporting COVID-19 infection in a household, COVID-19 infection and mortality among acquaintances, and respondent's perceived fair or poor health across household food insecurity status resulted from financial or non-financial barriers. Baseline health and socioeconomic circumstances were adjusted in the models. RESULTS Results showed a higher COVID-19 infection rate among food-insecure households than among their food-secure counterparts during the pandemic. Food insecurity due to non-financial obstacles was associated with greater likelihood of COVID-19 infection both within respondents' households (adjusted odds ratio [aOR] = 1.73, 95% confidence interval [CI]: 1.03-2.90) and among their acquaintances (aOR = 1.32, 95% CI: 1.05-1.65). Food insecurity caused by both non-financial and financial constraints was associated with twice the likelihood of knowing someone who died from COVID-19 than their food-secure counterparts (aOR = 2.14, 95% CI: 1.27-3.61). CONCLUSIONS Food insecurity driven by non-financial constraints played an important role in the ongoing pandemic among US older adults. Policies addressing COVID-19 need to recognize the vulnerability of food-insecure older adults beyond lack of monetary resources.
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Affiliation(s)
- S L Choi
- The University of Alabama, 304 Adams Hall, Box 870158, Tuscaloosa, AL 35487, United States.
| | - F Men
- The University of Alabama, 316 Adams Hall, Box 870158, Tuscaloosa, AL 35487, United States
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19
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Endrighi R, Zhao Y, Hughes RB, Kumar D, Borrelli B. Associations Between Smoking Status and Physical and Mental Health-Related Quality of Life Among Individuals With Mobility Impairments. Ann Behav Med 2021; 56:890-899. [PMID: 34453512 DOI: 10.1093/abm/kaab077] [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: 11/12/2022] Open
Abstract
BACKGROUND In the general population, quitting smoking is associated with improved health-related quality of life (QoL), but this association has not been examined in smokers with chronic mobility impairments (MIs). PURPOSE We examined associations between smoking status and health-related QoL over 6 months, and whether relationships are moderated by depression and MI severity. METHODS This is a secondary analysis of a smoking cessation induction trial among smokers with MIs (n = 241, 56% female, 36% Black) assessed at baseline, and 4 and 6 months after. Participants were grouped into "Smokers" (smoking at 4 and 6 months), "Abstainers" (quit at 4 and 6 months), "Relapsers" (relapsed at 6 months), and "Late-quitters" (quit at 6 months). Physical and mental health-related QoL was assessed with the Short-Form Health Survey. Depression was defined as scores ≥10 on the Patient Health Questionnaire, and MI severity by the use of skilled care for personal needs. Data were analyzed with linear mixed models. RESULTS Aggregating across time, among nondepressed participants, compared with "Smokers," the "Abstainer," and "Late-quitter" groups improved their physical health scores. "Late-quitters" also improved compared with "Relapsers." Among the total sample, compared with "Smokers," "Abstainers" showed improvements in mental health scores overtime, whereas "Relapsers" improved their score at 4 months, and "Late-quitters" improved at 6 months. CONCLUSIONS Quitting smoking is associated with improvements in physical health-related QoL regardless of the severity of MI but only among those without depression at baseline. For mental health-related QoL, associations with quitting smoking were independent of baseline depression and severity of MI.
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Affiliation(s)
- Romano Endrighi
- Center for Behavioral Science Research, Department of Health Policy & Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA
| | - Yihong Zhao
- Center of Alcohol and Substance Use Studies, Department of Applied Psychology, Rutgers University, Piscataway, NJ, USA
| | - Rosemary B Hughes
- Rural Institute for Inclusive Communities and the Department of Psychology, University of Montana, Missoula, MT, USA
| | - Deepak Kumar
- Department of Physical Therapy & Athletic Training, Sargent College, Boston University, Boston, MA, USA
| | - Belinda Borrelli
- Center for Behavioral Science Research, Department of Health Policy & Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA
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20
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Ng YL, Hill KD, Jacques A, Burton E. Reliability and Validity of a Modified Version of the Community Balance and Mobility Scale (CBMS-Home) for Use in Home Assessment. Phys Ther 2021; 101:6290102. [PMID: 34077548 DOI: 10.1093/ptj/pzab134] [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: 08/06/2020] [Revised: 02/09/2021] [Accepted: 04/09/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The Community Balance and Mobility Scale (CBMS) has been shown to be a valid and reliable outcome measure for evaluating balance and mobility among older adults; however, some items cannot be conducted in all home environments, limiting its use in home-based assessments. The purpose of this study was to evaluate the accuracy and selected measurement properties of a modified 12-item CBMS-Home (8 original items and 4 modified items of the CBMS) feasible for use within the constraints of home assessments for older adults. METHODS Fifty-five people (mean [SD] age = 77.2 [6.0] years) were recruited for this validation study. Participants completed the full original CBMS, CBMS-Home (the modified items of the CBMS), the Functional Reach Test, and Step Test. Principal components analysis, internal consistency, test-retest and intermethod reliability, agreements within and between methods, and criterion validity were calculated. RESULTS Principal components analysis of CBMS and CBMS-Home both revealed 3 similar components and loadings. Bland-Altman and weighted κ analyses revealed that the CBMS-Home demonstrated moderate to almost perfect agreement (weighted κ = 0.45-0.84) with CBMS. The distribution of scores of CBMS-Home were satisfactory, and other results showed excellent test-retest (intraclass correlation coefficient [ICC] = 0.95) and intermethod reliability (ICC = 0.94) and internal consistency (Cronbach α = 0.94). There were no ceiling effects (0%) or floor (1.8%) effects. CBMS-Home demonstrated a low (Spearman ρ = 0.39) and moderate positive (Spearman ρ = 0.63) relationship with the Functional Reach Test and Step Test, respectively. CONCLUSIONS The CBMS-Home has good psychometric properties and provides a useful multidimensional assessment tool. IMPACT A modified version of the CBMS (CBMS-Home) can be confidently used to assess older adults-within their own home-who might have mild balance impairments.
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Affiliation(s)
- Yoke Leng Ng
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.,Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
| | - Keith D Hill
- Rehabilitation, Ageing, and Independent Living (RAIL) Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Angela Jacques
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Elissa Burton
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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21
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Li J, Lai DWL, Chappell NL. The Older, the Happier?: A Cross-Sectional Study on the "Paradox of Aging" in China. Res Aging 2021; 44:34-43. [PMID: 33626994 DOI: 10.1177/0164027521994225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The "paradox of aging" refers to the phenomenon that even though people's physical health and functions may decline when they enter later adulthood, their happiness does not necessarily. Previous studies have shown that older adults' better emotional regulation skills may contribute to the maintenance of their happiness. This study aims to examine the relationship between age, health, and happiness, and the moderating role of emotional stability. We adopted a nationally representative sample (n = 10,968) from the Chinese General Social Survey (CGSS) and performed weight-adjusted regression models with interaction terms. There is generally an S-shaped age-happiness relationship with significant urban-rural differences. Emotional stability buffers the negative association between health and happiness, and this moderating effect was stronger among older than younger adults, especially in rural China. This study calls for special attention paid to the oldest-old population in rural China and older adults' emotional regulation skills.
