1
|
Liu W, Bai J. The correlation of gait and muscle activation characteristics with locomotion dysfunction grade in elderly individuals. Front Bioeng Biotechnol 2024; 12:1372757. [PMID: 39161347 PMCID: PMC11331308 DOI: 10.3389/fbioe.2024.1372757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 07/15/2024] [Indexed: 08/21/2024] Open
Abstract
Objective To investigate the differences and regularity of gait and muscle activation characteristics parameters in the Locomotion Dysfunction Grade (LDG) scale assessment in elderly individuals, and analyse the correlation between objective parameters and scale grading. Thus, to propose a novel detection mode for elderly individuals, which combined the LDG scale with objective detection. It can not only provide quantitative data for intelligent evaluation and rehabilitation, but also provided more accurate reference for the classification of care levels in elderly care policies. Methods Elderly individuals (n = 159) who underwent gait analysis and sEMG at the Chinese Rehabilitation Research Center from January 2019 to September 2023 were included. According to the LDG scale, the elderly individuals were divided into four groups, namely, the LDG4, LDG5, LDG6 groups and the healthy control group. Four indicators, namely, spatiotemporal, kinematic, dynamic gait parameters and muscle activation characteristics data, were collected. Changes in these characteristics of elderly individuals with lower extremity motor dysfunction were evaluated and analysed statistically. Results The spatiotemporal gait parameters were significantly lower in the LDG4, LDG5, LDG6 groups than in the healthy control group. The double support phase was positively correlated with the LDG, while the swing phase, step length and velocity were negatively correlated (P < 0.05). The movement angles of both hips, knees and ankles were significantly limited and negatively correlated with the LDG (P < 0.05). Compared with those in the healthy control group, the centre of pressure (COP) path length were greater, and the average COP velocity was significantly lower (P < 0.05) in the LDG4, LDG5, LDG6 groups. The regularity of muscle activation clearly changed. The root mean square of the gastrocnemius medialis was positively correlated with LDG (P < 0.05), while the tibialis anterior showed no regularity. Conclusion As the LDG increased, the differences in spatiotemporal, kinematic and dynamic gait parameters between elderly individuals with motor dysfunction and the healthy individuals gradually increased. The muscle activation characteristics parameters showed an abnormal activation pattern. These parameters were correlated with the LDG, providing a more comprehensive and objective assessment of lower extremity motor function in elderly individuals, improve assessment accuracy, and help accurate rehabilitation.
Collapse
Affiliation(s)
- Wen Liu
- Rehabilitation Medicine Center, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
- China Rehabilitation Research Center, Department of Spine and Spinal Cord Surgery, Beijing Boai Hospital, Beijing, China
| | - Jinzhu Bai
- Rehabilitation Medicine Center, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
- China Rehabilitation Research Center, Department of Spine and Spinal Cord Surgery, Beijing Boai Hospital, Beijing, China
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| |
Collapse
|
2
|
Rivan NFM, Ludin AFM, Clark BC, Shahar S. Predictors for the development of motoric cognitive risk syndrome in older adults. BMC Geriatr 2024; 24:575. [PMID: 38961342 PMCID: PMC11223433 DOI: 10.1186/s12877-024-05179-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 06/25/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Motoric cognitive risk (MCR) syndrome refers to a condition where both slow gait and memory complaints coexist, which heightens their vulnerability to developing dementia. Considering that the risk factors of MCR are elucidated from cross-sectional studies and also likely vary based on socioeconomic status, we conducted a community-based longitudinal study to determine the predictors of MCR among older adults in Malaysia. METHODS Out of 1,249 older participants (aged 60 years and above) without MCR at baseline (Wave II of LRGS-TUA cohort study), 719 were successfully followed up after 3.5 years to identify predictors of subsequent MCR development. A comprehensive interview-based questionnaire was administered for sociodemographic information, cognitive function, psychosocial, functional status, and dietary intake. Anthropometric measurements, body composition, and physical performance were assessed. Univariate analyses were performed for each variable, followed by a hierarchical logistic regression analysis to identify the predictors of MCR that accounted for confounding effects between the studied factors. RESULTS The incidence rate of MCR was 4.0 per 100 person-years. Smoking (Adjusted Odd Ratio (Adj OR) = 1.782; 95% Confidence Interval (CI):1.050-3.024), hypertension (Adj OR = 1.725; 95% CI:1.094-2.721), decreased verbal memory as assessed by the lower Rey Auditory Verbal Learning Test (RAVLT) (Adj OR = 1.891; 95% CI:1.103-3.243), and decreased functional status measured using instrumental activity of daily living (IADL) (Adj OR = 4.710; 95% CI:1.319-16.823), were predictors for MCR incidence. CONCLUSIONS Our study results provide an initial reference for future studies to formulate effective preventive management and intervention strategies to reduce the growing burden of adverse health outcomes, particularly among Asian older adults.
Collapse
Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Biomedical Science Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia.
| | - Brian C Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI) and Department of Biomedical Sciences, Ohio University, Athens, OH, USA
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
3
|
Igusa T, Uchida H, Tsuchiya K, Sema S, Kaneko S, Yoshita T, Nagai S, Kobayashi T, Akiba T, Tanaka Y, Kikuchi S, Hirao K. Effects of rhythmic auditory stimulation on gait speed in older adult inpatients in a convalescent rehabilitation ward: a pilot randomized controlled trial. Eur Geriatr Med 2024:10.1007/s41999-024-01010-0. [PMID: 38890234 DOI: 10.1007/s41999-024-01010-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE To assess the impact of gait training with rhythmic auditory stimulation (RAS) on enhancing gait speed in older people admitted to a convalescent rehabilitation ward (CRW), compared to conventional gait training methods. METHODS The study was designed as a single-center, open-label, pilot, randomized, parallel-group study. Thirty older people admitted to CRW were divided into two groups: the experimental group, which received gait training with RAS (n = 15, females = 53.3%, mean age = 83.9, SD = 6.5), and the control group, which underwent usual gait training (n = 15, females = 60.0%, mean age = 81.3, SD = 8.4). Regardless of their assigned group, all participants underwent 30 min training sessions, five times a week, for 3 weeks. The primary outcome was the 10 m walk test (10mWT), and the secondary outcomes included the Medical Outcome Study 8-Item Short-Form Health Survey and the Japanese version of the modified Gait Efficacy Scale. All measurements were taken at baseline and again at week 3. RESULTS Results indicated that older people in CRWs in the experimental group showed significant improvements in their 10mWT (effect size - 1.02) compared to the control group. None of the secondary outcomes were significant. CONCLUSIONS This study suggests the preliminary effectiveness and feasibility of a gait practice intervention using RAS in a CRW. TRIAL REGISTRATION The University Hospital Medical Information Network (UMIN) Registered 1 October 2022 (UMIN000049089).
Collapse
Affiliation(s)
- Takumi Igusa
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Hiroyuki Uchida
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Kenji Tsuchiya
- Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan
| | - Shota Sema
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Shunsuke Kaneko
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Taiki Yoshita
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Sakyo Nagai
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Takuya Kobayashi
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Japan Community Healthcare Organization, Gunma Chuo Hospital, Maebashi, Japan
| | - Takanari Akiba
- Department of Rehabilitation, Japan Community Healthcare Organization, Gunma Chuo Hospital, Maebashi, Japan
| | - Yukiko Tanaka
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Senichiro Kikuchi
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
| | - Kazuki Hirao
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan.
| |
Collapse
|
4
|
Chuang IC, Chen IC, Wu YR, Li KY. Prediction and mediation analysis for treatment responses to combined cognitive and physical training for older adults. Sci Rep 2024; 14:10571. [PMID: 38720025 PMCID: PMC11079002 DOI: 10.1038/s41598-024-61407-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/06/2024] [Indexed: 05/12/2024] Open
Abstract
Diminished cognitive and physical functions negatively affect the daily functions of individuals. Although combined cognitive and physical training prevents instrumental activities of daily living (IADL) disability in older adults, no predictive model or mediation analysis of IADL after combined training exists. This study aims to employ prediction and mediation analysis to identify the predictors of IADL performance and to elucidate the mediators of the association between baseline global cognition and subsequent IADL performance following combined cognitive and physical training. This study involved 177 participants aged 60 years and older who underwent combined training. Cognitive function was measured with the Montreal Cognitive Assessment (MoCA), Digit Symbol Substitution Test (DSST), Color Trails Test, Word List, and a dual task; physical function with the Timed Up and Go (TUG) test; daily function with the Lawton IADL Scale. We conducted regression analyses to identify the predictors of IADL performance, and mediation analysis to examine whether DSST and TUG mediate the relationship between MoCA and IADL. The pre-intervention DSST and TUG were significant independent predictors of post-intervention IADL. The association between the pre-intervention MoCA and post-intervention IADL was mediated by pre-intervention DSST and TUG. This study highlighted the importance of measuring and improving processing speed and functional mobility before and during interventions to enhance IADL outcomes.Trial registration: NCT03619577, 23/07/2018; NCT04689776, 29/12/2020.
Collapse
Affiliation(s)
- I-Ching Chuang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No. 259, Wunhua 1st Rd., Gueishan Township, Taoyuan, 333, Taiwan
- Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - I-Chen Chen
- Department of Occupational Therapy, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
| | - Yih-Ru Wu
- Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuan-Yi Li
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No. 259, Wunhua 1st Rd., Gueishan Township, Taoyuan, 333, Taiwan.
- Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
| |
Collapse
|
5
|
Laurienti PJ, Miller ME, Lyday RG, Boyd MC, Tanase AD, Burdette JH, Hugenschmidt CE, Rejeski WJ, Simpson SL, Baker LD, Tomlinson CE, Kritchevsky SB. Associations of physical function and body mass index with functional brain networks in community-dwelling older adults. Neurobiol Aging 2023; 127:43-53. [PMID: 37054493 PMCID: PMC10227726 DOI: 10.1016/j.neurobiolaging.2023.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 04/15/2023]
Abstract
Deficits in physical function that occur with aging contribute to declines in quality of life and increased mortality. There has been a growing interest in examining associations between physical function and neurobiology. Whereas high levels of white matter disease have been found in individuals with mobility impairments in structural brain studies, much less is known about the relationship between physical function and functional brain networks. Even less is known about the association between modifiable risk factors such as body mass index (BMI) and functional brain networks. The current study examined baseline functional brain networks in 192 individuals from the Brain Networks and mobility (B-NET) study, an ongoing longitudinal, observational study in community-dwelling adults aged 70 and older. Physical function and BMI were found to be associated with sensorimotor and dorsal attention network connectivity. There was a synergistic interaction such that high physical function and low BMI were associated with the highest network integrity. White matter disease did not modify these relationships. Future work is needed to understand the causal direction of these relationships.
Collapse
Affiliation(s)
- Paul J Laurienti
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
| | - Michael E Miller
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Robert G Lyday
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Madeline C Boyd
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Alexis D Tanase
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Jonathan H Burdette
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Christina E Hugenschmidt
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Sean L Simpson
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Laura D Baker
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Chal E Tomlinson
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| |
Collapse
|
6
|
Kim MK, Kang BH, Park JH, Ham SM, Park HY, Hong I. Longitudinal Changes in Dual Decline in Memory and Gait Speed Association with Instrumental Activities of Daily Living: Findings from the National Social Life, Health, and Aging Project. J Aging Health 2023; 35:256-264. [PMID: 36083125 DOI: 10.1177/08982643221125274] [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: 02/03/2023]
Abstract
Objective: We investigated the association between dual decline (DD) (loss of memory and gait speed) and the instrumental activities of daily living (IADL) degeneration in older adults. Methods: Data were drawn from the National Social Life, Health, and Aging Project (NSHAP) reflecting changes over 5 years. This study used the NSHAP data set wave 2 (2010-2011, N = 3196) and wave 3 (2015-2016, N = 4377). Results: Data from 1640 participants were retrieved. There were 601 people with DD and 1039 people without-DD. The DD group had a 28.4% (95% CI = 1.013-1.626) greater risk of degrading in IADL than the without-DD group (odds ratio = 1.284, p < .05). Conclusion: Current research can be used when establishing intervention programs or policies that can prevent IADL degradation through simple memory training and walking activities for older adults living in the community.
Collapse
Affiliation(s)
- Mi Kyeong Kim
- Dept. of Occupational Therapy, Graduate School, 65448Yonsei University, Republic of Korea
| | - Byoung-Ho Kang
- Dept. of Occupational Therapy, Graduate School, 65448Yonsei University, Republic of Korea
| | - Ji Hyeun Park
- Dept. of Occupational Therapy, Graduate School, 65448Yonsei University, Republic of Korea
| | - Sun Mi Ham
- Dept. of Occupational Therapy, College of Software and Digital Healthcare Convergence, 65448Yonsei University, Republic of Korea
| | - Hae Yean Park
- Dept. of Occupational Therapy, College of Software and Digital Healthcare Convergence, 65448Yonsei University, Republic of Korea
| | - Ickpyo Hong
- Dept. of Occupational Therapy, College of Software and Digital Healthcare Convergence, 65448Yonsei University, Republic of Korea
| |
Collapse
|
7
|
Memory performance mediates the relationship between depression and independence in instrumental activities of daily living among community-dwelling older adults: Evidence from the China Family Panel Study. Geriatr Nurs 2023; 50:1-6. [PMID: 36640513 DOI: 10.1016/j.gerinurse.2023.01.006] [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: 10/24/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 01/15/2023]
Abstract
Our objective was to examine the link between depression and independence in the instrumental activities of daily living (IADLs) and to explore the mediating role of memory performance through a cross-sectional analysis of a nationally representative sample of community-dwelling older adults in China. In total, 3730 respondents age ≥ 60 (51.7% males) from the 2020 survey of the China Family Panel Study (CFPS) constituted the study sample. Their depressive symptoms, memory performance, and independence in the IADLs were measured. Based on the descriptive statistics, bivariate correlation analysis and bootstrapping mediation analysis were conducted. As hypothesized, independence in the IADLs was negatively related to depression, while it was positively associated with memory performance. Moreover, after controlling for demographic factors, memory performance was demonstrated to be a partial mediator between depression and independence in the IADLs. These findings support the development of clinical interventions which prevent disability or maintain the physical functioning of older adults through alleviating depression and enhancing memory performance.
Collapse
|
8
|
Vogel O, Otto AK, Zimmel H, Hinrichs T, Giannouli E, Wollesen B. Definition and Contextual Factors of Nursing Home Residents' Mobility in a Holistic View: A Delphi Study. Innov Aging 2022; 7:igac067. [PMID: 36789366 PMCID: PMC9912704 DOI: 10.1093/geroni/igac067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Indexed: 11/05/2022] Open
Abstract
Background and Objectives Current definitions of older adults' mobility do not cover the full range of influencing factors and do not consider nursing home residents. The present study reports expert ratings from a Delphi study regarding factors influencing the mobility of long-term nursing home residents. Research Design and Methods We invited 129 professionals with expertise in a field relevant to research on mobility in older adults such as health care, medicine, or human movement science to participate in a Delphi study comprising 3 rounds of online questionnaires. Up to 40 experts participated in each round. In the first round, we used open-ended questions to solicit possible definitions, contextual factors, and assessment tools. In the second round, the participants used Likert scales (1-10) to rate their suitability. In the final round, we presented a definition based on consensus as well as the top-rated contextual factors and assessment tools from the first 2 rounds for a final rating of agreement. Results The experts showed broad agreement on the final version of the mobility definition, with 8.9 ± 1.4 (mean ± standard deviation) out of 10 points. The experts also showed broad consensus on the selected contextual factors, with 8.4 ± 1.8 points to 8.9 ± 1.2 points (out of 10 points). This was also the case for the top 3 assessment tools selected from results of previous rounds, which showed an agreement of 7 or more points (out of 10 points) by 81.6% to 100% of all experts in the different categories. Discussion and Implications Given that an interdisciplinary group of experts considered various hitherto neglected contextual factors as relevant, the Delphi survey and its results imply the need for an updated interdisciplinary and holistic understanding of mobility in nursing home residents and can provide a basis for putting it into practice.
Collapse
Affiliation(s)
- Oliver Vogel
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Ann-Kathrin Otto
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Hanna Zimmel
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Timo Hinrichs
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Eleftheria Giannouli
- Address correspondence to: Eleftheria Giannouli, PhD, ETH Zurich, Department of Health Sciences and Technology, Institute of HumanMovement Sciences and Sport, Leopold-Ruzicka-Weg 4, 8093 Zurich, Switzerland. E-mail:
| | - Bettina Wollesen
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
| |
Collapse
|
9
|
Sarcopenia and Mortality in Older Hemodialysis Patients. Nutrients 2022; 14:nu14112354. [PMID: 35684154 PMCID: PMC9182960 DOI: 10.3390/nu14112354] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Sarcopenia is a progressive loss of skeletal muscle mass and strength. The aim of this study was to determine the association of sarcopenia, defined according to the Working Group on Sarcopenia in Older People (EWGSOP2) diagnostic criteria, with mortality at 24 months in very elderly hemodialysis patients. (2) A prospective study was conducted in 60 patients on chronic hemodialysis who were older than 75 years. Sarcopenia was diagnosed according to EWGSOP2 criteria. Additionally, clinical, anthropometric and analytical variables and body composition by bioimpedance were assessed. The date and cause of death were recorded during 2 years of follow-up. (3) Among study participants, 41 (68%) were men, the mean age 81.85 ± 5.58 years and the dialysis vintage was 49.88 ± 40.29 months. The prevalence of probable sarcopenia was 75% to 97%, depending on the criteria employed: confirmed sarcopenia ranged from 37 to 40%, and severe sarcopenia ranged from 18 to 37%. A total of 30 (50%) patients died over 24 months. Sarcopenia probability variables were not related to mortality. In contrast, sarcopenia confirmation (appendicular skeletal muscle mass, ASM) and severity (gait speed, GS) variables were associated with mortality. In multivariate analysis, the hazard ratio (95% confidence interval) for all-cause death was 3.03 (1.14–8.08, p = 0.028) for patients fulfilling ASM sarcopenia criteria and 3.29 (1.04–10.39, p = 0.042) for patients fulfilling GS sarcopenia criteria. (4) The diagnosis of sarcopenia by EWGSOP2 criteria is associated with an increased risk of all-cause death in elderly dialysis patients. Specifically, ASM and GS criteria could be used as mortality risk markers in elderly hemodialysis patients. Future studies should address whether the early diagnosis and treatment of sarcopenia improve outcomes.
