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Carl J, Blaschke S, Sudeck G, Schmid J, Eckert K, Geidl W, Jaunig J, Köppel M, Wiskemann J, Liphardt AM, Pfeifer K. A life span perspective on competencies for a healthy, physically active lifestyle: Findings of a data pooling initiative with over 7000 individuals. Eur J Sport Sci 2024; 24:788-803. [PMID: 38874933 DOI: 10.1002/ejsc.12100] [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: 10/17/2023] [Revised: 02/01/2024] [Accepted: 03/07/2024] [Indexed: 06/15/2024]
Abstract
Individuals are recommended to lead active lifestyles throughout the life course. The model of physical activity-related health competence (PAHCO) adopts a competence approach by integrating physical, cognitive, and motivational determinants for health-enhancing PA (movement competence, control competence, self-regulation competence). Drawing on a comprehensive dataset pooling, the goal of the present study was to model the idiosyncratic courses of 10 PAHCO indicators over the life span. We identified studies that empirically operationalized PAHCO, combining data of 7134 individuals (age range: 15-97 years; 61% female) from 18 different populations (prevention and rehabilitation sectors). We applied a stepwise multilevel analysis approach with disjunct sub-samples (n = 48) to examine linear and quadratic associations between age and PAHCO. Indicators of movement competence (i.e., manageability of endurance, strength, and balance demands; task-specific self-efficacy) congruently showed negative associations with age (0.054 ≤ R marg 2 ${R}_{\text{marg}}^{2}$ ≤ 0.211). However, parameters of control competence remained stable across the life span (-0.066 ≤ β ≤ 0.028). The three indicators of self-regulation competence revealed an inconsistent relationship with age, though uncovering positive associations for self-control (β = 0.106) and emotional attitude toward PA (β = 0.088). The associations of some indicators varied significantly across sub-samples. The results suggest differential analyses for associations between PAHCO and age. While the physically determined PAHCO indicators (movement competence) probably decline across the life span, the ability to ensure regularity of PA (self-regulation competence) or align PAs with an individual's health (control competence) appear to remain constant or improve with increasing age. The findings reinforce a de-stigmatizing approach for PA promotion practices with considerable space for aligning activities with health also in the elderly.
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Affiliation(s)
- Johannes Carl
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Simon Blaschke
- School of Medicine and Health, Technical University Munich, Munich, Germany
| | - Gorden Sudeck
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
| | - Julia Schmid
- Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Katharina Eckert
- Health Management & Public Health, IST-University of Applied Sciences, Düsseldorf, Germany
| | - Wolfgang Geidl
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Johannes Jaunig
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Maximilian Köppel
- Heidelberg University Hospital and NCT Heidelberg, a partnership between DKFZ and University Medical Center Heidelberg, Heidelberg, Germany
| | - Joachim Wiskemann
- Heidelberg University Hospital and NCT Heidelberg, a partnership between DKFZ and University Medical Center Heidelberg, Heidelberg, Germany
| | - Anna-Maria Liphardt
- Medizinische Klinik 3 - Rheumatologie & Immunologie, Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg & Universitätsklinikum Erlangen, Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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van Elburg FRT, van de Klundert J, Nieboer AP, Askari M. The intention to use mHealth applications among Dutch older adults prior and during the COVID pandemic. Front Public Health 2023; 11:1130570. [PMID: 37383259 PMCID: PMC10298165 DOI: 10.3389/fpubh.2023.1130570] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/05/2023] [Indexed: 06/30/2023] Open
Abstract
Background Mobile health (mHealth) applications are widely valued for their potential to increase self-management among older adults and reduce their healthcare demands. However, the intention to use mHealth of Dutch older adults before the COVID-19 pandemic was modest. Healthcare access was considerably reduced during the pandemic and mHealth services substituted for in person health services. As older adults utilize health services more frequently and have been particularly vulnerable to the pandemic, they can be viewed to have especially benefitted from the transition toward mHealth services. Furthermore, one might expect their intention to use these services and reap the potential benefits has increased, especially during the pandemic. Objective The aim of this study was to examine whether the intention of Dutch older adults to use medical applications increased during the COVID pandemic and how the explanatory power of the extended Technology Acceptance Model (TAM) developed for this purpose was affected by the onset of the pandemic. Methods We conducted a cross-sectional survey using two samples collected before (n = 315) and after (n = 501) the onset of the pandemic. Data was collected using questionnaires which were distributed digitally and on paper, by convenience sampling and snowballing. Participants were 65 years or older, lived independently or in a senior living facility, without cognitive impairment. A controlled analysis was performed to test for significant differences in the intention to use mHealth. The before and after differences in extended TAM variables and their relationship with intention to use (ITU) were analyzed using controlled (multivariate) logistic and linear regression models. These models were also used to explore whether the onset of the pandemic had an effect on ITU not captured by the extended TAM model. Results While the two samples differed in ITU (p = 0.017; uncontrolled) there was no statistically significant difference in ITU in the controlled logistic regression analysis (p = 0.107). The scores of the extended TAM variables explaining intention to use were all significantly higher, except for Subjective norm and Feelings of Anxiety. The relationships of these variables with intention to use before and after the onset of the pandemic were similar, except for Social relationships which lost its significance. We found no indications of effects of the pandemic on intention to use not captured by our instrument. Conclusion The intention to use mHealth applications of Dutch older adults has not changed since the onset of the pandemic. The extended TAM model has robustly explained intention to use, with only minor differences after the first months of the pandemic. Interventions targeting facilitation and support are likely to promote the uptake of mHealth. Follow-up studies are needed to investigate whether the pandemic has had long term effects on the ITU of the older adult.
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Affiliation(s)
| | | | - Anna Petra Nieboer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Marjan Askari
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
- Rotterdam School of Management, Erasmus University, Rotterdam, Netherlands
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Carlson SM, Giovanni ME, Neyman Morris M. The Relationship of Food Insecurity to Nutritional Risk in Independent Living Older Adults. J Nutr Gerontol Geriatr 2023:1-19. [PMID: 37211756 DOI: 10.1080/21551197.2023.2202157] [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: 05/23/2023]
Abstract
Understanding the factors that augment optimal health during aging is critical as the US older adult population is increasing. Most research about food insecurity, nutritional risk, and perceived health among older adults are in urban areas or congregate living facilities. Thus, the purpose of this project was to study the relationships among these factors, plus activities of daily living, in community-dwelling older adults in a medium-sized city. Using a qualitative-quantitative study design, a cross-sectional survey was completed by 167 low-income senior apartment residents. Food insecurity in this group was higher than the national and state rate, yet nutrition assistance programs were underutilized and participants under 75 years were more food insecure than their older counterparts. Food insecure residents were at greater nutritional risk, had poorer self-reported health status, were more likely to be depressed, and had a less independent function, including limitations on the ability to shop for and prepare food. The study area is desirable to retirees due to lower cost of living; however, access to services, such as grocery stores, public transportation, and health care providers is limited. This research indicates the need for increased outreach, nutrition assistance, and support services to ensure healthy aging in these regions.