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Affiliation(s)
- Jia Li
- School of Public Health and Primary Health, Faculty of Medicine, 26680The Chinese University of Hong Kong
| | - Daniel W L Lai
- Faculty of Social Sciences, 26679Hong Kong Baptist University, Hong Kong
| | - Neena L Chappell
- Department of Sociology, 8205University of Victoria, British Columbia, Canada
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22
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Palapar L, Kerse N, Rolleston A, den Elzen WPJ, Gussekloo J, Blom JW, Robinson L, Martin-Ruiz C, Duncan R, Arai Y, Takayama M, Teh R. Anaemia and physical and mental health in the very old: An individual participant data meta-analysis of four longitudinal studies of ageing. Age Ageing 2021; 50:113-119. [PMID: 32939533 DOI: 10.1093/ageing/afaa178] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To determine the physical and mental health of very old people (aged 80+) with anaemia. METHODS Individual level meta-analysis from five cohorts of octogenarians (n = 2,392): LiLACS NZ Māori, LiLACS NZ non-Māori, Leiden 85-plus Study, Newcastle 85+ Study, and TOOTH. Mixed models of change in functional ability, cognitive function, depressive symptoms, and self-rated health over time were separately fitted for each cohort. We combined individual cohort estimates of differences according to the presence of anaemia at baseline, adjusting for age at entry, sex, and time elapsed. Combined estimates are presented as differences in standard deviation units (i.e. standardised mean differences-SMDs). RESULTS The combined prevalence of anaemia was 30.2%. Throughout follow-up, participants with anaemia, on average, had: worse functional ability (SMD -0.42 of a standard deviation across cohorts; CI -0.59,-0.25); worse cognitive scores (SMD -0.27; CI -0.39,-0.15); worse depression scores (SMD -0.20; CI -0.31,-0.08); and lower ratings of their own health (SMD -0.36; CI -0.47,-0.25). Differential rates of change observed were: larger declines in functional ability for those with anaemia (SMD -0.12 over five years; CI -0.21,-0.03) and smaller mean difference in depression scores over time between those with and without anaemia (SMD 0.18 over five years; CI 0.05,0.30). CONCLUSION Anaemia in the very old is a common condition associated with worse functional ability, cognitive function, depressive symptoms, and self-rated health, and a more rapid decline in functional ability over time. The question remains as to whether anaemia itself contributes to worse outcomes or is simply a marker of chronic diseases and nutrient deficiencies.
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Affiliation(s)
- Leah Palapar
- Department of General Practice and Primary Health Care, School of Population Health, The University of Auckland, New Zealand
| | - Ngaire Kerse
- Department of General Practice and Primary Health Care, School of Population Health, The University of Auckland, New Zealand
| | | | - Wendy P J den Elzen
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Jacobijn Gussekloo
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
- Department of Internal Medicine, Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Jeanet W Blom
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, United Kingdom
| | | | - Rachel Duncan
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Japan
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23
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Ko SU, Jerome GJ, Simonsick EM, Ferrucci L. Obstacle-Crossing Task-Related Usual Gait Patterns of Older Adults Differentiating Falls and Gait Ability. J Aging Phys Act 2020; 28:675-679. [PMID: 32084628 DOI: 10.1123/japa.2019-0227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 12/17/2019] [Accepted: 12/26/2019] [Indexed: 11/18/2022]
Abstract
Obstacle crossing, such as stepping over a curb, exerts additional demands on balance control, and therefore the study of usual-pace gait patterns associated with obstacle-crossing performance may provide additional insight into understanding falls and deterioration of gait in older adults. Participants included 432 adults aged 60-96 years (218 women). Participants who failed the obstacle-crossing task (n = 181) walked slower with smaller knee range of motion than participants who successfully completed the obstacle-crossing task (all ps < .001). Participants who failed the obstacle crossing reported a greater likelihood of falling in the previous year, more balance problems, lower walking ability, and needed longer time to complete 5 chair stands than those who passed the task (all ps < .05). Obstacle-crossing task may identify gait patterns in older adults who appear functionally intact, but who are nonetheless at risk of fall and balance problems.
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24
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Gual N, Pérez LM, Castellano-Tejedor C, Lusilla-Palacios P, Castro J, Soto-Bagaria L, Coll-Planas L, Roqué M, Vena AB, Fontecha B, Santiago JM, Lexell EM, Chiatti C, Iwarsson S, Inzitari M. IMAGINE study protocol of a clinical trial: a multi-center, investigator-blinded, randomized, 36-month, parallel-group to compare the effectiveness of motivational interview in rehabilitation of older stroke survivors. BMC Geriatr 2020; 20:321. [PMID: 32887564 PMCID: PMC7472581 DOI: 10.1186/s12877-020-01694-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 08/10/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Rehabilitation pathways are crucial to reduce stroke-related disability. Motivational Interviewing (MI), as a person-centered complex intervention, aimed to empower and motivate, and could be a resource to improve rehabilitation outcomes for older stroke survivors. The IMAGINE project aims to assess the impact of MI, as a complement to standard geriatric rehabilitation, on functional improvement at 30 days after admission, compared to standard geriatric rehabilitation alone, in persons admitted to geriatric rehabilitation after a stroke. Secondary objectives include assessing the impact of MI on physical activity and performance, self-efficacy, safety, cost-utility, participants' experiences and functional status at 3 months. METHODS We will conduct a multicenter randomized clinical trial in three geriatric rehabilitation hospitals in Spain. Older adults after mild-moderate stroke without previous severe cognitive impairment or disability will be randomized into the control or intervention group (136 per group, total N = 272). The intervention group will receive 4 sessions of MI by trained nurses, including the design of a personalized rehabilitation plan agreed between stroke survivors and nurses based on stroke survivors´ goals, needs, preferences and capabilities. Main outcome will be the Functional Independence Measure (FIM). In-hospital physical activity will be measured through accelerometers and secondary outcomes using validated scales. The study includes a process evaluation and cost-utility analysis. DISCUSSION Final results are expected by end of 2020. This study will provide relevant information on the implementation of MI as a rehabilitation reinforcement tool in older stroke survivors. A potential reduction in post-stroke disability and dependence would increase person's health-related quality of life and well-being and reduce health and social care costs. IMAGINE has the potential to inform practice and policymakers on how to move forward towards shared decision-making and shared responsibilities in the vulnerable population of older stroke survivors. TRIAL REGISTRATION ClinicalTrials.gov: NCT03434938 , registered on January 2018.
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Affiliation(s)
- Neus Gual
- REFiT BCN Research Group-Parc Sanitari Pere Virgili-Vall d'Hebron Institute of Research, Barcelona, Spain
| | - Laura Mónica Pérez
- REFiT BCN Research Group-Parc Sanitari Pere Virgili-Vall d'Hebron Institute of Research, Barcelona, Spain
| | - Carmina Castellano-Tejedor
- REFiT BCN Research Group-Parc Sanitari Pere Virgili-Vall d'Hebron Institute of Research, Barcelona, Spain. .,Autonomous University of Barcelona, Bellaterra, Spain.
| | | | - Judith Castro
- REFiT BCN Research Group-Parc Sanitari Pere Virgili-Vall d'Hebron Institute of Research, Barcelona, Spain
| | - Luís Soto-Bagaria
- REFiT BCN Research Group-Parc Sanitari Pere Virgili-Vall d'Hebron Institute of Research, Barcelona, Spain
| | - Laura Coll-Planas
- Fundació Salut i Envelliment (Foundation on Health and Ageing), Universitat Autònoma de Barcelona, Barcelona, Spain.,Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | - Marta Roqué
- Fundació Salut i Envelliment (Foundation on Health and Ageing), Universitat Autònoma de Barcelona, Barcelona, Spain.,Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | | | - Benito Fontecha
- Hospital General de l'Hospitalet (Consorci Sanitari Integral), Hospitalet de Llobregat, Spain
| | - Jose M Santiago
- Hospital General de l'Hospitalet (Consorci Sanitari Integral), Hospitalet de Llobregat, Spain
| | - Eva Månsson Lexell
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund-Malmö, Sweden
| | - Carlos Chiatti
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund-Malmö, Sweden
| | - Susanne Iwarsson
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund-Malmö, Sweden
| | - Marco Inzitari
- REFiT BCN Research Group-Parc Sanitari Pere Virgili-Vall d'Hebron Institute of Research, Barcelona, Spain.,Autonomous University of Barcelona, Bellaterra, Spain
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25
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Perri G, Mendonça N, Jagger C, Walsh J, Eastell R, Mathers JC, Hill TR. Dietary Selenium Intakes and Musculoskeletal Function in Very Old Adults: Analysis of the Newcastle 85+ Study. Nutrients 2020; 12:E2068. [PMID: 32664662 PMCID: PMC7400825 DOI: 10.3390/nu12072068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/30/2022] Open
Abstract
Background: Selenium is a trace element essential for health. Severe selenium deficiencies are associated with poor musculoskeletal (MSK) function. However, the effects of moderate deficiency on MSK function, especially in older adults, is unclear. Objectives: To determine the associations between selenium intake and MSK function in very old adults. Methods: Selenium intake at baseline and, hand-grip strength (HGS) and timed-up-and-go (TUG) at four phases over 5 years, were available in 791 participants in the Newcastle 85+ Study, a community-based, longitudinal cohort of ≥85 year old individuals. We investigated relationships between selenium intake and HGS and TUG in cross-sectional analyses at baseline using multivariate analyses and, prospectively using linear mixed models to explore HGS and TUG changes over 5 years in association with baseline selenium intake. Results: At baseline, 53% of participants had selenium intakes that were classified as low. These individuals had 2.80 kg lower HGS and were 2.30 s slower performing the TUG, cross-sectionally. In multivariate, baseline analyses, selenium intake had no significant impact on HGS or TUG. Selenium intake had no significant effect on MSK function, prospectively. Conclusion: Low selenium intake is common among very old adults and, in cross-sectional analyses, is associated with poorer MSK function.