Collapse
|
10
|
Naber AJ, Dendinger MM, Heier VL, Michels ML, Vandenberg DL, Lucas Molitor W. Sedentary Behavior, Quality of Life, and Occupational Performance among Community-Dwelling Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2021.2015049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Allison J. Naber
- Occupational Therapy, University of South Dakota, Vermillion, SD, USA
| | | | - Vitoria L. Heier
- Occupational Therapy, University of South Dakota, Vermillion, SD, USA
| | | | | | | |
Collapse
|
11
|
Factors influencing gait speed in community-dwelling older women: A Bayesian approach. Gait Posture 2022; 92:455-460. [PMID: 34999556 DOI: 10.1016/j.gaitpost.2021.12.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 12/24/2021] [Accepted: 12/29/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Human gait is a complex task resulting from the interaction of sensory perception, muscle force output, and sensory-motor integration, which declines with the aging process and impacts gait speed in older women. RESEARCH QUESTION What are the separate and combined impacts of sensory-motor factors on gait speed of older women? METHODS Sixty healthy older women (69.3 ± 5.9 years) volunteered for this study. A previous screening using Pearson's correlation selected variables significantly correlated with gait speed: age, plantar tactile perception, lower limb explosive force, and mean velocity (MV) of the center of pressure (CoP). Simple and multivariate regression models were performed with selected variables. The magnitude of evidence was obtained using Bayesian inference, determining posterior probabilities based on our data. RESULTS Gait speed was negatively correlated with age and positively correlated with plantar tactile perception, MV (Romberg index), and lower limb explosive force. The coefficient of determination (R2) varied between 0.06 for plantar tactile perception and 0.22 for explosive force (p < 0.05). The multivariate model, including age, MV (Romberg index), and lower limb explosive force, explained 44% (R2 = 0.44) of the variance in gait speed, with a small standard error of estimate (0.14 m/s). Bayesian inference confirmed the good posterior probability of the model. SIGNIFICANCE Age, plantar tactile perception, MV (Romberg index), and lower limb explosive force impact gait speed, whereas the combination of the first three factors has an excellent posterior probability of predicting or affecting gait speed.
Collapse
|
12
|
How Long Should GPS Recording Lengths Be to Capture the Community Mobility of An Older Clinical Population? A Parkinson's Example. SENSORS 2022; 22:s22020563. [PMID: 35062523 PMCID: PMC8781530 DOI: 10.3390/s22020563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/30/2021] [Accepted: 01/07/2022] [Indexed: 12/29/2022]
Abstract
Wearable global position system (GPS) technology can help those working with older populations and people living with movement disorders monitor and maintain their mobility level. Health research using GPS often employs inconsistent recording lengths due to the lack of a standard minimum GPS recording length for a clinical context. Our work aimed to recommend a GPS recording length for an older clinical population. Over 14 days, 70 older adults with Parkinson's disease wore the wireless inertial motion unit with GPS (WIMU-GPS) during waking hours to capture daily "time outside", "trip count", "hotspots count" and "area size travelled". The longest recording length accounting for weekend and weekdays was ≥7 days of ≥800 daily minutes of data (14 participants with 156, 483.9 min recorded). We compared the error rate generated when using data based on recording lengths shorter than this sample. The smallest percentage errors were observed across all outcomes, except "hotspots count", with daily recordings ≥500 min (8.3 h). Eight recording days will capture mobility variability throughout days of the week. This study adds empirical evidence to the sensor literature on the required minimum duration of GPS recording.
Collapse
|
13
|
Cho K, Suzuki M, Iso N, Okabe T, Goto H, Hirata K, Shimizu J. Impact of different bilateral knee extension strengths on lower extremity performance. Medicine (Baltimore) 2021; 100:e27297. [PMID: 34559141 PMCID: PMC8462631 DOI: 10.1097/md.0000000000027297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/03/2021] [Indexed: 01/05/2023] Open
Abstract
Despite the impact of leg muscle strength on lower extremity motor performance-including walking and sit-to-stand transfer-it remains difficult to predict the relationship between bilateral leg muscle strength and lower extremity performance. Therefore, this study was designed to predict lower extremity function through the differential modeling of logarithmic and linear regression, based on knee extension strength.The study included 121 individuals living in the same community. The bilateral strengths of the knee extensors were measured using a handheld dynamometer, and the Timed Up & Go test (TUG) performance time and 5-m minimum walking times were assessed to predict lower extremity motor functions. Bilateral normalized knee extension muscle strengths and lower extremity motor function scores, including walking or TUG performance times, were assessed on the logarithmic and linear models. The Akaike information criterion (AIC) was used to evaluate the coefficient compatibility between the logarithmic regression model and the linear regression model.The AIC value for the linear model was lower than that for the logarithmic model regarding the walking time. For walking time estimation in the linear model, the coefficient value of knee extension strength was larger on the strong than on the weak side; however, the AIC value for the logarithmic model was lower than that for the linear model regarding TUG performance time. In the logarithmic model's TUG performance time estimation, the coefficient value of knee extension strength was larger on the weak than on the strong side.In conclusion, our study demonstrated different models reflecting the relationship between both legs' strengths and lower extremity performance, including the walking and TUG performance times.
Collapse
|
14
|
Kawai H, Obuchi S, Hirayama R, Watanabe Y, Hirano H, Fujiwara Y, Ihara K, Kim H, Kobayashi Y, Mochimaru M, Tsushima E, Nakamura K. Intra-day variation in daily outdoor walking speed among community-dwelling older adults. BMC Geriatr 2021; 21:417. [PMID: 34238238 PMCID: PMC8268528 DOI: 10.1186/s12877-021-02349-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/15/2021] [Indexed: 12/30/2022] Open
Abstract
Background Walking speed is an important measure associated with health outcomes in older individuals, such as dependency and death. This study aimed to examine whether the walking speed of community-dwelling older adults varies between time periods within a day, as measured outdoors in daily life. We aimed to determine the types of walking speed variations and examine the factors associated with them. Methods Daily life outdoor walking speed was measured in 92 participants (average age 71.9 years±5.64) using a GPS smartphone app for 1 month. Average walking speeds for five time periods were analyzed with a linear mixed model. Intra-day walking speed variation patterns were classified by latent class analysis. Factors associated with the class were identified by logistic regression analysis. Results A statistically significant difference in average walking speed was found between early morning (1.33 m/s), and afternoon (1.27 m/s) and evening (1.26 m/s) (p < 0.01). The intra-day variation in walking speed was attributed to variation in cadence. Two classes were identified: (1) fast walking speed with large variation and (2) slow walking speed with little variation; hypertension and frailty level were associated with the class. Conclusion The results suggest that there is intra-day variation in walking speed in daily life, wherein the speed is the fastest early in the morning and slower in the afternoon and evening. A larger variation in the walking speed was related to the health status without hypertension or frailty. These results suggest that if a person shows less intra-day variation in walking speed, this could be a sign that they are susceptible to hypertension and an increased frailty level. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02349-w.
Collapse
Affiliation(s)
- Hisashi Kawai
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan.
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Ryo Hirayama
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan.,Osaka City University, Osaka, Japan
| | - Yutaka Watanabe
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan.,Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | | | - Hunkyung Kim
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Yoshiyuki Kobayashi
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Masaaki Mochimaru
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Eiki Tsushima
- Faculty of Medicine, Hirosaki University, Aomori, Japan
| | | |
Collapse
|
15
|
Zheng S, Tu L, Cicuttini F, Zhu Z, Han W, Antony B, Wluka AE, Winzenberg T, Aitken D, Blizzard L, Jones G, Ding C. Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms. BMC Musculoskelet Disord 2021; 22:40. [PMID: 33413273 PMCID: PMC7791830 DOI: 10.1186/s12891-020-03875-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 12/14/2020] [Indexed: 11/29/2022] Open
Abstract
Background To describe demographic and clinical factors associated with the presence and incidence of depression and explore the temporal relationship between depression and joint symptoms in patients with symptomatic knee osteoarthritis (OA). Methods Three hundred ninety-seven participants were selected from a randomized controlled trial in people with symptomatic knee OA and vitamin D deficiency (age 63.3 ± 7.1 year, 48.6% female). Depression severity and knee joint symptoms were assessed using the patient health questionnaire (PHQ-9) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively, at baseline and 24 months. Results The presence and incidence of depression was 25.4 and 11.2%, respectively. At baseline, having younger age, a higher body mass index (BMI), greater scores of WOMAC pain (PR: 1.05, 95%CI:1.03, 1.07), dysfunction (PR: 1.02, 95%CI:1.01, 1.02) and stiffness (PR: 1.05, 95%CI: 1.02, 1.09), lower education level, having more than one comorbidity and having two or more painful body sites were significantly associated with a higher presence of depression. Over 24 months, being female, having a higher WOMAC pain (RR: 1.05, 95%CI: 1.02, 1.09) and dysfunction score (RR: 1.02, 95%CI: 1.01, 1.03) at baseline and having two or more painful sites were significantly associated with a higher incidence of depression. In contrast, baseline depression was not associated with changes in knee joint symptoms over 24 months. Conclusion Knee OA risk factors and joint symptoms, along with co-existing multi-site pain are associated with the presence and development of depression. This suggests that managing common OA risk factors and joint symptoms may be important for prevention and treatment depression in patients with knee OA. Trial registration ClinicalTrials.gov identifier: NCT01176344. Anzctr.org.au identifier: ACTRN12610000495022. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-020-03875-1.