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Affiliation(s)
- S M Carlson
- Montefiore Health System, Bronx, New York, USA
| | - M E Giovanni
- Department of Nutrition and Food Science, California State University, Chico, California, USA
| | - M Neyman Morris
- Department of Nutrition and Food Science, California State University, Chico, California, USA
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van Elburg FRT, Klaver NS, Nieboer AP, Askari M. Gender differences regarding intention to use mHealth applications in the Dutch elderly population: a cross-sectional study. BMC Geriatr 2022; 22:449. [PMID: 35610577 PMCID: PMC9128125 DOI: 10.1186/s12877-022-03130-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In light of the increasing demands in health care, a call has been made for the development of new strategies. One of these strategies is placing a higher emphasis on individuals, who are expected to better manage their own health and illness. mHealth applications could increase this self-management behaviour among older adults. However, it is crucial to know the intention to use mHealth of older adults before implementing these services. Even less is known regarding differences between genders on factors influencing this intention to use mHealth applications. OBJECTIVE The aim of this study was to study the gender differences regarding the relationship between technology acceptance factors and the intention to use mHealth applications in the Dutch elderly population. METHODS We conducted a quantitative cross-sectional study using questionnaires. The participants were 65 years or older, lived independently or in a senior living facility, without cognitive impairment. Logistic regression with interaction terms was done to determine gender differences in the relationship between the intention to use mHealth applications and technology acceptance factors. RESULTS While we found that half of the studied population had intention to use medical applications (50.3%) a notable difference was observed within gender groups which showed more men had intention to use medical applications rather than women (59.4% vs. 43.4% respectively). Adjusted logistic regression analysis per factor on the male and female part of the study population respectively showed that the factors Perceived usefulness (OR 21,69 and 2,39, resp.), Perceived ease of use (OR 7,21 and 2,74), Attitude toward use (OR 24,61 and 4,94), Sense of control (OR 4,12 and 2,67), Personal innovativeness (OR 2,54 and 1,58), Self-perceived effectiveness (OR 3,21 and 2,34), Service availability (OR 4,38 and 2,51) and Facilitating circumstances (OR 3,04 and 2,18) had a statistically significant influence on intention to use in both models. Logistic regression with interaction terms showed that two of the technology acceptance factors differed statistically significant in their relationship with intention to use when comparing females to males, namely Perceived usefulness (OR 0,11) and Attitude toward use (OR 0.24). Both factors were more strongly associated with intention to use for men compared to women. CONCLUSION Policymakers and interventions aiming to stimulate the uptake of mHealth applications should acknowledge gender differences. Interventions based on improving the Perceived usefulness and Attitude toward use among female users could be a means to stimulate the full potential of medical applications and improve the uptake.
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Affiliation(s)
| | - Nicky Sabine Klaver
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 3000 DR Rotterdam, P.O. Box 1738, Rotterdam, The Netherlands
| | - Anna Petra Nieboer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 3000 DR Rotterdam, P.O. Box 1738, Rotterdam, The Netherlands
| | - Marjan Askari
- Rotterdam School of Management, Erasmus University, Rotterdam, The Netherlands. .,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 3000 DR Rotterdam, P.O. Box 1738, Rotterdam, The Netherlands.
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Cândido LM, Niehues JR, Avelar NCPD, Danielewicz AL. Incapacidade, desempenho físico-funcional e ambiente de vizinhança: avaliação de idosos comunitários com base na Classificação Internacional de Funcionalidade, Incapacidade e Saúde. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/20030829012022pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO A Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) ainda é uma ferramenta distante e muitas vezes temida na área da saúde do idoso. Diante disso, o objetivo deste estudo foi descrever a incapacidade nas atividades da vida diária (AVDs), as limitações no desempenho físico-funcional e a percepção do ambiente de vizinhança em idosos comunitários do extremo sul de Santa Catarina, classificando-os segundo os domínios e qualificadores propostos pela CIF. Tratou-se de estudo transversal realizado com idosos de ambos os sexos. As variáveis analisadas foram categorizadas de acordo com os domínios da CIF: (1) funções e estruturas do corpo: testes de desempenho físico-funcional; (2) atividade e participação: instrumento de autoavaliação das AVDs; e (3) fatores ambientais: autopercepção do ambiente de vizinhança. Foram avaliados 308 idosos, sendo a maioria mulheres (57,8%) e com idade entre 60 e 69 anos (54,7%). Considerando os qualificadores da CIF, verificou-se maior dificuldade moderada/grave para o teste de sentar e levantar da cadeira de 5 repetições (TSLC5R) (66,2%) no domínio “função e estrutura do corpo”, enquanto para o domínio “atividade e participação” observou-se a prevalência de incapacidade moderada/grave para a tarefa de cortar as unhas dos pés (21,2%). No domínio “fatores ambientais”, verificou-se o predomínio de ausência de locais para a prática de atividade física no ambiente de vizinhança (72,5%).