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Affiliation(s)
- Giorgia Perri
- The MRC-Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Newcastle upon Tyne NE2 4HH, UK; (J.W.); (R.E.); (J.C.M.); (T.R.H.)
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK;
| | - Nuno Mendonça
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK;
- EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa (NMS-UNL), 1150-082 Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Universidade Nova de Lisboa, 1150-082 Lisbon, Portugal
| | - Carol Jagger
- Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK;
| | - Jennifer Walsh
- The MRC-Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Newcastle upon Tyne NE2 4HH, UK; (J.W.); (R.E.); (J.C.M.); (T.R.H.)
- Department of Oncology and Metabolism, University of Sheffield, Sheffield S5 7AU, UK
| | - Richard Eastell
- The MRC-Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Newcastle upon Tyne NE2 4HH, UK; (J.W.); (R.E.); (J.C.M.); (T.R.H.)
- Department of Oncology and Metabolism, University of Sheffield, Sheffield S5 7AU, UK
| | - John C. Mathers
- The MRC-Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Newcastle upon Tyne NE2 4HH, UK; (J.W.); (R.E.); (J.C.M.); (T.R.H.)
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK;
| | - Tom R. Hill
- The MRC-Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Newcastle upon Tyne NE2 4HH, UK; (J.W.); (R.E.); (J.C.M.); (T.R.H.)
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK;
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26
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Zullo A, Fleckenstein J, Schleip R, Hoppe K, Wearing S, Klingler W. Structural and Functional Changes in the Coupling of Fascial Tissue, Skeletal Muscle, and Nerves During Aging. Front Physiol 2020; 11:592. [PMID: 32670080 PMCID: PMC7327116 DOI: 10.3389/fphys.2020.00592] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/11/2020] [Indexed: 12/18/2022] Open
Abstract
Aging is a one-way process associated with profound structural and functional changes in the organism. Indeed, the neuromuscular system undergoes a wide remodeling, which involves muscles, fascia, and the central and peripheral nervous systems. As a result, intrinsic features of tissues, as well as their functional and structural coupling, are affected and a decline in overall physical performance occurs. Evidence from the scientific literature demonstrates that senescence is associated with increased stiffness and reduced elasticity of fascia, as well as loss of skeletal muscle mass, strength, and regenerative potential. The interaction between muscular and fascial structures is also weakened. As for the nervous system, aging leads to motor cortex atrophy, reduced motor cortical excitability, and plasticity, thus leading to accumulation of denervated muscle fibers. As a result, the magnitude of force generated by the neuromuscular apparatus, its transmission along the myofascial chain, joint mobility, and movement coordination are impaired. In this review, we summarize the evidence about the deleterious effect of aging on skeletal muscle, fascial tissue, and the nervous system. In particular, we address the structural and functional changes occurring within and between these tissues and discuss the effect of inflammation in aging. From the clinical perspective, this article outlines promising approaches for analyzing the composition and the viscoelastic properties of skeletal muscle, such as ultrasonography and elastography, which could be applied for a better understanding of musculoskeletal modifications occurring with aging. Moreover, we describe the use of tissue manipulation techniques, such as massage, traction, mobilization as well as acupuncture, dry needling, and nerve block, to enhance fascial repair.
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Affiliation(s)
- Alberto Zullo
- Department of Sciences and Technologies, University of Sannio, Benevento, Italy
- CEINGE Advanced Biotechnologies, Naples, Italy
| | - Johannes Fleckenstein
- Department of Sports Medicine, Institute of Sports Sciences, Goethe-University Frankfurt, Frankfurt, Germany
| | - Robert Schleip
- Department of Sport and Health Sciences, Technical University Munich, Munich, Germany
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller University Jena, Jena, Germany
| | - Kerstin Hoppe
- Department of Anaesthesiology, Würzburg University, Würzburg, Germany
| | - Scott Wearing
- Department of Sport and Health Sciences, Technical University Munich, Munich, Germany
- Faculty of Health School, Queensland University of Technology, Brisbane, QLD, Australia
| | - Werner Klingler
- Department of Sport and Health Sciences, Technical University Munich, Munich, Germany
- Faculty of Health School, Queensland University of Technology, Brisbane, QLD, Australia
- Fascia Research Group, Department of Experimental Anaesthesiology, Ulm University, Ulm, Germany
- Department of Anaesthesiology, SRH Hospital Sigmaringen, Sigmaringen, Germany
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27
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Abstract
To effectively communicate with people, social robots must be capable of detecting, interpreting, and responding to human affect during human–robot interactions (HRIs). In order to accurately detect user affect during HRIs, affect elicitation techniques need to be developed to create and train appropriate affect detection models. In this paper, we present such a novel affect elicitation and detection method for social robots in HRIs. Non-verbal emotional behaviors of the social robot were designed to elicit user affect, which was directly measured through electroencephalography (EEG) signals. HRI experiments with both younger and older adults were conducted to evaluate our affect elicitation technique and compare the two types of affect detection models we developed and trained utilizing multilayer perceptron neural networks (NNs) and support vector machines (SVMs). The results showed that; on average, the self-reported valence and arousal were consistent with the intended elicited affect. Furthermore, it was also noted that the EEG data obtained could be used to train affect detection models with the NN models achieving higher classification rates
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28
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Sonido M, Arnold S, Higgins J, Hwang YIJ. Autism in Later Life: What Is Known and What Is Needed? CURRENT DEVELOPMENTAL DISORDERS REPORTS 2020. [DOI: 10.1007/s40474-020-00192-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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29
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Waters DL, Vlietstra L, Qualls C, Morley JE, Vellas B. Sex-specific muscle and metabolic biomarkers associated with gait speed and cognitive transitions in older adults: a 9-year follow-up. GeroScience 2020; 42:585-593. [PMID: 32002783 PMCID: PMC7205909 DOI: 10.1007/s11357-020-00163-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 01/21/2020] [Indexed: 12/19/2022] Open
Abstract
Physical frailty and cognitive frailty share biological mechanisms, but sex-specific biomarkers associated with transitions in gait speed and cognition during ageing are poorly understood.Gait speed, cognition (3MSE), body composition (DXA) and serological biomarkers were assessed annually over 9 years in 216 males (72.7 + 8.07 years) and 384 females (71.1 + 8.44 years). In females, maintaining normal gait speed was associated with lower percent body fat (IRR 0.793, p = 0.001, 95%CI 0.691-0.910) and lower lactate dehydrogenase (LDH) (IRR 0.623, p = 0.00, 95%CI 0.514-0.752), and in males, the association was with higher cholesterol (IRR 1.394, p = 0.001, 95%CI 1.154-1.684). Abnormal to normal gait speed transitions were associated with higher insulin in females (IRR 1.325, p = 0.022, 95%CI 1.041-1.685) and lower creatinine in males (IRR 0.520, p = 0.01, 95%CI 0.310-0.870). Normal to slow gait speed transitions in males were associated with IGF-1 (IRR 1.74, p = 0.022, 95%CI 1.08-2.79) and leptin in females (IRR 1.39, p = 0.043, 95%CI 1.01-1.91.) Maintaining normal cognition was associated with lower LDH in females (IRR 0.276, p = 0.013, 95%CI 0.099-0.765) and higher appendicular skeletal muscle mass in males (IRR 1.52, p = 0.02, 95%CI 1.076-2.135). Improved cognition was associated with higher leptin (IRR 7.5, p = 0.03, 95%CI 1.282-44.34) and lower triglyceride (IRR 0.299, p = 0.017, 95%CI 0.110-0.809) in males. Education was protective against cognitive decline in females (IRR 0.84, p = 0.037, 0.732-0.982). Sex-specific biomarkers of muscle (LDH, Creatinine, IGF-1, APSM) and metabolism (%fat, insulin,cholesterol, leptin, tryglycerides) were associated with gait speed and cognitive transitions. These data suggest that modifiable biomarkers of muscle and metabolism could be targeted for interventions.
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Affiliation(s)
- D L Waters
- Department of Medicine and School of Physiotherapy, University of Otago, Dunedin, 9054, New Zealand.
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, 87131, USA.
| | - L Vlietstra
- Department of Medicine and School of Physiotherapy, University of Otago, Dunedin, 9054, New Zealand
| | - C Qualls
- Department of Mathematics & Statistics and School of Medicine, University of New Mexico, Albuquerque, NM, 87131, USA
| | - J E Morley
- Division of Geriatric Medicine, Saint Louis University, 1402 South Grand Blvd, Room M238, St. Louis, MO, 63110-0250, USA
| | - B Vellas
- Department of Internal and Geriatrics Medicine, Gerontopole, CHU de Toulouse, UMR 1027 INSERM, University Toulouse III, Toulouse, France
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30
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Xin C, Zhang B, Fang S, Zhou J. Daytime napping and successful aging among older adults in China: a cross-sectional study. BMC Geriatr 2020; 20:2. [PMID: 31898552 PMCID: PMC6941277 DOI: 10.1186/s12877-019-1408-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/22/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The study aimed to examine the association between daytime napping and successful aging (including its five dimensions, "low probability of disease," "no disease-related disability," "high cognitive functioning," "high physical functioning," and "active engagement with life") among China's older adults using data from the Chinese Health and Retirement Longitudinal Study conducted in 2015. METHODS Cross-sectional data were used in the analysis. Multivariable logistic regressions were conducted to investigate the association between daytime napping and successful aging, and stratified analyses were performed to explore differences in nighttime sleep duration. RESULTS A total of 7469 participants were included in the analysis. Daytime napping was prevalent in China's older adults (59.3%). The proportion of study participants with "successful aging" was 13.7%. Additionally, 48.6, 91.7, 54.1, 78.5, and 49.1% participants achieved "low probability of disease," "no disease-related disability," "high cognitive functioning," "high physical functioning," and "active engagement with life," respectively. Compared with the 0 min/day napping group, the > 60 min/day napping group was associated with a lower probability of achieving successful aging (OR, 0.762; 95% CI, 0.583-0.996). In the nighttime sleep duration stratification, the findings showed that in the ≥8 h/night group, napping > 60 min per day was associated with a lower likelihood of aging successfully (OR, 0.617; 95% CI, 0.387-0.984). Considering the five dimensions of successful aging, moderate and long daytime napping were negatively associated with "low probability of disease"; long daytime napping had negative associations with "no disease-related disability" and "high physical functioning"; moderate daytime napping had positive associations with "high cognitive functioning" and "active engagement with life." CONCLUSIONS Long daytime napping showed a lower likelihood of successful aging among the elderly in China. Special attention is necessary for elderly people who sleep for longer duration both during day and night. Biological and social factors affecting the relationship between daytime napping and successful aging need to be explored in depth in the future.
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Affiliation(s)
- Chunyu Xin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Baiyang Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Shu Fang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Hong Kong, 999077, Pokfulam, China
| | - Junmin Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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Wallace ML, Buysse DJ, Redline S, Stone KL, Ensrud K, Leng Y, Ancoli-Israel S, Hall MH. Multidimensional Sleep and Mortality in Older Adults: A Machine-Learning Comparison With Other Risk Factors. J Gerontol A Biol Sci Med Sci 2019; 74:1903-1909. [PMID: 30778527 PMCID: PMC6853700 DOI: 10.1093/gerona/glz044] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Sleep characteristics related to duration, timing, continuity, and sleepiness are associated with mortality in older adults, but rarely considered in health recommendations. We applied machine learning to: (i) establish the predictive ability of a multidimensional self-reported sleep domain for all-cause and cardiovascular mortality in older adults relative to other established risk factors and (ii) to identify which sleep characteristics are most predictive. METHODS The analytic sample includes N = 8,668 older adults (54% female) aged 65-99 years with self-reported sleep characterization and longitudinal follow-up (≤15.5 years), aggregated from three epidemiological cohorts. We used variable importance (VIMP) metrics from a random survival forest to rank the predictive abilities of 47 measures and domains to which they belong. VIMPs > 0 indicate predictive variables/domains. RESULTS Multidimensional sleep was a significant predictor of all-cause (VIMP [99.9% confidence interval {CI}] = 0.94 [0.60, 1.29]) and cardiovascular (1.98 [1.31, 2.64]) mortality. For all-cause mortality, it ranked below that of the sociodemographic (3.94 [3.02, 4.87]), physical health (3.79 [3.01, 4.57]), and medication (1.33 [0.94, 1.73]) domains but above that of the health behaviors domain (0.22 [0.06, 0.38]). The domains were ranked similarly for cardiovascular mortality. The most predictive individual sleep characteristics across outcomes were time in bed, hours spent napping, and wake-up time. CONCLUSION Multidimensional sleep is an important predictor of mortality that should be considered among other more routinely used predictors. Future research should develop tools for measuring multidimensional sleep-especially those incorporating time in bed, napping, and timing-and test mechanistic pathways through which these characteristics relate to mortality.
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Affiliation(s)
- Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh, Pennsylvania
- Department of Biostatistics, University of Pittsburgh, Pennsylvania
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pennsylvania
| | - Susan Redline
- Departments of Medicine, Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Katie L Stone
- California Pacific Medical Center, Research Institute, San Francisco
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Kristine Ensrud
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis
- Center for Chronic Disease Outcomes Research, Veterans Affairs Health Care System, Minneapolis, Minnesota
| | - Yue Leng
- Department of Psychiatry, University of California, San Francisco
| | | | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pennsylvania
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de Breij S, Huisman M, Deeg DJH. Macro-level determinants of post-retirement health and health inequalities: A multilevel analysis of 18 European countries. Soc Sci Med 2019; 245:112669. [PMID: 31739142 DOI: 10.1016/j.socscimed.2019.112669] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 10/30/2019] [Accepted: 11/07/2019] [Indexed: 11/25/2022]
Abstract
Poor health after retirement may have an important economic and societal impact and may be affected by macro-level factors. Our aim was to examine whether macro-level factors are associated with health and educational differences in health in recent retirees. We used data covering 18 European countries from the Survey on Health, Ageing and Retirement in Europe (SHARE) and the English Longitudinal Study of Ageing (ELSA) on 8867 respondents who had been retired less than 5 years. We performed multi-level linear regression analyses to examine whether social expenditure in nine policy areas, minimum pension replacement rates, and unemployment replacement rates explained cross-country differences in post-retirement self-rated health (SRH) and educational inequalities in SRH. In both men and women, a higher total expenditure as well as higher expenditures on health, old age, housing, and 'other social policy areas' (non-categorical cash benefits to low-income households and other social services) were associated with better SRH. Cross-level interactions showed that in the presence of a higher old age expenditure, a higher unemployment expenditure, and a higher total expenditure, the absolute educational inequalities in post-retirement SRH were smaller than with lower expenditures in these areas, in both men and women. We found the same effect in women only for a higher expenditure on health as well as a higher minimum pension replacement rate. A higher expenditure on survivors pensions, a lower expenditure on family, and a higher unemployment replacement rate had this effect in men only. This study showed that social expenditure and replacement rates were associated with post-retirement health and health inequalities.
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Affiliation(s)
- Sascha de Breij
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, the Netherlands.
| | - Martijn Huisman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, the Netherlands; Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Dorly J H Deeg
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, the Netherlands.
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Food cultures and aging: a qualitative study of grandparents' food perceptions and influence of food choice on younger generations. Public Health Nutr 2019; 23:221-230. [PMID: 31566158 DOI: 10.1017/s1368980019002489] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore food perceptions among grandparents and understand the influence of these perceptions on food choice for the younger generations in their family. DESIGN Qualitative methodology, thematic analysis of the transcripts from fourteen focus groups. SETTING Grandparents in the southern region of the United States. SUBJECTS Participants were fifty-eight Black, Hispanic, and White grandparents, predominantly women (72%), ranging in age from 44-86 years (mean age = 65·4 (sd 9·97) years). RESULTS Grandparents' perceptions related to personal food choice were related to health issues and the media. Grandparents' perceived influence on their children's and grandchildren's food choices was described through the themes of proximity and power (level of influence based on an interaction of geographic proximity to grandchildren and the power given to them by their children and grandchildren to make food decisions), healthy v. unhealthy spoiling, cultural food tradition, and reciprocal exchange of knowledge. CONCLUSION Our results highlight areas for future research including nutrition interventions for older adults as well as factors that may be helpful to consider when engaging grandparents concerning food decisions for younger generations to promote health. Specifically, power should be assessed as part of a holistic approach to addressing dietary influence, the term 'healthy spoiling' can be used to reframe notions of traditional spoiling, and the role of cultural food tradition should be adapted differently by race.
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Lee YH, Lu P, Chang YC, Shelley M, Lee YT, Liu CT. Associations of alcohol consumption status with activities of daily living among older adults in China. J Ethn Subst Abuse 2019; 20:428-443. [PMID: 31530097 DOI: 10.1080/15332640.2019.1664961] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND With the rapid growth of the elderly population and public health challenges in China, concerns arise related to disability associated with activities of daily living (ADLs) and alcohol consumption status. This study assesses the relationships of alcohol consumption status with basic daily activities among Chinese older adults. METHODS A total of 5,133 participants aged 60 years or above from three waves of the Chinese Longitudinal Healthy Longevity Survey (2009, 2012, and 2014) were analyzed. Independent ADL items included bathing, dressing, toileting, indoor moving, continence, and feeding (without others' assistance). Multilevel ordered logistic regression model estimation was used to examine the results of total scores based on the Katz index. Multilevel logistic regression models also were estimated to study each index item separately to examine differences across each of the six ADLs. Additional confirmatory factor analysis (CFA) was performed to examine the validity of the index. RESULTS Preliminary CFA showed that most items had good factor loadings (>0.700), except for continence (0.256) and feeding (0.481). Based on the ordered regression model, former (AOR = 0.412, 95% CI: 0.294, 0.579, p < 0.001) and non-alcohol consumption (AOR = 0.598, 95% CI: 0.447, 0.800, p < 0.001) were negatively associated with the total score. Non-alcohol consumption status was negatively associated with ADL items separately (all ps < 0.05), with the exceptions of continence and feeding. CONCLUSION Alcohol consumption may be associated with Chinese older adults' better ADLs. However, further clinical or experimental trials are needed to examine the impact of alcohol consumption on older adults' ADLs.
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Cano Porras D, Sharon H, Inzelberg R, Ziv-Ner Y, Zeilig G, Plotnik M. Advanced virtual reality-based rehabilitation of balance and gait in clinical practice. Ther Adv Chronic Dis 2019; 10:2040622319868379. [PMID: 31489154 PMCID: PMC6710712 DOI: 10.1177/2040622319868379] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 07/06/2019] [Indexed: 11/16/2022] Open
Abstract
Background Extensive research shows that virtual reality (VR) enhances motor learning and has advantages in balance and gait rehabilitation of neurological patients. There is still uncertainty, however, as for the practicality and efficacy of VR in long-term clinical routine. The objective of this study was to report on 3 years of clinical practice conducting VR-based rehabilitation of balance and gait in a large medical center. Methods This retrospective study systematically analyzed clinical records of patients who received VR-based rehabilitation in a large rehabilitation center during 3 years. We evaluated the effect of VR-based rehabilitation treatments on balance and gait, cognitive dual-task load, patient's balance confidence (ABC-scale) and perception of suitability. Patients were either neurological patients, allocated to five groups: Parkinson's disease (PD), poststroke (PS), multiple sclerosis, traumatic brain injury, and 'other conditions', or non-neurological patients. Results Records of 167 patients were analyzed. The availability of multiple VR systems and environments contributed to highly personalized interventions that tailored specific deficits with therapeutic goals. VR-based rehabilitation significantly improved balance and gait (measured by 10-Meter Walk Test, Timed-Up-and-Go, Berg Balance Scale, and Mini BESTest). Patients with PD and PS decreased dual-task cost while walking. Patients increased balance confidence and deemed VR suitable for rehabilitation. Conclusions Our results suggest that VR-based rehabilitation is practicable and effective in clinical routine. Functional measures of balance and gait show significant improvements following VR-based interventions. Clinical approaches should exploit VR advantages for promoting motor learning and motivation. This study serves to aid transition to long-term clinical implementation of VR.
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Affiliation(s)
- Desiderio Cano Porras
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Tel HaShomer, Israel
| | - Hadar Sharon
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Tel HaShomer, Israel
| | - Rivka Inzelberg
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel HaShomer, Israel
| | - Yitzhak Ziv-Ner
- Department of Orthopedic Rehabilitation, Sheba Medical Center, Tel HaShomer, Israel
| | - Gabriel Zeilig
- Department of Neurological Rehabilitation, Sheba Medical Center, Tel HaShomer, Israel
| | - Meir Plotnik
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Derech Sheba 2, Ramat Gan, Tel HaShomer 52621, Israel
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Technology to Support Aging in Place: Older Adults' Perspectives. Healthcare (Basel) 2019; 7:healthcare7020060. [PMID: 30974780 PMCID: PMC6627975 DOI: 10.3390/healthcare7020060] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/03/2019] [Accepted: 04/03/2019] [Indexed: 11/17/2022] Open
Abstract
The U.S. population over 65 years of age is increasing. Most older adults prefer to age in place, and technologies, including Internet of things (IoT), Ambient/Active Assisted Living (AAL) robots and other artificial intelligence (AI), can support independent living. However, a top-down design process creates mismatches between technologies and older adults’ needs. A user-centered design approach was used to identify older adults’ perspectives regarding AAL and AI technologies and gauge interest in participating in a co-design process. A survey was used to obtain demographic characteristics and assess privacy perspectives. A convenience sample of 31 retirement community residents participated in one of two 90-min focus group sessions. The semi-structured group interview solicited barriers and facilitators to technology adoption, privacy attitudes, and interest in project co-design participation to inform technology development. Focus group sessions were audiotaped and professionally transcribed. Transcripts were reviewed and coded to identify themes and patterns. Descriptive statistics were applied to the quantitative data. Identified barriers to technology use included low technology literacy, including lack of familiarity with terminology, and physical challenges, which can make adoption difficult. Facilitators included an eagerness to learn, interest in co-design, and a desire to understand and control their data. Most participants identified as privacy pragmatics and fundamentalists, indicating that privacy is important to older adults. At the same time, they also reported a willingness to contribute to the design of technologies that would facilitate aging independently. There is a need to increase technology literacy of older adults along with aging literacy of technologists.
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Bůžková P, Barzilay JI, Fink HA, Robbins JA, Cauley JA, Ix JH, Mukamal KJ. Higher albumin:creatinine ratio and lower estimated glomerular filtration rate are potential risk factors for decline of physical performance in the elderly: the Cardiovascular Health Study. Clin Kidney J 2019; 12:788-794. [PMID: 31807292 PMCID: PMC6885681 DOI: 10.1093/ckj/sfz024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Indexed: 12/23/2022] Open
Abstract
Introduction Mildly reduced renal function and elevated urine protein levels are each prospectively associated with hip fracture risk in older adults. Here we determine whether these markers are associated with reduced appendicular muscle performance. Methods We prospectively examined the associations of urine albumin:creatinine ratio (ACR) and reduced estimated glomerular filtration rate (eGFR) with longitudinal changes in grip strength and gait speed >2 years in 2317 older community-dwelling men and women (median age 77 years). The median ACR was 9.8 [interquartile range (IQR) 5.40–21.50] mg/g creatinine and the median eGFR was 71.6 (IQR 59.1–83.56) mL/min/1.73 m2. Models were adjusted for demographic factors, clinical history and biochemical measures in four candidate pathways: diabetes, oxidative stress, inflammation and fibrosis. Results In demographic- and covariate-adjusted models, a 2-fold higher baseline urine ACR was associated with longitudinal changes of −0.17 kg [95% confidence interval (CI) −0.29 to −0.06) in grip strength and −1.10 cm/s (95% CI −1.67 to −0.53) gait speed per year. Corresponding estimates for a 10 mL/min/1.73 m2 lower baseline eGFR were −0.13 kg (95% CI −0.23 to −0.04) and −0.89 cm/s (95% CI −1.37 to −0.40), respectively. The associations of a 2-fold higher baseline ACR and a 10 mL/min/1.73 m2 lower baseline eGFR using cystatin C with grip strength and gait speed were equivalent to ∼1.2–1.9 additional years of age. Adjustment for covariates in candidate pathways did not attenuate these estimates. Conclusions In older adults, higher ACR and lower eGFR are potential risk factors for a decline of physical performance >2 years.
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Affiliation(s)
- Petra Bůžková
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Joshua I Barzilay
- Division of Endocrinology, Kaiser Permanente of Georgia, Emory University School of Medicine, Atlanta, GA, USA
| | - Howard A Fink
- Geriatric Research Education and Clinical Center, VA Health Care System, Minneapolis, MN, USA
| | - John A Robbins
- Department of Medicine, University of California, Davis, Modesto, CA, USA
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joachim H Ix
- Division of Nephrology, University of California, San Diego, San Diego, CA, USA
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Tzeng HJ, Lee MC. Authors' reply "Multifaceted changes and mortality in the elderly". Geriatr Gerontol Int 2019; 17:2644-2645. [PMID: 29265752 DOI: 10.1111/ggi.13199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Huei-Jia Tzeng
- Department of Social Welfare, National Chung Cheng University, Chia-Yi, Taiwan.,Department of Preventive Medicine, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan
| | - Miaw-Chwen Lee
- Department of Social Welfare, National Chung Cheng University, Chia-Yi, Taiwan
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Cordier R, Chen Y, Clemson L, Byles J, Mahoney N. Subjective memory complaints and difficulty performing activities of daily living among older women in Australia. Aust Occup Ther J 2018; 66:227-238. [DOI: 10.1111/1440-1630.12548] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Reinie Cordier
- School of Occupational Therapy Social Work and Speech Pathology Curtin University Perth Western Australia
| | - Yu‐Wei Chen
- Faculty of Health Sciences University of Sydney Sydney New South Wales
| | - Lindy Clemson
- Faculty of Health Sciences University of Sydney Sydney New South Wales
| | - Julie Byles
- Research Centre for Gender, Health and Ageing Faculty of Health The University of Newcastle Callaghan New South Wales Australia
| | - Natasha Mahoney
- School of Occupational Therapy Social Work and Speech Pathology Curtin University Perth Western Australia
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Bendayan R, Kelly A, Hofer SM, Piccinin AM, Muniz-Terrera G. Memory Decline and Depression Onset in U.S. and European Older Adults. J Aging Health 2018; 32:189-198. [PMID: 30466361 PMCID: PMC7008550 DOI: 10.1177/0898264318813019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: We explore the association between different patterns of change in depressive symptoms and memory trajectories in US and European Mediterranean (Spain, France, Italy, and Israel) and non-Mediterranean (Sweden, Denmark, Netherlands, Germany, Belgium, Switzerland, and Austria) older adults. Methods: Samples consisted of 3,466 participants from the Health Retirement Study (HRS) and 3,940 participants from the Survey of Health, Aging and Retirement (SHARE). Individuals were grouped as follows: non-case depression (NO DEP), persistent depression (DEP), depression onset (ONSET), depression recovery (RECOV), and fluctuating (FLUCT). Memory was measured using immediate and delayed recall tests. Linear mixed models were used. Results: DEP and RECOV had significantly lower baseline memory scores compared to NO DEP, at intercept level. At slope level, ONSET had a significantly faster decline in both tasks compared to NO DEP. Discussion: Cross-cohort robust and consistent new empirical evidence on the association between depression onset and faster decline in memory scores is provided.
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Affiliation(s)
- Rebecca Bendayan
- MRC Unit for Lifelong Health and Ageing at UCL, UK.,Department Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK
| | - Amanda Kelly
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Scott M Hofer
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Andrea M Piccinin
- Department of Psychology, University of Victoria, British Columbia, Canada
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Siemonsma PC, Blom JW, Hofstetter H, van Hespen ATH, Gussekloo J, Drewes YM, van Meeteren NLU. The effectiveness of functional task exercise and physical therapy as prevention of functional decline in community dwelling older people with complex health problems. BMC Geriatr 2018; 18:164. [PMID: 30016948 PMCID: PMC6050649 DOI: 10.1186/s12877-018-0859-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 07/09/2018] [Indexed: 12/05/2022] Open
Abstract
Background A physically active lifestyle in older people contributes to the preservation of good health. We assessed the influence of physiotherapy on daily functioning among community dwelling older people (75+) with complex health problems identified with screening, versus usual care. We also compared functional task exercise (FTE), with problems prioritized by older people, trained in the home environment, versus usual preventive physical therapy (PPT). Methods Design: FTE and PPT were compared in a randomized controlled trial (RCT). Both interventions were compared with daily functioning in an observational study: control group. Setting/Participants: Community-dwelling persons aged ≥75 years with daily activity limitations enlisted in 83 general practices (n = 155). Interventions: Both intervention groups (FTE, n = 76 and PPT, n = 79) received individual, 30 min treatments. The control group (n = 228) did not get any experimental intervention offered. Measurements: Groningen Activities of Daily Living Restriction Scale (GARS). Statistical analyses: Linear Mixed Model analysis, correcting for age, sex, baseline scores and clustering by physiotherapist were used to compare the different groups. Results At baseline, 74% percent of the intervention trial group was female vs 79% in the control group. Median ages were 83.9 and 84.7 respectively. The median baseline GARS-score for the control group was 41.0 (25 and 75 percentile): 35.0; 48.0) and 40.0 (25 and 75 percentile: 32.3; 46.0) for the intervention group (FTE + PPT). The mean change over time was 3.3 (2.5; 4.1) for the control group. Mean difference in change over time between the intervention (FTE + PPT) and the control group was − 2.5 (− 4.3; − 0.6) (p = .009). Between FTE and PPT the difference in change was − 0.4 (95% CI: -2.3; 3.0, p = 0.795). Conclusion An exercise intervention led by physiotherapists may slow down decline in self-reported daily functioning in older persons with daily activity limitations, identified by pro-active case finding. Trial registration Netherlands trial register (NTR2407). Registered 6th of July 2010. Electronic supplementary material The online version of this article (10.1186/s12877-018-0859-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Petra C Siemonsma
- TNO Healthy Living, Leiden, Schipholweg 77-89, 2316, ZL, Leiden, The Netherlands
| | - Jeanet W Blom
- Department of Public Health and Primary Care (V0-P), Leiden University Medical Center, Postbox 9600, 2300, RC, Leiden, The Netherlands.
| | - Hedwig Hofstetter
- TNO Healthy Living, Leiden, Schipholweg 77-89, 2316, ZL, Leiden, The Netherlands
| | | | - Jacobijn Gussekloo
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Yvonne M Drewes
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Nico L U van Meeteren
- TNO Healthy Living, Leiden, Schipholweg 77-89, 2316, ZL, Leiden, The Netherlands.,Topsector Life Sciences and Health (Health~Holland), The Hague, the Netherlands.,CAPHRI, Maastricht University, Maastricht, the Netherlands
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Minahan J, Siedlecki KL. Physical Health Mediates the Relationship between Psychological Well-Being and Engagement in Exercise across Age in a German Sample. J Funct Morphol Kinesiol 2018; 3:E39. [PMID: 33466968 PMCID: PMC7739430 DOI: 10.3390/jfmk3030039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/26/2018] [Accepted: 06/28/2018] [Indexed: 11/17/2022] Open
Abstract
The prevalence of chronic illness among middle-aged and older adults is increasing worldwide as the population continues to age. One way to prevent the continued increase and subsequent negative outcomes of chronic illness is to increase the number of individuals who engage in exercise. Thus, it is important to examine which factors predict engagement in exercise in middle-aged and older adults. As a result, the current study examined the relationship between physical health, psychological well-being, and engagement in exercise in a sample of middle-aged and older German adults. We found that increased age was associated with less frequent engagement in exercise. We also found that physical health mediated the relationship between psychological well-being and engagement in exercise. Finally, we found that age did not moderate the relationship between subjective well-being and engagement in exercise, suggesting that the role of physical health as a mediator was similar in older adults compared to middle-aged adults. These findings have important implications for interventions seeking to promote exercise among adults.