Collapse
Affiliation(s)
- Shuang Zheng
- Department of Rheumatology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.,Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, Australia
| | - Liudan Tu
- Department of Rheumatology, The Third Affiliated Hospital of SUN YAT-SEN University, Guangzhou, China
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Zhaohua Zhu
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, Australia.,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Weiyu Han
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, Australia.,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, Australia
| | - Dawn Aitken
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, Australia
| | - Changhai Ding
- Department of Rheumatology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China. .,Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, Australia. .,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. .,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| |
Collapse
|
16
|
Pothisiri W, Prasitsiriphon O, Aekplakorn W. Extent of aging across education and income subgroups in Thailand: Application of a characteristic-based age approach. PLoS One 2020; 15:e0243081. [PMID: 33290428 PMCID: PMC7723296 DOI: 10.1371/journal.pone.0243081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 11/15/2020] [Indexed: 01/03/2023] Open
Abstract
Aim This study aimed to identify differences in physical performance across various socioeconomic groups within an older population and to convert those differences into a common metric to facilitate comparisons of aging speed across socioeconomic subgroups. Methods We employed data from the 2009 National Health Examination Survey of Thailand. Physical performance was assessed using three health characteristics: grip strength, as a measure of upper body strength; walking speed, as a measure of lower body strength; and a combined measure of grip strength and walking speed, to capture the strength of the whole body. Education level and income were used to distinguish socioeconomic subpopulations. We followed a characteristic-based age approach to transform these population characteristics, which were measured in different units, into a common and comparable aging metric, referred to as α − age. Results Physical aging trajectories varied by sex and socioeconomic status. Some education, particularly secondary or higher education levels, was significantly associated with greater physical strength in older age for both men and women, whereas higher income was significantly associated with physical strength only for men. Across the three health characteristics, having a primary education slowed age-related declines by up to 6.3 years among men and 2.8 years among women, whereas being in a higher income group slowed age-related declines by 8.2 years among men and up to 4.9 years among women. Conclusions This study adds new evidence from a developing Asian country regarding the difference in aging speeds across subpopulations associated with different levels of education and income.
Collapse
Affiliation(s)
- Wiraporn Pothisiri
- College of Population Studies, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Orawan Prasitsiriphon
- College of Population Studies, Chulalongkorn University, Pathumwan, Bangkok, Thailand
- Health Insurance System Research Office, Health System Research Institute, Bang Khen, Nonthaburi, Thailand
- * E-mail:
| | - Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok, Thailand
| |
Collapse
|
17
|
Ikezaki H, Hashimoto M, Ishikawa T, Fukuhara R, Tanaka H, Yuki S, Kuribayashi K, Hotta M, Koyama A, Ikeda M, Takebayashi M. Relationship between executive dysfunction and neuropsychiatric symptoms and impaired instrumental activities of daily living among patients with very mild Alzheimer's disease. Int J Geriatr Psychiatry 2020; 35:877-887. [PMID: 32281119 DOI: 10.1002/gps.5308] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 03/30/2020] [Accepted: 04/03/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Patients with Alzheimer's disease (AD) experience a gradual loss in their ability to perform instrumental activities of daily living (IADLs) from the early stage. A better understanding of the possible factors associated with IADL decline is important for the development of effective rehabilitation and support programs for patients with AD. Thus, we examined the relationships between comprehensive cognitive functions and neuropsychiatric symptoms and IADLs in patients with very mild AD. METHODS In total, 230 outpatients with probable AD were recruited from the Memory Clinic at Kumamoto University Hospital between May 2007 and October 2016. All patients scored ≥21 points on the Mini-Mental State Examination at the first assessment. Relationships between the subdomains of the Lawton IADL scale and neuropsychological/neuropsychiatric tests were examined by multiple regression analysis. All analyses were performed separately in men and women. RESULTS In female patients, scores on the Frontal Assessment Battery were significantly associated with telephone use ability, shopping, and ability to handle finances. Apathy scores in the Neuropsychiatric Inventory (NPI) were associated with telephone use ability, housekeeping, responsibility for own medications, and ability to handle finances. NPI agitation scores were associated with food preparation and housekeeping. Geriatric Depression Scale scores were associated with telephone use ability and ability to handle finances. In male patients, only NPI apathy scores were associated with telephone use ability. CONCLUSIONS These results suggest the importance of properly assessing executive function, depression, and apathy at interventions for impaired IADLs among female patients with very mild AD.
Collapse
Affiliation(s)
- Hiroto Ikezaki
- Division of Speech-Language-Hearing Therapy, Department of Rehabilitation, Faculty of Health Science, Kumamoto Health Science University, Kumamoto, Japan.,Department of Neuropsychiatry, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Mamoru Hashimoto
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.,Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Suita, Japan
| | - Tomohisa Ishikawa
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| | - Ryuji Fukuhara
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| | - Hibiki Tanaka
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| | - Seiji Yuki
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| | | | - Maki Hotta
- Department of Psychiatry, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Asuka Koyama
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Minoru Takebayashi
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.,Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| |
Collapse
|
18
|
Nevill A, Duncan M, Cheung DSK, Wong ASW, Kwan RYC, Lai CKY. The use of functional performance tests and simple anthropomorphic measures to screen for comorbidity in primary care. Int J Older People Nurs 2020; 15:e12333. [PMID: 32638518 DOI: 10.1111/opn.12333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/18/2020] [Accepted: 06/09/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Many older adults are unaware that they have comorbid diseases. Increased adiposity and reduced muscle mass are identified as key contributors to many chronic diseases in older adults. Understanding the role they play in the development of comorbidities in older populations is of prime importance. OBJECTIVES To identify the optimal body shape associated with three common functional performance tests and to determine which anthropometric and functional performance test best explains comorbidity in a sample of older adults in Hong Kong. METHODS A total of 432 older adults participated in this cross-sectional study. Researchers assessed their body height, body mass index, waist circumference, waist-to-hip ratio, handgrip strength (kg), functional reach (cm) and results in the timed-up-and-go (TUG) test (seconds). The Charlson Comorbidity Index was used to assess comorbidity. RESULTS Allometric modelling indicated that the optimal body shape associated with all functional performance tests would have required the participants to be taller and leaner. The only variable that predicted comorbidity was the TUG test. The inclusion of body size/shape variables did not improve the prediction model. CONCLUSION Performance in the TUG test alone was found to be capable of identifying participants at risk of developing comorbidities. The TUG test has potential as a screening tool for the early detection of chronic diseases in older adults. IMPLICATIONS FOR PRACTICE Many older people are unaware of their own co-existing illnesses when they consult physicians for a medical condition. TUG can be a quick and useful screening measure to alert nurses in primary care to the need to proceed with more detailed assessments. It is an especially useful screening measure in settings with high patient volumes and fiscal constraints. TUG is low cost and easy to learn and is therefore also relevant for nurses and health workers in low-resource, low-income countries.
Collapse
Affiliation(s)
- Alan Nevill
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Walsall, UK
| | - Michael Duncan
- Faculty Research Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK
| | - Daphne S K Cheung
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Anthony S W Wong
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Rick Yiu Cho Kwan
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Claudia K Y Lai
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| |
Collapse
|
19
|
Duarte Wisnesky U, Olson J, Paul P, Dahlke S, Slaughter SE, de Figueiredo Lopes V. Sit-to-stand activity to improve mobility in older people: A scoping review. Int J Older People Nurs 2020; 15:e12319. [PMID: 32500976 DOI: 10.1111/opn.12319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 03/13/2020] [Accepted: 04/03/2020] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To identify the current state of knowledge about the use of the sit-to-stand intervention with older people and to identify implications for further research. BACKGROUND Many older people experience mobility challenges which can negatively affect their well-being. Physical activities are vital to improving or maintaining mobility. Although there is evidence that mobility challenged older people benefit from the sit-to-stand intervention, there is a need to systematically examine the state of knowledge about this intervention. DESIGN Scoping review using Arksey and O'Malley's methodological framework. METHODS A systematic search of three databases was completed. Abstracts were evaluated for relevance using predetermined inclusion criteria. Studies that met the inclusion criteria had data extracted and were appraised for internal and external validity. Narrative synthesis was based on methods described by Popay and colleagues. RESULTS Of 3,041 papers, six studies met the inclusion criteria. Publications provided a range of sit-to-stand interventions with durations varying from four weeks to six months. The frequency of each intervention fluctuated from three to seven times/week with a duration of 15-45 min. Different professionals prompted the activity. Three themes were identified the following: (a) sit-to-stand activity as an intervention; (b) generalisability of findings; and (c) sustainability. CONCLUSIONS Most of the studies reviewed indicated improvements in performance of the sit-to-stand activity and in motor function. However, issues with studies rigour do not allow us to make generalisations. Further research is needed to confirm the effectiveness of the intervention. IMPLICATIONS FOR PRACTICE Healthcare providers are expected to offer evidence-based patient care. This review details current knowledge about the sit-to-stand intervention with older people.
Collapse
Affiliation(s)
| | - Joanne Olson
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Pauline Paul
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | | | | |
Collapse
|
20
|
Kawai H, Obuchi S, Watanabe Y, Hirano H, Fujiwara Y, Ihara K, Kim H, Kobayashi Y, Mochimaru M, Tsushima E, Nakamura K. Association between Daily Living Walking Speed and Walking Speed in Laboratory Settings in Healthy Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082707. [PMID: 32326419 PMCID: PMC7215567 DOI: 10.3390/ijerph17082707] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022]
Abstract
Although there is evidence on the predictors of adverse health outcomes in older individuals, walking speed has typically been measured in laboratory settings (LWS); LWS may be distinct from individuals' actual walking speed in their daily lives (DWS). We examined whether DWS differs from LWS among older adults, and its association with physical frailty. Participants were 90 community-dwelling older adults. A five-meter normal (LWSnor) and maximum (LWSmax) walking speed was measured with a stopwatch. DWS was measured using a global positioning system-related smartphone application for one month during their daily lives. DWSavr, DWSmax, and DWSsd were defined as the average, maximum, and standard deviation of walking speed for one month. Participants' mean DWSavr and DWSmax were 1.28 m/s and 2.14 m/s, respectively, significantly slower than the mean LWSnor (1.42 m/s) and LWSmax (2.24 m/s); the intraclass correlation coefficient between DWS and LWS were 0.188 to 0.341. DWS was significantly correlated with grip strength, one-legged stance, and LWS. The area under the receiver operating characteristic curve of DWSsd concerning pre-frailty was largest among DWSs, at 0.615, while that of LWSnor was 0.643. The findings suggest that DWS differs from LWS and is associated with physical function and pre-frailty.
