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Portela D, Almada M, Midão L, Costa E. Instrumental Activities of Daily Living (iADL) Limitations in Europe: An Assessment of SHARE Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207387. [PMID: 33050460 PMCID: PMC7599802 DOI: 10.3390/ijerph17207387] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 12/16/2022]
Abstract
This study aims to evaluate the instrumental activities of daily living (iADLs) limitations in Europe and its association with socio-demographic characteristics, economic parameters and physical and mental health status. We used data from the wave 6 of SHARE database. Individuals were classified as having either none or one or more limitations on iADLs. Participants aged 65 or more years who answered all questions for the variables included in this work were selected. A total of 54.8% of participants were female and had a mean age of 74.37 (SD = 7.08) years. A global prevalence of 1 or more iADLs in Europe was shown to be 23.8% and more prevalent in women than in men (27.1% vs. 17.6%) and in people aged 85 years or more (51.5%). Older age, female gender, lower education, physical inactivity, frailty, having two or more chronic diseases, presence of depression, polypharmacy, poor self-perception of health and lower network satisfaction were found to be factors associated with the presence of 1 or more iADLs limitation. This study highlights the burden of iADLs limitations at the European level. These are based on a multidimensional biopsychosocial model and are associated with both health conditions and environmental factors. This intersection between the physical and social world underscores its potential as a health indicator and can, to some extent, explain some of the pronounced differences seen among European countries. Different inter-tasks can also stress different dimensions of health indicators in distinct and specific groups of individuals. Minimizing the impact of iADL limitations can improve the quality and sustainability of public health systems.
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Affiliation(s)
- Diana Portela
- Agrupamento de Centros de Saúde (ACES) Entre Douro e Vouga I—Feira Arouca, Faculdade de Medicina da Universidade do Porto, 4200-450 Porto, Portugal;
| | - Marta Almada
- Applied Molecular Biosciences Unit (UCIBIO) Requimte (Rede de Química e Tecnologia), Porto4Ageing, Faculdade de Farmácia da Universidade do Porto, 4050-047 Porto, Portugal; (M.A.); (L.M.)
| | - Luís Midão
- Applied Molecular Biosciences Unit (UCIBIO) Requimte (Rede de Química e Tecnologia), Porto4Ageing, Faculdade de Farmácia da Universidade do Porto, 4050-047 Porto, Portugal; (M.A.); (L.M.)
| | - Elísio Costa
- Applied Molecular Biosciences Unit (UCIBIO) Requimte (Rede de Química e Tecnologia), Porto4Ageing, Faculdade de Farmácia da Universidade do Porto, 4050-047 Porto, Portugal; (M.A.); (L.M.)
- Laboratory of Biochemistry, Department of Biological Sciences, University of Porto, 4050-313 Porto, Portugal
- Correspondence: ; Tel.: +35-12-2042-8500
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Martins T, Midão L, Martínez Veiga S, Dequech L, Busse G, Bertram M, McDonald A, Gilliland G, Orte C, Vives M, Costa E. Intergenerational Programs Review: Study Design and Characteristics of Intervention, Outcomes, and Effectiveness. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2018. [DOI: 10.1080/15350770.2018.1500333] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Teresa Martins
- UCIBIO, REQUIMTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), University of Porto, Porto, Portugal
| | - Luís Midão
- UCIBIO, REQUIMTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), University of Porto, Porto, Portugal
| | - Silvia Martínez Veiga
- UCIBIO, REQUIMTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), University of Porto, Porto, Portugal
| | - Lisa Dequech
- UCIBIO, REQUIMTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), University of Porto, Porto, Portugal
| | - Grazyna Busse
- Educational Centre for Intergenerational Integration HIPOKAMP, Lodz, Poland
| | - Mariola Bertram
- Educational Centre for Intergenerational Integration HIPOKAMP, Lodz, Poland
| | - Alix McDonald
- The Centre for Lifelong Learning, University of Strathclyde, Glasgow, UK
| | - Gemma Gilliland
- The Centre for Lifelong Learning, University of Strathclyde, Glasgow, UK
| | - Carmen Orte
- Department of Pedagogy and Didactics, University of Balearic Islands, Balearic Islands, Spain
| | - Marga Vives
- Department of Pedagogy and Didactics, University of Balearic Islands, Balearic Islands, Spain
| | - Elísio Costa
- UCIBIO, REQUIMTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), University of Porto, Porto, Portugal