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Affiliation(s)
- Jillian Minahan
- Department of Psychology, Fordham University, Bronx, NY 10458, USA
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Delgado J, Bowman K, Ble A, Masoli J, Han Y, Henley W, Welsh S, Kuchel GA, Ferrucci L, Melzer D. Blood Pressure Trajectories in the 20 Years Before Death. JAMA Intern Med 2018; 178:93-99. [PMID: 29204655 PMCID: PMC5833502 DOI: 10.1001/jamainternmed.2017.7023] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
IMPORTANCE There is mixed evidence that blood pressure (BP) stabilizes or decreases in later life. It is also unclear whether BP trajectories reflect advancing age, proximity to end of life, or selective survival of persons free from hypertension. OBJECTIVE To estimate individual patient BP for each of the 20 years before death and identify potential mechanisms that may explain trajectories. DESIGN, STUDY, AND PARTICIPANTS We analyzed population-based Clinical Practice Research Datalink primary care and linked hospitalization electronic medical records from the United Kingdom, using retrospective cohort approaches with generalized linear mixed-effects modeling. Participants were all available individuals with BP measures over 20 years, yielding 46 634 participants dying aged at least 60 years, from 2010 to 2014. We also compared BP slopes from 10 to 3 years before death for 20 207 participants who died, plus 20 207 birth-year and sex-matched participants surviving longer than 9 years. MAIN OUTCOMES AND MEASURES Clinically recorded individual patient repeated systolic BP (SBP) and diastolic BP (DBP). RESULTS In 46 634 participants (51.7% female; mean [SD] age at death, 82.4 [9.0] years), SBPs and DBPs peaked 18 to 14 years before death and then decreased progressively. Mean changes in SBP from peak values ranged from -8.5 mm Hg (95% CI, -9.4 to -7.7) for those dying aged 60 to 69 years to -22.0 mm Hg (95% CI, -22.6 to -21.4) for those dying at 90 years or older; overall, 64.0% of individuals had SBP changes of greater than -10 mm Hg. Decreases in BP appeared linear from 10 to 3 years before death, with steeper decreases in the last 2 years of life. Decreases in SBP from 10 to 3 years before death were present in individuals not treated with antihypertensive medications, but mean yearly changes were steepest in patients with hypertension (-1.58; 95% CI, -1.56 to -1.60 mm Hg vs -0.70; 95% CI, -0.65 to -0.76 mm Hg), dementia (-1.81; 95% CI, -1.77 to -1.87 mm Hg vs -1.41; 95% CI, -1.38 to -1.43 mm Hg), heart failure (-1.66; 95% CI, -1.62 to -1.69 mm Hg vs -1.37; 95% CI, -1.34 to -1.39 mm Hg), and late-life weight loss. CONCLUSIONS AND RELEVANCE Mean SBP and DBP decreased for more than a decade before death in patients dying at 60 years and older. These BP decreases are not simply attributable to age, treatment of hypertension, or better survival without hypertension. Late-life BP decreases may have implications for risk estimation, treatment monitoring, and trial design.
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Affiliation(s)
- João Delgado
- Epidemiology and Public Health, Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
| | - Kirsty Bowman
- Epidemiology and Public Health, Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
| | - Alessandro Ble
- Epidemiology and Public Health, Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
| | - Jane Masoli
- Epidemiology and Public Health, Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
| | - Yang Han
- Health Statistics Research Group, Institute of Health Research, University of Exeter Medical School, St Luke's Campus, Exeter, United Kingdom
| | - William Henley
- Health Statistics Research Group, Institute of Health Research, University of Exeter Medical School, St Luke's Campus, Exeter, United Kingdom
| | - Scott Welsh
- University of Connecticut Center on Aging, University of Connecticut Health, Farmington
| | - George A Kuchel
- University of Connecticut Center on Aging, University of Connecticut Health, Farmington
| | - Luigi Ferrucci
- Longitudinal Studies Section, National Institutes of Health, Harbor Hospital, Baltimore, Maryland
| | - David Melzer
- Epidemiology and Public Health, Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
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Hou C, Ping Z, Yang K, Chen S, Liu X, Li H, Liu M, Ma Y, Van Halm-Lutterodt N, Tao L, Luo Y, Yang X, Wang W, Li X, Guo X. Trends of Activities of Daily Living Disability Situation and Association with Chronic Conditions among Elderly Aged 80 Years and Over in China. J Nutr Health Aging 2018; 22:439-445. [PMID: 29484359 DOI: 10.1007/s12603-017-0947-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES In China, few studies reported the disability situation and the association between disabilities with chronic conditions in aged people. This study investigates the cross-sectional trends of prevalence and severity of activities of daily living disability (ADL) in Chinese oldest-old people from 1998 to 2008, and identified the potential risk factors of disability. DESIGN A combination of population-based longitudinal prospective study and probabilistically sampling cross-sectional studies. SETTING The Chinese Longitudinal Healthy Longevity Survey (CLHLS) was based on a random sampling of aged people from twenty-two provinces in China. PARTICIPANTS A total of 52,667 participants aged from 80 years old to 105 years old sampled in the year of 1998 (n=8,768), 2000 (n=10,940), 2002 (n=10,905), 2005 (n=10,396) and 2008 (n=11,658) were analyzed respectively. RESULTS The prevalence of ADL disability decreased from the year of 1998 (18%) to 2008 (12%). The disability prevalence significantly increased in 2002 and decreased in 2008 (P<0.001) in total participants than the year of 1998. The prevalence trends of low ADL disability level were almost identical with that of the total ADL disability. Stroke/cerebrovascular disease (CVD) and cognitive impairment were the strongest risk factors of disability. Vision impairment became less associated with ADL disability (P=0.045), while the association between multimorbidity and ADL disability became stronger (P=0.033). CONCLUSIONS The prevalence of ADL disability declined among the oldest-old population in China from the year of 1998 to 2008 without obeying a linear pattern. Temporal trends of ADL disability mainly attributed to the change of low disability level prevalence. Stroke/CVD and cognitive impairment were the most common risk factors of disability. Vision impairment caused disability has become less common, while risks of multimorbidity related disability increased.
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Affiliation(s)
- C Hou
- Xiuhua Guo, PhD, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China. E-mail:
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45
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Kawada T. Multifaceted changes and mortality in older adults. Geriatr Gerontol Int 2017; 17:2643. [DOI: 10.1111/ggi.13173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health; Nippon Medical School; Tokyo Japan
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46
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Santoni G, Marengoni A, Calderón-Larrañaga A, Angleman S, Rizzuto D, Welmer AK, Mangialasche F, Orsini N, Fratiglioni L. Defining Health Trajectories in Older Adults With Five Clinical Indicators. J Gerontol A Biol Sci Med Sci 2017; 72:1123-1129. [PMID: 28329788 PMCID: PMC5861965 DOI: 10.1093/gerona/glw204] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 09/23/2016] [Indexed: 11/13/2022] Open
Abstract
Background: People age differently, challenging the identification of those more at risk of rapid health deterioration. This study aimed to explore the heterogeneity in the health of older adults by using five clinical indicators to detect age-related variation and individual health trajectories over time. Methods: Health of 3,363 people aged 60+ from the Swedish National study on Aging and Care-Kungsholmen (SNAC-K) assessed at baseline and at 3- and 6-year follow-ups. Number of chronic diseases, physical and cognitive performance, personal and instrumental activities of daily living were integrated in a health assessment tool (HAT). Interindividual health differences at baseline and follow-ups were assessed with logistic quantile regression. Intraindividual health trajectories were traced with quantile mixed-effect models. Results: The HAT score ranges from 0 (poor health) to 10 (good health); each score corresponds to a specific clinical profile. HAT was reliable over time and accurately predicted adverse health outcomes (receiver-operating characteristic areas: hospitalization = 0.78; 95% confidence interval = 0.74–0.81; mortality = 0.85; 95% confidence interval = 0.83–0.87; similar areas obtained for gait speed). Before age 85, at least 90% of participants were free of severe disability, and at least 50% were functionally independent despite chronic disorders. Age- and sex-related variation and high heterogeneity in health were detected at baseline and confirmed by intraindividual health trajectories. Conclusions: This study provides a positive picture of the health status of people 60+. Despite the complexity and heterogeneity of health in this age group, we could identify age- and sex-specific health trajectories using an integrated HAT. HAT is potentially useful in clinical practice and public health interventions.
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Affiliation(s)
- Giola Santoni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Sweden
| | - Alessandra Marengoni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Sweden.,Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Sweden.,EpiChron Research Group on Chronic Diseases, Aragon Health Sciences Institute, Sweden
| | - Sara Angleman
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Sweden
| | - Debora Rizzuto
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Sweden
| | - Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Sweden.,Stockholm Gerontology Research Center, Sweden
| | - Francesca Mangialasche
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Sweden
| | - Nicola Orsini
- Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Sweden.,Stockholm Gerontology Research Center, Sweden
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47
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Bendayan R, Cooper R, Wloch EG, Hofer SM, Piccinin AM, Muniz-Terrera G. Hierarchy and Speed of Loss in Physical Functioning: A Comparison Across Older U.S. and English Men and Women. J Gerontol A Biol Sci Med Sci 2017; 72:1117-1122. [PMID: 27753610 PMCID: PMC5861940 DOI: 10.1093/gerona/glw209] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 09/25/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND We aimed to identify the hierarchy of rates of decline in 16 physical functioning measures in U.S. and English samples, using a systematic and integrative coordinated data analysis approach. METHODS The U.S. sample consisted of 13,612 Health and Retirement Study participants, and the English sample consisted of 5,301 English Longitudinal Study of Ageing participants. Functional loss was ascertained using self-reported difficulties performing 6 activities of daily living and 10 mobility tasks. The variables were standardized, rates of decline were computed, and mean rates of decline were ranked. Mann-Whitney U tests were performed to compare rates of decline between studies. RESULTS In both studies, the rates of decline followed a similar pattern; difficulty with eating was the activity that showed the slowest decline and climbing several flights of stairs and stooping, kneeling, or crouching the fastest declines. There were statistical differences in the speed of decline in all 16 measures between countries. American women had steeper declines in 10 of the measures than English women. Similar differences were found between American and English men. CONCLUSIONS Reporting difficulties climbing several flights of stairs without resting, and stooping, kneeling, or crouching are the first indicators of functional loss reported in both populations.
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Affiliation(s)
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | | | - Scott M Hofer
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Andrea M Piccinin
- Department of Psychology, University of Victoria, British Columbia, Canada
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48
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Levine DM, Lipsitz SR, Linder JA. Changes in Everyday and Digital Health Technology Use Among Seniors in Declining Health. J Gerontol A Biol Sci Med Sci 2017; 73:552-559. [DOI: 10.1093/gerona/glx116] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 06/09/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- David M Levine
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Stuart R Lipsitz
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jeffrey A Linder
- Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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49
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Kim SK, Kim SG, HwangBo G. The effect of horse-riding simulator exercise on the gait, muscle strength and muscle activation in elderly people with knee osteoarthritis. J Phys Ther Sci 2017; 29:693-696. [PMID: 28533611 PMCID: PMC5430274 DOI: 10.1589/jpts.29.693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/10/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to examine the effects of horse-riding simulator
exercise on gait ability and muscle strength, muscle activation in elderly with knee
osteoarthritis. [Subjects and Methods] Thirty elderly patients with knee osteoarthritis
were recruited, a horse-riding simulator group consisted of fifteen subjects and they
performed exercise three times a week for eight weeks. And each exercise was performed,
horse riding simulator exercise for 15 minutes and knee strengthening exercise for 15
minutes. Knee strengthening exercise group consisted of fifteen subjects and performed
knee strengthening exercise for 30 minutes. [Results] The horse-riding simulator group
showed significant differences after the intervention in timed 10-meter walk test (10MWT),
muscle strength, muscle activation. [Conclusion] The results of this study indicate that
horse-riding simulator exercise is effective on knee osteoarthritis. Therefore,
horse-riding simulator exercise can be used for gait training for knee osteoarthritis.
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Affiliation(s)
- Seung-Kyu Kim
- Department of Rehabilitation Science, Graduate School, Daegu University, Republic of Korea
| | - Seong-Gil Kim
- Department of Physical Therapy, Uiduk University, Republic of Korea
| | - Gak HwangBo
- Department of Rehabilitation Science, Graduate School, Daegu University, Republic of Korea
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50
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Pereira C, Fernandes J, Raimundo A, Biehl-Printes C, Marmeleira J, Tomas-Carus P. Increased Physical Activity and Fitness above the 50(th) Percentile Avoid the Threat of Older Adults Becoming Institutionalized: A Cross-sectional Pilot Study. Rejuvenation Res 2016; 19:13-20. [PMID: 26083134 DOI: 10.1089/rej.2015.1669] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The objective of this study was to analyze the impact of physical fitness and physical activity on the threat of older adults without cognitive impairment becoming institutionalized. This cross-sectional study involved 195 non-institutionalized (80.1 ± 4.4 years) and 186 institutionalized (83.8 ± 5.2years) participants. Cognitive impairment was assessed using Mini-Mental State Examination, measures of physical fitness were determined by the Senior Fitness Test, and physical activity was assessed using the International Physical Activity Questionnaire. Multivariate binary logistic analysis selected four main determinants of institutionalization in both genders: The likelihood of becoming institutionalized increased by +18.6% for each additional year of age, whereas it decreased by -24.8% by each fewer kg/m(2) in body mass index (BMI), by -0.9% for each additional meter performed in the aerobic endurance test, and by -2.0% for each additional 100 metabolic equivalent of task (MET)-min/week of physical activity expenditure (p < 0.05). Values ≤50(th) percentile (age ≥81 years, BMI ≥26.7 kg/m(2), aerobic endurance ≤367.6 meters, and physical activity ≤693 MET-min/week) were computed using receiver operating characteristics analysis as cutoffs discriminating institutionalized from non-institutionalized older adults. The performance of physical activity, allied to an improvement in physical fitness (mainly BMI and aerobic endurance), may avoid the threat of institutionalization of older adults without cognitive impairment only if they are above the 50(th) percentile. The following parameters are highly recommended: Expending ≥693 MET-min/week on physical activity, having a BMI ≤26.7 kg/m(2), and being able to walk ≥367.6 meters in the aerobic endurance test, especially above the age of 80 years. The discovery of this trigger justifies the development of physical activity programs targeting the pointed cutoffs in old and very old adults.
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Affiliation(s)
- Catarina Pereira
- 1 Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Research Center in Sports Sciences , Health Sciences and Human Development (CIDESD), Évora, Portugal
| | - Jorge Fernandes
- 1 Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Research Center in Sports Sciences , Health Sciences and Human Development (CIDESD), Évora, Portugal
| | - Armando Raimundo
- 1 Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Research Center in Sports Sciences , Health Sciences and Human Development (CIDESD), Évora, Portugal
| | - Clarissa Biehl-Printes
- 2 Department of Sport Science, High Institute of Educational Sciences , Lisbon, Portugal
| | - José Marmeleira
- 1 Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Research Center in Sports Sciences , Health Sciences and Human Development (CIDESD), Évora, Portugal
| | - Pablo Tomas-Carus
- 1 Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Research Center in Sports Sciences , Health Sciences and Human Development (CIDESD), Évora, Portugal
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