Collapse
Affiliation(s)
- Hisashi Kawai
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan; (S.O.); (Y.W.); (H.H.); (Y.F.); (H.K.)
- Correspondence: ; Tel.: +81-3-3964-3241 (ext. 4243)
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan; (S.O.); (Y.W.); (H.H.); (Y.F.); (H.K.)
| | - Yutaka Watanabe
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan; (S.O.); (Y.W.); (H.H.); (Y.F.); (H.K.)
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Kita13, Nishi7, Kita-Ku, Sapporo 060-8586, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan; (S.O.); (Y.W.); (H.H.); (Y.F.); (H.K.)
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan; (S.O.); (Y.W.); (H.H.); (Y.F.); (H.K.)
| | - Kazushige Ihara
- Faculty of Medicine, Hirosaki University, 5 Zaifu-cho Hirosaki City, Aomori 036-8562, Japan; (K.I.); (E.T.)
| | - Hunkyung Kim
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo 173-0015, Japan; (S.O.); (Y.W.); (H.H.); (Y.F.); (H.K.)
| | - Yoshiyuki Kobayashi
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, c/o Kashiwa II Campus, University of Tokyo, 6-2-3 Kashiwanoha, Kashiwa, Chiba 277-0882, Japan; (Y.K.); (M.M.)
| | - Masaaki Mochimaru
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, c/o Kashiwa II Campus, University of Tokyo, 6-2-3 Kashiwanoha, Kashiwa, Chiba 277-0882, Japan; (Y.K.); (M.M.)
| | - Eiki Tsushima
- Faculty of Medicine, Hirosaki University, 5 Zaifu-cho Hirosaki City, Aomori 036-8562, Japan; (K.I.); (E.T.)
| | - Kozo Nakamura
- Towa Hospital, 4-7-10 Towa, Adachi-Ku, Tokyo 120-0003, Japan;
| |
Collapse
|
21
|
Wang DX, Yao J, Zirek Y, Reijnierse EM, Maier AB. Muscle mass, strength, and physical performance predicting activities of daily living: a meta-analysis. J Cachexia Sarcopenia Muscle 2020; 11:3-25. [PMID: 31788969 PMCID: PMC7015244 DOI: 10.1002/jcsm.12502] [Citation(s) in RCA: 291] [Impact Index Per Article: 72.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/06/2019] [Accepted: 09/09/2019] [Indexed: 12/16/2022] Open
Abstract
Background Activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are essential for independent living and are predictors of morbidity and mortality in older populations. Older adults who are dependent in ADLs and IADLs are also more likely to have poor muscle measures defined as low muscle mass, muscle strength, and physical performance, which further limit their ability to perform activities. The aim of this systematic review and meta-analysis was to determine if muscle measures are predictive of ADL and IADL in older populations. Methods A systematic search was conducted using four databases (MEDLINE, EMBASE, Cochrane, and CINAHL) from date of inception to 7 June 2018. Longitudinal cohorts were included that reported baseline muscle measures defined by muscle mass, muscle strength, and physical performance in conjunction with prospective ADL or IADL in participants aged 65 years and older at follow-up. Meta-analyses were conducted using a random effect model. Results Of the 7760 articles screened, 83 articles were included for the systematic review and involved a total of 108 428 (54.8% female) participants with a follow-up duration ranging from 11 days to 25 years. Low muscle mass was positively associated with ADL dependency in 5/9 articles and 5/5 for IADL dependency. Low muscle strength was associated with ADL dependency in 22/34 articles and IADL dependency in 8/9 articles. Low physical performance was associated with ADL dependency in 37/49 articles and with IADL dependency in 9/11 articles. Forty-five articles were pooled into the meta-analyses, 36 reported ADL, 11 reported IADL, and 2 reported ADL and IADL as a composite outcome. Low muscle mass was associated with worsening ADL (pooled odds ratio (95% confidence interval) 3.19 (1.29-7.92)) and worsening IADL (1.28 (1.02-1.61)). Low handgrip strength was associated with both worsening ADL and IADL (1.51 (1.34-1.70); 1.59 (1.04-2.31) respectively). Low scores on the short physical performance battery and gait speed were associated with worsening ADL (3.49 (2.47-4.92); 2.33 (1.58-3.44) respectively) and IADL (3.09 (1.06-8.98); 1.93 (1.69-2.21) respectively). Low one leg balance (2.74 (1.31-5.72)), timed up and go (3.41 (1.86-6.28)), and chair stand test time (1.90 (1.63-2.21)) were associated with worsening ADL. Conclusions Muscle measures at baseline are predictors of future ADL and IADL dependence in the older adult population.
Collapse
Affiliation(s)
- Daniel X.M. Wang
- Department of Medicine and Aged Care, @AgeMelbourneThe University of Melbourne, The Royal Melbourne HospitalParkvilleVICAustralia
| | - Jessica Yao
- Department of Medicine and Aged Care, @AgeMelbourneThe University of Melbourne, The Royal Melbourne HospitalParkvilleVICAustralia
| | - Yasar Zirek
- Department of Medicine and Aged Care, @AgeMelbourneThe University of Melbourne, The Royal Melbourne HospitalParkvilleVICAustralia
| | - Esmee M. Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourneThe University of Melbourne, The Royal Melbourne HospitalParkvilleVICAustralia
| | - Andrea B. Maier
- Department of Medicine and Aged Care, @AgeMelbourneThe University of Melbourne, The Royal Melbourne HospitalParkvilleVICAustralia
- Department of Human Movement Sciences, @AgeAmsterdamVrije Universiteit Amsterdam, Amsterdam Movement SciencesAmsterdamThe Netherlands
| |
Collapse
|
22
|
Prasitsiriphon O, Weber D. Objective physical measures and their association with subjective functional limitations in a representative study population of older Thais. BMC Geriatr 2019; 19:73. [PMID: 30836934 PMCID: PMC6402119 DOI: 10.1186/s12877-019-1093-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 02/26/2019] [Indexed: 01/10/2023] Open
Abstract
Background In this study, we analyzed elderly people in Thailand to identify the validity of suggested cutoff points of physical measures, handgrip strength, usual walking speed, and a composite score of both measures to predict functional limitations. Moreover, we examined whether these physical performance measures are accurate indicators of the investigated health outcomes. Methods Using Receiver Operating Characteristics (ROC) analysis, we investigated a sample of 8272 respondents aged 60 to 79 years. All data were based on the 2009 National Health Examination Survey (NHES IV) of Thailand. Results For males aged 60 to 69 years, handgrip strength was used as an indicator of functional limitations. The cutoff point for disabilities in the activities of daily living (ADLs) was 29.5 kg, while in other limitations it ranged from 28.7 to 31.3 kg. In contrast, usual walking speed was able to indicate ADL disabilities at 0.7 m per second (m/s). As one might expect, the cutoff points for males aged 70 to 79 years were lower than for males in the 60 to 69 age group. For females, handgrip strength was able to indicate ADL disabilities at 16.5 kg for both the 60 to 69, and 70 to 79 age groups. Likewise, walking speed was indicative of ADL disabilities at 0.6 m/s for both age groups. Interestingly, the composite measure increases the ability to detect ADL disabilities in the younger group but not in the older group. The area under the curve (AUC) of cutoffs measuring the detection power of a diagnostic test was varied, ranging from 0.535 to 0.7386. Conclusions The cutoff points of three measures varied according to sex and type of functional limitations. Our findings also showed that physical performance measures were useful for identifying people with an increased risk of functional limitations, particularly for ADL disabilities. However, although the AUC of the cutoffs of other functional limitations were relatively low, they should be considered with caution. Electronic supplementary material The online version of this article (10.1186/s12877-019-1093-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Orawan Prasitsiriphon
- College of Population Studies, Chulalongkorn University, Bangkok, 10330, Thailand. .,Wittgenstein Centre for Demography and Global Human Capital (IIASA, VID/OEAW, WU), International Institute for Applied Systems Analysis (IIASA), 2361, Laxenburg, Austria.
| | - Daniela Weber
- Wittgenstein Centre for Demography and Global Human Capital (IIASA, VID/OEAW, WU), International Institute for Applied Systems Analysis (IIASA), 2361, Laxenburg, Austria.,Health Economics and Policy Division, Vienna University of Economics and Business, Welthandelsplatz 1, 1020, Vienna, Austria
| |
Collapse
|
23
|
Neuropsychological correlates of instrumental activities of daily living in neurocognitive disorders: a possible role for executive dysfunction and mood changes. Int Psychogeriatr 2018; 30:1871-1881. [PMID: 29789032 DOI: 10.1017/s1041610218000455] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTSince baseline executive dysfunction predicts worsening Instrumental Activities of Daily Living (i-ADL) over time and progression to Alzheimer's Disease (AD), we aimed to analyze the role of neuropsychological variables to outline which factors can contribute to functional impairment. Specific attention to executive functions (EFs) has been given.A total of 144 subjects complaining of different cognitive deficits - ranging from "MCI likely due to AD" to "mild AD patients" - underwent an overall neuropsychological assessment. The Behavioral Assessment of the Dysexecutive Syndrome was used to analyze EFs. We conducted multiple linear regression analyses to study whether the level of independent living skills - assessed with the Lawton-scale - could be associated with cognitive and behavioral measurements.We found a significant association between i-ADL and specific EFs measured by Rule Shift Cards (p = 0.04) and Modified Six Elements (p = 0.02). Moreover, considering i-ADL scores, we observed an involvement of mood changes and a reduced awareness of deficits in terms of Hamilton Depression Rating Scale (p = 0.02) and Awareness of Deficit Questionnaire - Dementia scale (p < 0.0001), respectively.Our results suggest the importance of considering the association between a reduction in i-ADL and executive dysfunction in patients who have AD etiopathology, for which the ability to inhibit a response, self-monitoring, set-shifting and mood deflection play a key role. Besides, no straightforward associations between i-ADL scores and global cognition, memory, language comprehension, attention, and perspective taking abilities were found.