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Cândido LM, Niehues JR, Avelar NCPD, Danielewicz AL. Disability, physical-functional performance, and neighborhood environment: evaluation of community-dwelling older adults based on the International Classification of Functioning, Disability, and Health. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/20030829012022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT The International Classification of Functioning, Disability, and Health (ICF) is still a distant and often feared tool in the area of older adults health. This study aimed to describe the inabilities to perform activities of daily living (ADLs), limitations in the physical-functional performance, and the perception of the surrounding environment in community-dwelling older adults from the extreme South of Santa Catarina, classifying them according to the domains and qualifiers proposed by the ICF. This is a cross-sectional study, with older adults of both sexes. The analyzed variables were classified and categorized according to the ICF: (1) Body Functions and Structures: physical-functional performance tests; (2) Activity and Participation: ADL self-assessment instrument; and (3) Environmental factors: self-perception of the surrounding environment. A total of 308 older adults were evaluated, most of them were women (57.8%) and aged 60-69 years (54.7%). There were higher prevalence of moderate/severe difficulty in the 5-times sit-to-stand test (5TSTS) (66.2%), of moderate/severe disability in the activity of cutting toenails (21.2%), and no reports of places for the practice of physical activity near the residence (72.5%). As for the ICF qualifiers, there was greater “moderate/severe difficulty” for the 5TSTS in the “Body Function and Structure” categories and in the task of cutting toenails in the “Activity and Participation” categories. In the category “Environmental factors,” there was a higher prevalence of lack of places for physical activity in the neighborhood.
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Liu H, Zhang X, Chen B, Fang B, Lou VWQ, Hu J. The Differential Impact of Multimorbidity Patterns and Subsequent Accumulation on Longitudinal Trajectories of Physical Function Decline in a Population-based Cohort of Older People. J Gerontol A Biol Sci Med Sci 2021; 77:1629-1636. [PMID: 34951651 DOI: 10.1093/gerona/glab384] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although both the patterns and accumulation of multimorbidity are important for predicting physical function, studies have not simultaneously examined their impact on functional decline. This study aimed to associate multimorbidity patterns and subsequently developed conditions with longitudinal trajectories of functional decline, and it tested whether the effects of newly developed conditions on functional decline varied across distinct multimorbidity patterns. METHODS We included 6,634 participants aged at least 60 years from the China Health and Retirement Longitudinal Survey. Latent class analysis identified multimorbidity patterns from 14 chronic conditions. Mixed negative binomial models estimated the changes in physical function measured across four waves as a function of multimorbidity patterns, subsequently developed conditions and their interactions. RESULTS Five distinct patterns were identified three years before wave 1: stomach/arthritis (15.7%), cardiometabolic (6.7%), arthritis/hypertension (47.9%), hepatorenal/multi-system (18.3%), and lung/asthma (11.4%). The hepatorenal/multi-system and the lung/asthma pattern were associated with worse baseline physical function, and the hypertension/arthritis pattern was associated with greater decline of physical function. The effect of developing new conditions on decline of physical function over time was most evident for individuals from the cardiometabolic pattern. DISCUSSION Considering both the combinations and progressive nature of multimorbidity is important for identifying individuals at greater risk of disability. Future studies are warranted to differentiate the factors responsible for the progression of chronic conditions in distinct multimorbidity patterns and investigate the potential implications for improved prediction of functional decline.