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Karasu A, Šrámek A, Rosendaal FR, van der Geest RJ, van Hylckama Vlieg A. Aging of the venous valves as a new risk factor for venous thrombosis in the elderly: the BATAVIA study. J Thromb Haemost 2018; 16:96-103. [PMID: 29065242 DOI: 10.1111/jth.13880] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Indexed: 11/29/2022]
Abstract
Essentials Risk of venous thrombosis (VT) related to valve thickness and valvular reflux in unknown. Venous valves and reflux were measured by ultrasonography in cases and controls aged 70+. Risk of VT was associated with increased valve thickness and valvular reflux >1second. Thickening of valves is a generic process: there was no difference between right and left legs. SUMMARY Background Increasing age is the strongest risk factor for venous thrombosis (VT). Increasing age has been related to a thickening of the venous valves and a decreased valvular function. The association between valve thickness and the risk of VT is not known. Objectives To assess the association between increased valve thickness and valve closure time (VCT) and the risk of VT. Methods Analyses were performed in the BATAVIA study, including 70 cases aged 70 + with a first VT and 96 controls. We performed an ultrasound examination of the valves in the popliteal veins. The valves were imaged with a 9 MHz linear probe using B-mode ultrasonography. VCT was measured as an indicator for valve function using an automatic inflatable cuff. To estimate the risk of VT, valve thickness was dichotomized at the 90th percentile as measured in controls and VCT was dichotomized at 1 s. Results Mean valve thickness of controls was similar in the left (0.36 mm, 95% CI 0.34-0.37) and right (0.36 mm, 95% CI 0.35-0.38) leg. In 45 cases a valve was observed in the contralateral leg with a mean valve thickness of 0.39 mm (95% CI 0.36-0.42). Cases had an increased valve thickness compared with controls: mean difference 0.028 mm (95%CI 0.001-0.055). Valve thickness > 90th percentile increased the risk of VT 2.9-fold. Mean VCT in controls was 0.38 s, in contralateral leg of cases 0.58 s. VCT > 1 s increased the risk of VT 2.8-fold (95% CI 0.8-10.4). Conclusions Risk of VT was associated with increased valve thickness and valvular reflux of > 1 s.
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Affiliation(s)
- A Karasu
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - A Šrámek
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - F R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Thrombosis and Haemostasis Research Center, Leiden University Medical Center, Leiden, the Netherlands
| | - R J van der Geest
- Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands
| | - A van Hylckama Vlieg
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
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Shapo L, Pomerleau J, McKee M. Physical Inactivity in a country in transition: a population-based survey in Tirana City, Albania. Scand J Public Health 2016; 32:60-7. [PMID: 14757550 DOI: 10.1080/14034940310011801] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aims: This paper describes the work and leisure-time physical activity levels of adults living in Tirana City (Albania). Methods: A cross-sectional survey was undertaken in Tirana City in mid-2001. It included 1120 adults aged 25 years and over (response rate=72.7%). Results: Overall, 19.3% of male and 28.4% of female respondents reported a low level of physical activity at work. During leisure time, 49.5% of men and 57.6% of women (age-standardized prevalence [adjusted to the adult population of Tirana]: 43.4% and 51.9% for men and women respectively) said that they participated in only sedentary activities such as reading and watching television. The gender difference in the likelihood of low physical activity at work and during leisure time was significant even after adjusting for age (age adjusted odds ratios (OR)=1.86 99% confidence interval (CI) 1.12; 3.09 and OR=1.60 99% CI 1.17; 2.22 respectively). The likelihood of leisure-time sedentarity increased with age in both genders but it did not vary significantly with education level or income. Being sedentary during leisure time was also not significantly associated with other unhealthy lifestyle behaviours, including smoking, consumption of vegetables less than six days per week, and daily alcohol intake. Conclusions: In a country such as Albania that has undergone a rapid transition from a largely unmechanized society, characterized inevitably by high levels of exercise, the generalized high prevalence of low physical activity level during leisure time gives cause for concern regarding future health trends.