Collapse
|
24
|
Lee MC, Hsu CC, Tsai YF, Chen CY, Lin CC, Wang CY. Criterion-Referenced Values of Grip Strength and Usual Gait Speed Using Instrumental Activities of Daily Living Disability as the Criterion. J Geriatr Phys Ther 2018; 41:14-19. [PMID: 28079633 DOI: 10.1519/jpt.0000000000000106] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND PURPOSE Current evidence suggests that grip strength and usual gait speed (UGS) are important predictors of instrumental activities of daily living (IADL) disability. Knowing the optimum cut points of these tests for discriminating people with and without IADL disability could help clinicians or researchers to better interpret the test results and make medical decisions. The purpose of this study was to determine the cutoff values of grip strength and UGS for best discriminating community-dwelling older adults with and without IADL disability, separately for men and women, and to investigate their association with IADL disability. METHODS We conducted secondary data analysis on a national dataset collected in the Sarcopenia and Translational Aging Research in Taiwan (START). The data used in this study consisted of health data of 2420 community-dwelling older adults 65 years and older with no history of stroke and with complete data. IADL disability was defined as at least 1 IADL item scored as "need help" or "unable to perform." Receiver operating characteristics analysis was used to estimate the optimum grip strength and UGS cut points for best discriminating older adults with/without IADL disability. The association between each physical performance (grip strength and UGS) and IADL disability was assessed with odds ratios (ORs). RESULTS AND DISCUSSION With IADL disability as the criterion, the optimal cutoff values of grip strength were 28.7 kg for men and 16.0 kg for women, and those for UGS were 0.76 m/s for men and 0.66 m/s for women. The grip strength test showed satisfactory discriminant validity (area under the curve > 0.7) in men and a strong association with IADL disability (OR > 4). Our cut points using IADL disability as the criterion were close to those indicating frailty or sarcopenia. CONCLUSIONS Our reported cutoffs can serve as criterion-referenced values, along with those previously determined using different indicators, and provide important landmarks on the performance continua of older adults' grip strength and UGS. These landmarks could be useful in interpreting test results, monitoring changes in performance, and identifying individuals requiring timely intervention. For identifying older adults at risk of IADL disability, grip strength is superior to UGS.
Collapse
Affiliation(s)
- Meng-Chih Lee
- Taichung Hospital, Ministry of Health and Welfare, and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Yi-Fen Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Ching-Yu Chen
- Department of Family Medicine, National Taiwan University, Taipei, Taiwan
| | - Cheng-Chieh Lin
- Department of Family Medicine, China Medical University & Hospital, Taichung, Taiwan
| | - Ching-Yi Wang
- School of Physical Therapy & Center for Education and Research on Geriatrics and Gerontology, Chung Shan Medical University, and Physical Therapy Room, Chung Shan Medical University Hospital, Taichung Taiwan
| |
Collapse
|
25
|
Ćwirlej-Sozańska A, Sozański B, Wiśniowska-Szurlej A, Wilmowska-Pietruszyńska A, Kujawa J. Assessment of Disability and Factors Determining Disability among Inhabitants of South-Eastern Poland Aged 71-80 Years. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3872753. [PMID: 30018979 PMCID: PMC6029473 DOI: 10.1155/2018/3872753] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 04/30/2018] [Accepted: 05/15/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The aim of the study was to assess the level of disability in a sample of older people in south-eastern Poland and to identify any potential relationship between their profile of functioning and a complex set of variables including activities, participation, and contextual factors. MATERIALS AND METHODS The study included 800 people aged 71-80 years. The WHODAS 2.0 questionnaire was applied for the assessment of disability. RESULTS A total of 43.88% of the interviewees showed a moderate level of disability, while 17.75% had severe or extremely high levels of disability. In addition, 7.75% of the interviewees had no functional limitations and 30.62% demonstrated a mild level of disability. The studied individuals reported the greatest difficulties with life activities such as cleaning, cooking, or shopping, followed by Limited Participation and then getting along. Age, number of chronic diseases, a low level of education, a low level of physical activity, poor living conditions, and lack of opportunities for daily help significantly contributed to higher levels of disability. CONCLUSIONS Measures intended to reduce the level of disability in older adults should focus on improving medical care, health education, increasing physical activity, adapting housing to the needs of everyday functioning, and providing daily help.
Collapse
Affiliation(s)
| | - Bernard Sozański
- Center for Innovative Research in Medical and Natural Sciences, University of Rzeszow, Rzeszow, Poland
| | | | | | - Jolanta Kujawa
- Department of Medical Rehabilitation, Military Medical Faculty, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
26
|
Abstract
There are normal physiologic changes that occur as people age. Gait and mobility are altered with aging, and these changes are a combination of alterations in the gait pattern and in the function of organs. Changes in gait are associated with functional decline, less independence, and impaired quality of life. Reduced walking speed is the most consistent age-related change, but there are other contributors to an altered gait: impaired balance and stability, lower extremity strength, and the fear of falling.
Collapse
Affiliation(s)
- Maricarmen Cruz-Jimenez
- Physical Medicine and Rehabilitation, VA Caribbean Healthcare System, San Juan, PR, USA; Physical Medicine and Rehabilitation, University of Puerto Rico, San Juan, PR, USA.
| |
Collapse
|
27
|
Seaton L, Brown T. The Relationship between Body Function and Structure Factors and the Activity-Participation of Healthy Community-Dwelling Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2018. [DOI: 10.1080/02703181.2018.1443193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Linda Seaton
- Occupational Science and Therapy Program, School of Health and Social Development, Faculty of Health, Deakin University – Waterfront Campus, Geelong, Victoria, Australia
| | - Ted Brown
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University – Peninsula Campus, Frankston, Victoria, Australia
| |
Collapse
|
28
|
Skinner JS, Abel WM, McCoy K, Wilkins CH. Exploring the "Obesity Paradox" as a Correlate of Cognitive and Physical Function in Community-dwelling Black and White Older Adults. Ethn Dis 2017; 27:387-394. [PMID: 29225439 PMCID: PMC5720948 DOI: 10.18865/ed.27.4.387] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objective The obesity paradox has been documented in aged populations, yet it remains unclear if this paradox persists for physical and cognitive outcomes in community-dwelling older adult populations. Our study examines associations between body mass index (BMI) classification, cognitive function, and physical function. We also investigate whether these associations are modified by race or age. Design Cross-sectional study. Setting Senior residential sites and community centers in Saint Louis, Missouri. Participants Study participants included 331 adults, aged >55 years. Age was stratified into young-old (aged 55-74 years) and older (aged ≥75 years). Outcome Measures Physical function was measured using the mini-Physical Performance Test (mini-PPT) and grip strength. Cognitive function was assessed with the Short Blessed Test (SBT) and the Trail Making Tests (TMT-A and TMT-B) performance. Results Older adults who were obese had significantly better cognitive flexibility (TMT-B) performance than normal weight older adults (P=.02), and this association was not influenced by age or race. Adiposity was not associated with psychomotor speed (TMT-A), general cognition (SBT), or measures of physical function (Ps>.05). Conclusion In a diverse sample of community-dwelling older adults, we found partial support for the controversial obesity paradox. Our results suggest excess adiposity may be protective for executive function processes. Future research is needed to examine the underlying physiological processes linking adiposity to executive function in older adults.
Collapse
Affiliation(s)
- Jeannine S. Skinner
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC
| | - Willie Mae Abel
- School of Nursing, University of North Carolina at Charlotte, Charlotte, NC
| | - Katryna McCoy
- School of Nursing & Health Studies, University of Washington Bothell, Bothell, WA
| | - Consuelo H. Wilkins
- Meharry-Vanderbilt Alliance, Vanderbilt University Medical Center, Nashville, TN
| |
Collapse
|
29
|
Stenroth L, Sipilä S, Finni T, Cronin NJ. Slower Walking Speed in Older Men Improves Triceps Surae Force Generation Ability. Med Sci Sports Exerc 2017; 49:158-166. [PMID: 27471788 DOI: 10.1249/mss.0000000000001065] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE Older adults walk slower than young adults, but it is not known why. Previous research suggests that ankle plantarflexors may have a crucial role in the reduction of walking speed. The purpose of this study was to investigate age-related differences in triceps surae muscle-tendon function during walking to further investigate the role of plantarflexors in the age-related reduction of walking speed. METHODS Medial gastrocnemius and soleus muscle fascicle lengths were measured using ultrasound imaging during walking from 13 young (25 ± 4 yr) men at preferred walking speed and from 13 older (73 ± 5 yr) men at preferred speed and at the young men's preferred speed. Muscle-tendon unit lengths were calculated from joint kinematics, and tendinous tissue lengths were calculated by subtracting muscle lengths from muscle-tendon unit lengths. In addition, ground reaction forces and electromyographic activity of medial gastrocnemius and soleus were measured. RESULTS In both medial gastrocnemius and soleus, it was observed that at preferred walking speed, older men used a narrower muscle fascicle operating range and lower shortening velocity at the estimated time of triceps surae peak force generation compared with young men. Fascicles also accounted for a lower proportion of muscle-tendon unit length changes during the stance phase in older compared with young men. Significant differences in triceps surae muscle function were not observed between age groups when compared at matched walking speed. CONCLUSIONS In older men, walking at preferred speed allows triceps surae muscles to generate force with more favorable shortening velocity and to enhance use of tendinous tissue elasticity compared with walking at young men's preferred speed. The results suggest that older men may prefer slower walking speeds to compensate for decreased plantarflexor strength.
Collapse
Affiliation(s)
- Lauri Stenroth
- 1Department of Biology of Physical Activity, Neuromuscular Research Center, University of Jyvaskyla, Jyvaskyla, FINLAND; 2Department of Health Sciences, Gerontology Research Center, University of Jyvaskyla, Jyvaskyla, FINLAND
| | | | | | | |
Collapse
|
30
|
Timed Up and Go Test Performance as an Indicator of Fall History in Institutionalized Elderly. TOPICS IN GERIATRIC REHABILITATION 2017. [DOI: 10.1097/tgr.0000000000000164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
31
|
Whitehead BR. Investigating the function spiral in later life: Aging attitudes, physical activity, and gait. J Health Psychol 2017; 24:1955-1964. [PMID: 28810468 DOI: 10.1177/1359105317710814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study tests the Function Spiral Model, which proposes that functional decline often occurs prematurely: negative aging attitudes reduce activity engagement, which then advances functional decline via physical deconditioning. A total of 89 adults aged 61-96 (M = 77) years completed a questionnaire assessing aging attitudes and physical activity and participated in a follow-up assessment of gait/balance and function. Results supported the process model: physical activity mediated the impact of negative aging attitudes on gait/balance, and gait/balance mediated the impact of physical activity on function. Findings highlight multiple points of intervention that could mitigate the acceleration of functional decline in later life.
Collapse
|
32
|
White DK, Neogi T, Zhang Y, Niu J, Katz PP. Association of Slow Gait Speed With Trajectories of Worsening Depressive Symptoms in Knee Osteoarthritis: An Observational Study. Arthritis Care Res (Hoboken) 2017; 69:209-215. [PMID: 27158972 DOI: 10.1002/acr.22928] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 03/15/2016] [Accepted: 04/26/2016] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To investigate the association of slow gait speed, defined as walking slower than is necessary for the community, with trajectories of depressive symptoms over 7 years among people with or at high risk of knee OA. METHODS Using data from the Osteoarthritis Initiative, we described trajectories of depressive symptoms measured annually with the Center for Epidemiologic Studies Depression Scale. We categorized speed during a 20-meter walk of <1.2 meters/second as slow gait speed. We used a group-based method to agnostically identify homogeneous clusters of depressive symptom trajectories. We then examined the association of slow gait speed with depressive symptom trajectories, using multinomial logistic regression adjusted for potential confounders. RESULTS From the 3,939 participants included (mean ± SD age 61.4 ± 9.2 years, body mass index 28.4 ± 4.7, 58% women, and 63% with a college degree), we identified 5 trajectories. The first 3 were stable over time and included 74% of the sample. The remainder had worsening depressive symptoms over time. Slow gait speed was associated with 2.1 times the odds of having the worst depressive symptoms trajectory compared to those without slow gait speed. CONCLUSION Slow gait speed may represent an important risk factor for worsening depressive symptoms over time in people with or at high risk of knee OA, and may signal the need for rehabilitation.
Collapse
Affiliation(s)
| | - Tuhina Neogi
- Boston University School of Medicine, Boston, Massachusetts
| | - Yuqing Zhang
- Boston University School of Medicine, Boston, Massachusetts
| | - Jingbo Niu
- Boston University School of Medicine, Boston, Massachusetts
| | | |
Collapse
|
33
|
Ogama N, Sakurai T, Nakai T, Niida S, Saji N, Toba K, Umegaki H, Kuzuya M. Impact of frontal white matter hyperintensity on instrumental activities of daily living in elderly women with Alzheimer disease and amnestic mild cognitive impairment. PLoS One 2017; 12:e0172484. [PMID: 28253275 PMCID: PMC5333806 DOI: 10.1371/journal.pone.0172484] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 02/06/2017] [Indexed: 11/19/2022] Open
Abstract
Background Instrumental activities of daily living (IADL) start to decline during the progression of amnestic mild cognitive impairment (aMCI) to Alzheimer disease (AD). Cognitive and physical decline are involved in the loss of functional independence. However, little is known about AD-related neural change that leads to IADL impairment. The purpose of this study was to clarify the effects of regional white matter hyperintensity (WMH) on IADL impairment in persons with AD and aMCI. Methods The participants were 347 female subjects aged 65–85 years diagnosed with AD (n = 227), aMCI (n = 44) or normal cognition (n = 76). IADL was assessed by the Lawton Index. Cognition, mood and mobility function were evaluated by comprehensive geriatric assessment batteries. WMH and brain atrophy were analyzed with brain magnetic resonance imaging, using an automatic segmentation program. Regional WMH was measured in the frontal, temporal, occipital and parietal lobes. Results Ability to carry out IADL of shopping, food preparation, mode of transportation, responsibility for own medication, and ability to handle finances was obviously impaired in the early stage of AD. Frontal WMH was specifically associated with disability to do shopping and food preparation even after adjusting for several confounders including brain atrophy. Conclusions IADL subcategories were differentially impaired along with cognitive status in persons with AD and aMCI. Frontal WMH was an important predictor of impaired ability to do shopping and food preparation. A preventive strategy for WMH might lead to suppression of IADL disability and slow the progression of AD.
Collapse
Affiliation(s)
- Noriko Ogama
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Sakurai
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
- * E-mail:
| | - Toshiharu Nakai
- NeuroImaging and Informatics, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Shumpei Niida
- Medical Genome Center, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Naoki Saji
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Toba
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
34
|
Inzitari M, Calle A, Esteve A, Casas Á, Torrents N, Martínez N. [Do you measure gait speed in your daily clinical practice? A review]. Rev Esp Geriatr Gerontol 2017; 52:35-43. [PMID: 26908071 DOI: 10.1016/j.regg.2015.12.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 12/18/2015] [Accepted: 12/22/2015] [Indexed: 06/05/2023]
Abstract
Gait speed (GS), measured at usual pace, is an easy, quick, reliable, non-expensive and informative measurement. With a standard chronometer, like those that currently found in mobile phones, and with two marks on the floor, trained health professionals obtain a more objective and quick measurement compared with many geriatric scales used in daily practice. GS is one of the pillars of the frailty phenotype, and is closely related to sarcopenia. It is a powerful marker of falls incidence, disability and death, mostly useful in the screening of older adults that live in the community. In recent years, the evidence is reinforcing the usefulness of GS in acute care and post-surgical patients. Its use in patients with cognitive impairment is suggested, due to the strong link between cognitive and physical function. Although GS meets the criteria for a good geriatric screening tool, it is not much used in clinical practice. Why? This review has different aims: (i)disentangling the relationship between GS and frailty; (ii)reviewing the protocols to measure GS and the reference values; (iii)reviewing the evidence in different clinical groups (older adults with frailty, with cognitive impairment, with cancer or other pathologies), and in different settings (community, acute care, rehabilitation), and (iv)speculating about the reasons for its poor use in clinical practice and about the gaps to be filled.
Collapse
Affiliation(s)
- Marco Inzitari
- Parc Sanitari Pere Virgili, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España.
| | - Alicia Calle
- Parc Sanitari Pere Virgili, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España
| | - Anna Esteve
- Parc Sanitari Pere Virgili, Barcelona, España
| | - Álvaro Casas
- Servicio de Geriatría, Complejo Hospitalario de Navarra. IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, España
| | | | - Nicolás Martínez
- Servicio de Geriatría, Complejo Hospitalario de Navarra. IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, España; REDISSEC, Red de Investigación en Servicios de Salud en Enfermedades Crónicas, España
| |
Collapse
|
35
|
Ross LA, Sprague BN, Phillips CB, O'Connor ML, Dodson JE. The Impact of Three Cognitive Training Interventions on Older Adults' Physical Functioning Across 5 Years. J Aging Health 2016; 30:475-498. [PMID: 28553791 DOI: 10.1177/0898264316682916] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Physical functioning is closely associated with cognition. The current study assessed the impact of three cognitive training programs on objective measures of physical functioning across 5 years. METHOD Older adults randomized to a processing speed ( n = 702), reasoning ( n = 694), or memory ( n = 703) training intervention were compared with those randomized to a no-contact control condition ( n = 698). Intention-to-treat (ITT) and treatment-received/dosage (time-varying number of training sessions) analyses were conducted. RESULTS There were no transfer effects in the ITT analyses. Treatment-received models demonstrated that training sessions (i.e., higher dosage) across all intervention arms transferred to better maintained Digit Symbol Copy and Turn 360 performance relative to the control group. More reasoning training transferred to better grip strength. DISCUSSION This is the first study to demonstrate differential longitudinal cognitive training transfer effects to three performance-based physical functioning measures. Future research should investigate mechanisms of far-transfer effects.
Collapse
Affiliation(s)
- Lesley A Ross
- 1 The Pennsylvania State University, University Park, USA
| | | | | | | | | |
Collapse
|
36
|
Nagamatsu LS, Hsu CL, Davis JC, Best JR, Liu-Ambrose T. White Matter Volume Mediates the Relationship Between Self-Efficacy and Mobility in Older Women. Exp Aging Res 2016; 42:460-470. [PMID: 27749206 DOI: 10.1080/0361073x.2016.1224657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background/Study Context: With our aging population, understanding determinants of healthy aging is a priority. One essential component of healthy aging is mobility. Although self-efficacy can directly impact mobility in older adults, it is unknown what role brain health may play in this relationship. METHODS The authors conducted a cross-sectional pilot analysis of community-dwelling women (N = 80, mean age = 69 years) to examine whether brain volume mediates the relationship between falls-related self-efficacy, as measured by the Activities-specific Balance Confidence (ABC) scale, and mobility, as measured by the Timed Up and Go (TUG) test. Age, depression, education, functional comorbidities, and Montreal Cognitive Assessment (MoCA) were included in the model as covariates. RESULTS The authors report that total white matter volume, specifically, significantly mediates the relationship between self-efficacy and mobility, where higher self-efficacy was associated with greater white matter volume (r = .28), which, in turn, was associated with better mobility (r = -.30). CONCLUSION This pilot study extends our understanding of the psychosocial and neurological factors that contribute to mobility and provides insight into effective strategies that may be used to improve functional independence among older adults. Future prospective and intervention studies are required to further elucidate the nature of the relationship between self-efficacy, mobility, and brain health.
Collapse
Affiliation(s)
- Lindsay S Nagamatsu
- a Beckman Institute for Advanced Science and Technology , University of Illinois at Urbana-Champaign , Urbana , Illinois , USA
| | - Chun Liang Hsu
- b Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, and Centre for Hip Health and Mobility , University of British Columbia , Vancouver , British Columbia , Canada
| | - Jennifer C Davis
- c Aging, Mobility, and Cognitive Neuroscience Laboratory and Centre for Clinical Epidemiology and Evaluation , University of British Columbia, Vancouver, British Columbia, Canada; and Vancouver Coastal Health Research Institute , Vancouver , British Columbia , Canada
| | - John R Best
- b Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, and Centre for Hip Health and Mobility , University of British Columbia , Vancouver , British Columbia , Canada
| | - Teresa Liu-Ambrose
- b Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, and Centre for Hip Health and Mobility , University of British Columbia , Vancouver , British Columbia , Canada
| |
Collapse
|
37
|
Anton SD, Woods AJ, Ashizawa T, Barb D, Buford TW, Carter CS, Clark DJ, Cohen RA, Corbett DB, Cruz-Almeida Y, Dotson V, Ebner N, Efron PA, Fillingim RB, Foster TC, Gundermann DM, Joseph AM, Karabetian C, Leeuwenburgh C, Manini TM, Marsiske M, Mankowski RT, Mutchie HL, Perri MG, Ranka S, Rashidi P, Sandesara B, Scarpace PJ, Sibille KT, Solberg LM, Someya S, Uphold C, Wohlgemuth S, Wu SS, Pahor M. Successful aging: Advancing the science of physical independence in older adults. Ageing Res Rev 2015; 24:304-27. [PMID: 26462882 DOI: 10.1016/j.arr.2015.09.005] [Citation(s) in RCA: 163] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 09/08/2015] [Accepted: 09/30/2015] [Indexed: 02/08/2023]
Abstract
The concept of 'successful aging' has long intrigued the scientific community. Despite this long-standing interest, a consensus definition has proven to be a difficult task, due to the inherent challenge involved in defining such a complex, multi-dimensional phenomenon. The lack of a clear set of defining characteristics for the construct of successful aging has made comparison of findings across studies difficult and has limited advances in aging research. A consensus on markers of successful aging is furthest developed is the domain of physical functioning. For example, walking speed appears to be an excellent surrogate marker of overall health and predicts the maintenance of physical independence, a cornerstone of successful aging. The purpose of the present article is to provide an overview and discussion of specific health conditions, behavioral factors, and biological mechanisms that mark declining mobility and physical function and promising interventions to counter these effects. With life expectancy continuing to increase in the United States and developed countries throughout the world, there is an increasing public health focus on the maintenance of physical independence among all older adults.
Collapse
|
38
|
Mollaoğlu M, Kayataş M. Disability is associated with nonadherence to diet and fluid restrictions in end-stage renal disease patients undergoing maintenance hemodialysis. Int Urol Nephrol 2015; 47:1863-70. [DOI: 10.1007/s11255-015-1102-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 09/01/2015] [Indexed: 10/23/2022]
|
39
|
Bartali B, Curto T, Maserejian NN, Araujo AB. Intake of antioxidants and subsequent decline in physical function in a racially/ethnically diverse population. J Nutr Health Aging 2015; 19:542-7. [PMID: 25923484 DOI: 10.1007/s12603-015-0449-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES Oxidative stress is considered a risk factor for physical function (PF) decline with aging. The objective of this study was to examine the relationship between antioxidant intake and change in PF over a 5-year period. DESIGN, SETTING, PARTICIPANTS The Boston Area Community Health (BACH) Survey is a population-based longitudinal study including 5,502 racially/ethnically diverse and randomly selected participants aged 30-79 years. MEASUREMENTS In total, 2828 persons aged 30-79 years completed the validated Block Food Frequency Questionnaire (FFQ) and participated in the follow-up study. Change in PF from baseline (2002-2005) to follow-up (2006-2010) was assessed using the validated SF-12 questionnaire. Linear models were used to examine the association between energy-adjusted quartiles of vitamins C, E and carotenoids and change in PF. RESULTS A low intake (first quartile) of vitamin E was associated with a greater decline in PF compared with the highest quartile, with a mean difference in change in PF of -1.73 (95%CI:-3.31,-0.15). Notably, this mean difference was clinically meaningful as it was equivalent to the effect estimate we found for participants who were approximately 15 years apart in age in our cohort, as 1 year increase in age was associated with a mean difference in change in PF of -0.11 (95%CI:-0.16,-0.06). PF decline was not significantly different in the lowest compared with the highest quartile of vitamin C (mean difference=-1.29, 95%CI:-2.61, 0.03) or carotenoids (mean difference=-0.62, 95%CI:-2.22,0.99). CONCLUSIONS Low intake of vitamin E was significantly associated with decline in PF with aging. These results are clinically meaningful, extend previous findings that oxidative stress contributes to PF decline, and may inform the development of future prevention strategies aimed at reducing this clinical and public health problem.
Collapse
Affiliation(s)
- B Bartali
- B. Bartali, Senior Research Scientist, ; Office Tel: +1 617972 3350
| | | | | | | |
Collapse
|
40
|
Helvik AS, Høgseth LD, Bergh S, Šaltytė-Benth J, Kirkevold Ø, Selbæk G. A 36-month follow-up of decline in activities of daily living in individuals receiving domiciliary care. BMC Geriatr 2015; 15:47. [PMID: 25888187 PMCID: PMC4406178 DOI: 10.1186/s12877-015-0047-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 03/31/2015] [Indexed: 12/01/2022] Open
Abstract
Background There have been few studies of how personal and instrumental activities of daily living (P-ADL and I-ADL) develop over time in older people receiving domiciliary care. This study aimed at assessing variables associated with the development of P-ADL and I-ADL functioning over a 36-month follow-up period, with a particular focus on cognitive functioning. Method In all, 1001 older people (≥70 years) receiving domiciliary care were included in a longitudinal study with three assessments of P-ADL and I-ADL functioning during 36 months. P-ADL and I-ADL were assessed using the Lawton and Brody’s Physical Self-Maintenance Scale and Instrumental Activities of Daily Living Scale, respectively. Mini Mental State Examination (MMSE), diagnosis of dementia and MCI, neuropsychiatric symptoms and use of psychotropic medication were also evaluated during the three assessments. Baseline demographic and general medical health information and information of being a nursing home resident at follow-up were recorded. Linear mixed models were estimated. Results There was a significant decline in P-ADL and I-ADL functioning throughout the follow-up. A lower MMSE sum-score, diagnosed MCI and dementia, a higher level of neuropsychiatric symptoms and the use of antipsychotics and antidepressants recorded at each assessment were associated with a decline in both P-ADL and I-ADL functioning. Furthermore, a decline in P-ADL and I-ADL functioning at follow-ups was associated with being male, a higher baseline age and in poorer medical health as well as residing in a nursing home at follow-up. Conclusion P-ADL and I-ADL functioning in older people worsened over time. The worsening was associated with lower MMSE sum-score, diagnosed MCI and dementia, poorer medical health, neuropsychiatric symptoms, use of psychotropic medication and being transferred to nursing home care. Clinicians should pay close attention to the assessment and treatment of these factors to help older people maintain their level of functioning for as long as possible.
Collapse
Affiliation(s)
- Anne-Sofie Helvik
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Postbox 8905, NO7491, Trondheim, Norway. .,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway. .,St Olavs University Hospital, Trondheim, Norway.
| | - Lisbeth D Høgseth
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway.
| | - Sverre Bergh
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway.
| | - Jūratė Šaltytė-Benth
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway. .,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway. .,HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway.
| | - Øyvind Kirkevold
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway. .,Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway. .,Faculty of Health, Care and Nursing, Gjøvik University College, Gjøvik, Norway.
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway. .,Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway. .,Akershus University Hospital, Lørenskog, Norway.
| |
Collapse
|
41
|
Stenroth L, Sillanpää E, McPhee JS, Narici MV, Gapeyeva H, Pääsuke M, Barnouin Y, Hogrel JY, Butler-Browne G, Bijlsma A, Meskers CGM, Maier AB, Finni T, Sipilä S. Plantarflexor Muscle–Tendon Properties are Associated With Mobility in Healthy Older Adults. J Gerontol A Biol Sci Med Sci 2015; 70:996-1002. [DOI: 10.1093/gerona/glv011] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 01/19/2015] [Indexed: 11/14/2022] Open
|