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Affiliation(s)
- Huiying Liu
- Department of Sociology, Central South University, Changsha, Hunan province, China.,Sau Po Centre on Ageing, University of Hong Kong, Hong Kong, China
| | - Xinyan Zhang
- Department of Sociology, Central South University, Changsha, Hunan province, China
| | - Beizhuo Chen
- Department of Sociology, Central South University, Changsha, Hunan province, China
| | - Boye Fang
- Sun Yat-Sen University, School of Sociology & Anthropology, Guangzhou, Guangdong province, CN
| | - Vivian W Q Lou
- Sau Po Centre on Ageing, University of Hong Kong, Hong Kong, China.,Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Jian Hu
- Department of Hematology, Xiangya Hospital, Central South University, Changsha, Hunan province, China
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Nikbakht Nasrabadi A, Mardanian Dehkordi L, Taleghani F. Nurses’ Experiences of Transitional Care in Multiple Chronic Conditions. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2021. [DOI: 10.1177/10848223211002166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Transitional care is a designed plan to ensure the continuity of care received by patients as they transfer between different locations or levels of care. The aim of this paper is to explore nurses’ experiences of transitional care in multiple chronic conditions. A qualitative method with a conventional content analysis approach was utilized. The study was conducted at university hospitals in 2 big cities (Isfahan and Tehran) of Iran. This study is performed from November 2018 to December 2019 using deep, semi-structured, and face-to-face interviews which are focused on nurses’ experiences of transitional care. Data collection continued until saturation was reached. Finally, 15 nurses take part in this study. Data collection and data analysis were conducted concurrently. Data were analyzed using Graneheim and Lundman’s techniques. Two main themes providing a descriptive summary of the major elements of transitional care identified: “threat to patient safety” and “Care breakdown”. Findings showed an exclusive image of unsafe transitional care which was done unplanned without appropriate delegating care to family and threat patient safety. There is still a gap in the transition from hospital to home. Nursing managers can address this issue by creating a culture of teamwork, training competent nurses by continuum education, and more supervision of nursing care. Policymakers can ensure continuity of care by developing policies and programs about transitional care.
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Affiliation(s)
| | - Leila Mardanian Dehkordi
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Taleghani
- Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Samy AL, Kamaruzzaman SB, Chinna K, Shunnmugam B, Krishnaswamy S, Low WY. Psychometric assessment of the Bahasa Malaysia version of the Older Americans Resources and Services-Instrumental Activities of Daily Living. Australas J Ageing 2021; 40:423-429. [PMID: 33942961 DOI: 10.1111/ajag.12958] [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: 10/06/2020] [Revised: 03/27/2021] [Accepted: 03/29/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aimed to determine the psychometric properties of the Bahasa Malaysia (BM) version of the Older Americans Resources and Services-Instrumental Activities of Daily Living (OARS-IADL) questionnaire among older persons in Malaysia. METHODS The English version of OARS-IADL was translated to BM. The psychometric properties of the BM version of OARS-IADL were tested among older persons attending a health-care facility. RESULTS Two hundred and seventy-one older persons participated in the study. The mean age of participants was 67.7 ± 6.1 years. Internal consistency of the items was good (Cronbach's alpha, >0.7). Exploratory factor analysis revealed a single dimension with item factor loadings of >0.5. Confirmatory factor analysis results confirmed a single-factor model (AVE > 50%, CR > 0.7 and CR > AVE). CONCLUSION The BM version of the OARS-IADL questionnaire is a valid and reliable instrument that can be used to assess the IADL among older persons in Malaysia.