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Affiliation(s)
- Laidon Shapo
- London School of Hygiene and Tropical Medicine, London, UK
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Karasu A, Engbers MJ, Cushman M, Rosendaal FR, van Hylckama Vlieg A. Genetic risk factors for venous thrombosis in the elderly in a case-control study. J Thromb Haemost 2016; 14:1759-64. [PMID: 27377285 DOI: 10.1111/jth.13409] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Indexed: 12/01/2022]
Abstract
UNLABELLED Essentials Risk of venous thrombosis (VT) related to common genetic variants in those aged 70+ is unknown. We studied Factor V Leiden, prothrombin mutation, non-O blood group and family history (FH) of VT. Risk of VT was increased 2.2-, 1.4-, 1.3- and 2.1-fold respectively. FH is easy to obtain and can be implemented in clinical decision rules of VT risk in the elderly. Click to hear Prof. Reitsma discuss genetic risk factors of arterial and venous thrombosis SUMMARY Background As the incidence of venous thrombosis (VT) increases steeply with age and the number of elderly people is on the rise, studies of VT in this age group are important. Objectives We aimed to study the associations of common genetic risk factors (i.e. the factor V Leiden and prothrombin G20210A mutations, non-O blood group and family history of VT) with risk of a first VT in older age (> 70 years). Methods Four hundred and one consecutive cases with a first-time thrombosis and 431 controls (all ≥ 70 years) were included in the AT-AGE case-control study. Information on risk factors for VT, including family history of VT in first-degree relatives, was obtained by interview. Unprovoked VT was defined as thrombosis not related to surgery, fracture, plaster cast or immobility within 3 months prior to VT. Results The risk of VT was 2.2-fold increased in factor V Leiden carriers (95% confidence interval [CI], 1.2-3.9), 1.4-fold increased in prothrombin mutation carriers (95% CI, 0.5-3.9), and 1.3-fold increased in those with non-O blood group (95% CI, 1.0-1.8). Positive family history of VT was associated with a 2.1-fold increased risk of VT (95% CI, 1.5-3.1). The highest risk of VT was found in individuals who had both a positive family history and were carriers of one of the two prothrombotic mutations. Conclusions Genetic factors clearly related to VT in younger populations were also risk factors in older age and a positive family history was also important in this age group.
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Affiliation(s)
- A Karasu
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - M J Engbers
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - M Cushman
- Department of Medicine, Cardiovascular Research Institute, University of Vermont, Burlington, VT, USA
| | - F R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Thrombosis and Haemostasis Research Center, Leiden University Medical Center, Leiden, the Netherlands
| | - A van Hylckama Vlieg
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
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Ifeachor E, Henderson G, Goh C, Wimalaratna HS, Hudson N. Biopattern analysis and subject-specific diagnosis and care of dementia. CONFERENCE PROCEEDINGS : ... ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL CONFERENCE 2007; 2005:2490-3. [PMID: 17282743 DOI: 10.1109/iembs.2005.1616974] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Worldwide, the number of people that develop Alzheimer's disease and other types of dementia is rapidly rising and will create a considerable financial burden on the health and social services. The availability of new drugs that may slow or even halt the disease progression makes accurate early detection crucial. Objective methods are needed to support clinical diagnosis and care for patients; to quantify severity, monitor progression and response to new treatments. Electrophysiological markers have an important role to play in the objective assessment and care for dementia. The EEG provides a measure of brain dysfunction and EEG changes could be detected fairly early in the dementing process. Subject-specific EEG analysis offers the possibility of using objective methods to assess and care for dementia on an individual basis. The main objectives of this paper are: (i) to introduce the concepts of subject-specific EEG analysis as a basis for improving diagnosis and care for dementia; and (ii) present two novel methods for deriving suitable subject-specific electrophysiological markers analysis of fractal dimension and zero crossing interval density of the EEG. We present findings that indicate that the methods are potentially good candidates for the development of individualized, low-cost, easy to administer and reasonably accurate methods for detecting dementia within the growing at risk population.
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Westerbotn M, Hillerås P, Fastbom J, Agüero-Torres H. Factors influencing the handling of medicines among very old people living at home in an urban area. Aging Clin Exp Res 2006; 18:497-502. [PMID: 17255639 DOI: 10.1007/bf03324850] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS Elderly people in Sweden live longer in their own homes, some of them with good health, and others with chronic conditions that require medical treatment. