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Pai M, Muhammad T. Separate and combined associations of cognitive impairment and body pain with functional and mobility disabilities among older women and men in India. Geriatr Nurs 2024; 59:463-470. [PMID: 39146637 DOI: 10.1016/j.gerinurse.2024.08.003] [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: 03/31/2024] [Revised: 07/16/2024] [Accepted: 08/05/2024] [Indexed: 08/17/2024]
Abstract
This study examined the separate and combined associations of cognitive impairment and body pain with functional and mobility disabilities (FMDs) among older women and men in India. Multivariable linear regression models were applied using data from the Longitudinal Aging Study in India (2017-18) comprising 31,464 adults aged 60+. Older adults with cognitive impairment and pain reported higher levels of FMDs than peers without any pain and cognitive impairment. The likelihood of FMDs was significantly greater among older Indians enduring both cognitive impairment and pain (p < 0.05). Moreover, the association between cognitive impairment and functional disability was noticeably stronger in older women, particularly those with frequent pain, while the link between cognitive impairment and mobility disability was more pronounced in men with pain. Integrated cognitive rehabilitation and pain management programs, along with guided physical therapy, gender-specific support groups, and community-based health promotion activities, should be considered to reduce FMDs in older Indians.
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Affiliation(s)
- Manacy Pai
- Department of Sociology and Criminology, Kent State University, Kent, OH 44242, USA.
| | - T Muhammad
- Center for Healthy Aging, Pennsylvania State University, University Park, PA 16802, USA.
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Piacenza F, Di Rosa M, Fedecostante M, Madotto F, Montesanto A, Corsonello A, Cherubini A, Provinciali M, Soraci L, Lisa R, Bustacchini S, Bonfigli AR, Lattanzio F. Improving the prognostic value of multimorbidity through the integration of selected biomarkers to the comprehensive geriatric assessment: An observational retrospective monocentric study. Front Med (Lausanne) 2022; 9:999767. [PMID: 36388885 PMCID: PMC9659967 DOI: 10.3389/fmed.2022.999767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/04/2022] [Indexed: 11/22/2022] Open
Abstract
Background Multimorbidity (MM) burdens individuals and healthcare systems, since it increases polypharmacy, dependency, hospital admissions, healthcare costs, and mortality. Several attempts have been made to determine an operational definition of MM and to quantify its severity. However, the lack of knowledge regarding its pathophysiology prevented the estimation of its severity in terms of outcomes. Polypharmacy and functional impairment are associated with MM. However, it is unclear how inappropriate drug decision-making could affect both conditions. In this context, promising circulating biomarkers and DNA methylation tools have been proposed as potential mortality predictors for multiple age-related diseases. We hypothesize that a comprehensive characterization of patients with MM that includes the measure of epigenetic and selected circulating biomarkers in the medical history, in addition to the functional capacity, could improve the prognosis of their long-term mortality. Methods This monocentric retrospective observational study was conducted as part of a project funded by the Italian Ministry of Health titled “imProving the pROgnostic value of MultimOrbidity through the inTegration of selected biomarkErs to the comprehensive geRiatric Assessment (PROMOTERA).” This study will examine the methylation levels of thousands of CpG sites and the levels of selected circulating biomarkers in the blood and plasma samples of older hospitalized patients with MM (n = 1,070, age ≥ 65 years) recruited by the Reportage Project between 2011 and 2019. Multiple statistical approaches will be utilized to integrate newly measured biomarkers into clinical, demographic, and functional data, thus improving the prediction of mortality for up to 10 years. Discussion This study's results are expected to: (i) identify the clinical, biological, demographic, and functional factors associated with distinct patterns of MM; (ii) improve the prognostic accuracy of MM patterns in relation to death, hospitalization-related outcomes, and onset of new comorbidities; (iii) define the epigenetic signatures of MM; (iv) construct multidimensional algorithms to predict negative health outcomes in both the overall population and specific disease and functional patterns; and (v) expand our understanding of the mechanisms underlying the pathophysiology of MM.
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Affiliation(s)
- Francesco Piacenza
- Unit of Advanced Technology of Aging Research, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale di Ricovero e Cura per Anziani (INRCA), Ancona, Italy
| | - Mirko Di Rosa
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale di Ricovero e Cura per Anziani (INRCA), Cosenza, Italy
| | - Massimiliano Fedecostante
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale di Ricovero e Cura per Anziani (INRCA), Ancona, Italy
- *Correspondence: Massimiliano Fedecostante
| | - Fabiana Madotto
- Value-Based Healthcare Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, Italy
| | - Alberto Montesanto
- Department of Biology, Ecology and Earth Sciences, University of Calabria, Cosenza, Italy
| | - Andrea Corsonello
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale di Ricovero e Cura per Anziani (INRCA), Cosenza, Italy
| | - Antonio Cherubini
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale di Ricovero e Cura per Anziani (INRCA), Ancona, Italy
| | - Mauro Provinciali
- Unit of Advanced Technology of Aging Research, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale di Ricovero e Cura per Anziani (INRCA), Ancona, Italy
| | - Luca Soraci
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale di Ricovero e Cura per Anziani (INRCA), Cosenza, Italy
| | - Rosamaria Lisa
- Scientific Direction, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale di Ricovero e Cura per Anziani (INRCA), Ancona, Italy
| | - Silvia Bustacchini
- Scientific Direction, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale di Ricovero e Cura per Anziani (INRCA), Ancona, Italy
| | - Anna Rita Bonfigli
- Scientific Direction, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale di Ricovero e Cura per Anziani (INRCA), Ancona, Italy
| | - Fabrizia Lattanzio
- Scientific Direction, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale di Ricovero e Cura per Anziani (INRCA), Ancona, Italy
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