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Affiliation(s)
- Alexander Lourdes Samy
- Division of Geriatrics, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Centre for ASEAN Regionalism University of Malaya, Kuala Lumpur, Malaysia.,Asia-Europe Institute, University of Malaya, Kuala Lumpur, Malaysia
| | - Shahrul Bahyah Kamaruzzaman
- Division of Geriatrics, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Bairave Shunnmugam
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Saroja Krishnaswamy
- Department of Psychiatry, University of Western Sydney, Sydney, NSW, Australia
| | - Wah-Yun Low
- Centre for ASEAN Regionalism University of Malaya, Kuala Lumpur, Malaysia.,Asia-Europe Institute, University of Malaya, Kuala Lumpur, Malaysia.,Dean's Office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Lange-Maia BS, Karvonen-Gutierrez CA, Kazlauskaite R, Strotmeyer ES, Karavolos K, Appelhans BM, Janssen I, Avery EF, Dugan SA, Kravitz HM. Impact of Chronic Medical Condition Development on Longitudinal Physical Function from Mid- to Early Late-Life: The Study of Women's Health Across the Nation. J Gerontol A Biol Sci Med Sci 2021; 75:1411-1417. [PMID: 31732730 DOI: 10.1093/gerona/glz243] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic medical conditions (CMCs) often emerge and accumulate during the transition from mid- to late-life, and the resulting multimorbidity can greatly impact physical function. We assessed the association of CMC presence and incidence on trajectories of physical function from mid- to early late-life in the Study of Women's Health Across the Nation. METHODS Physical function was assessed at eight clinic visits (average 14 years follow-up) using the physical function subscale of the Short Form-36. CMCs included osteoarthritis, diabetes, stroke, hypertension, heart disease, cancer, osteoporosis, and depressive symptomatology, and were considered cumulatively. Repeated-measures Poisson models estimated longitudinal change (expressed as percent difference) in physical function by chronic CMCs. Change-points assessed physical function change coincident with the development of a new condition. RESULTS Women (N = 2,283) followed from age 50.0 ± 2.7 to 64.0 ± 3.7 years; 7.3% had zero CMCs through follow-up, 22.5% (N = 513) had no baseline CMCs but developed ≥1, 22.7% women had ≥1 baseline CMC but never developed another, and 47.6% had ≥1 baseline CMC and developed ≥1 more. Each additional baseline CMC was associated with 4.0% worse baseline physical function and annual decline of 0.20%/year. Women with more baseline CMCs had greater decline in physical function with a new CMC (-1.90% per condition); and annual decline when developing a new condition accelerated by -0.33%/year per condition. CONCLUSIONS Self-reported physical function changes are evident from mid- to early late-life with the development of CMCs. Preventing or delaying CMCs may delay declines in physical function, and these potential pathways to disability warrant further research.
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Affiliation(s)
- Brittney S Lange-Maia
- Department of Preventive Medicine, Chicago, Illinois.,Center for Community Health Equity, Rush University Medical Center, Chicago, Illinois
| | | | - Rasa Kazlauskaite
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh
| | | | | | - Imke Janssen
- Department of Preventive Medicine, Chicago, Illinois
| | - Elizabeth F Avery
- Department of Preventive Medicine, Chicago, Illinois.,Center for Community Health Equity, Rush University Medical Center, Chicago, Illinois
| | - Sheila A Dugan
- Department of Physical Medicine and Rehabilitation, Chicago, Illinois
| | - Howard M Kravitz
- Department of Preventive Medicine, Chicago, Illinois.,Department of Psychiatry, Rush University Medical Center, Chicago, Illinois
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Askari M, Klaver NS, van Gestel TJ, van de Klundert J. Intention to use Medical Apps Among Older Adults in the Netherlands: Cross-Sectional Study. J Med Internet Res 2020; 22:e18080. [PMID: 32624465 PMCID: PMC7501579 DOI: 10.2196/18080] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 05/15/2020] [Accepted: 06/03/2020] [Indexed: 01/12/2023] Open
Abstract
Background The increasing health service demand driven by the aging of the global population calls for the development of modes of health service delivery that are less human resource–intensive. Electronic health (eHealth) and medical apps are expected to play an important role in this development. Although evidence shows mobile medical apps might be effective in improving the care, self-management, self-efficacy, health-related behavior, and medication adherence of older adults, little is known about older adults’ intention to use these technologies when needed, or the factors influencing this intention. Objective The objective of this study was to investigate the relationship of technology acceptance factors and intention to use mobile medical apps among community-dwelling older adults. Methods Data was collected using questionnaires. The factors selected from the literature have been validated using Cronbach α and tested for significance using logistic regressions. Results Almost half (49.7%) of the included older adults reported no intention to use medical apps. Adjusted logistic regression analysis per factor showed that the factors Attitude toward use (odds ratio [OR] 8.50), Perceived usefulness (OR 5.25), Perceived ease of use (OR 4.22), Service availability (OR 3.46), Sense of control (OR 3.40), Self-perceived effectiveness (OR 2.69), Facilities (OR 2.45), Personal innovativeness (OR 2.08), Social relationships (OR 1.79), Subjective norm (OR 1.48), and Feelings of anxiety (OR 0.62) significantly influenced the intention to use mobile medical apps among older adults, whereas the factor Finance (OR 0.98) did not. When considered together, a controlled multivariate logistic regression yielded high explained variances of 0.542 (Cox-Snell R2) and 0.728 (Nagelkerke R2). Conclusions The high odds ratios and explained variance indicate that the factors associated with the intention to use medical apps are largely understood and the most important factors have been identified. To advance the evidence base, experimental controlled research should investigate the causality between the factors, intention to use, and actual use. For this purpose, our evidence suggests that policies designed to improve Attitude toward use appear most effective, followed by policies addressing Perceived usefulness, Perceived ease of use, Service availability, and Sense of control.
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Affiliation(s)
- Marjan Askari
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands
| | - Nicky Sabine Klaver
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands
| | | | - Joris van de Klundert
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands.,Prince Mohammad Bin Salman College of Business & Entrepreneurship, King Abdullah Economic City, Saudi Arabia
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Collins K, Johnson N, Klawitter L, Waldera R, Stastny S, Kraemer WJ, Christensen B, McGrath R. Handgrip Strength Asymmetry and Weakness are Differentially Associated with Functional Limitations in Older Americans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093231. [PMID: 32384713 PMCID: PMC7246814 DOI: 10.3390/ijerph17093231] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 11/16/2022]
Abstract
Background: Handgrip strength (HGS) is a convent measure of strength capacity and associated with several age-related health conditions such as functional disability. Asymmetric strength between limbs has been linked to diminished function. Therefore, both HGS asymmetry and weakness could be associated with functional disability. We examined the associations of HGS asymmetry and weakness on functional limitations in a nationally representative sample of older Americans. Methods: Data were analyzed from 2689 adults ≥ 60 years who participated in the 2011–2012 and 2013–2014 waves of the National Health and Nutrition Examination Survey. Weakness was defined as HGS < 26 kg for men and < 16 kg for women. Asymmetry was determined from the ratio of the dominant and non-dominant HGS. Those with HGS ratio 0.9–1.1 were considered as having HGS symmetry, and those outside this range had asymmetry. Results: Compared to those with symmetric HGS and were not weak, those with weakness alone, and both weakness and HGS asymmetry had 2.47 (95% confidence interval [CI]: 1.14–5.35) and 3.93 (CI: 1.18–13.07) greater odds for functional limitations, respectively. However, HGS asymmetry alone was not associated with functional limitations (odds ratio: 0.80; CI: 0.62–1.03). Conclusion: The use of HGS asymmetry in protocols could improve the prognostic value of handgrip dynamometers.
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Affiliation(s)
- Kyle Collins
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58105, USA; (K.C.); (N.J.); (L.K.); (R.W.); (S.S.); (B.C.)
| | - Nathaniel Johnson
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58105, USA; (K.C.); (N.J.); (L.K.); (R.W.); (S.S.); (B.C.)
| | - Lukus Klawitter
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58105, USA; (K.C.); (N.J.); (L.K.); (R.W.); (S.S.); (B.C.)
| | - Roman Waldera
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58105, USA; (K.C.); (N.J.); (L.K.); (R.W.); (S.S.); (B.C.)
| | - Sherri Stastny
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58105, USA; (K.C.); (N.J.); (L.K.); (R.W.); (S.S.); (B.C.)
| | - William J. Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, OH 43210, USA;
| | - Bryan Christensen
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58105, USA; (K.C.); (N.J.); (L.K.); (R.W.); (S.S.); (B.C.)
| | - Ryan McGrath
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58105, USA; (K.C.); (N.J.); (L.K.); (R.W.); (S.S.); (B.C.)
- Correspondence:
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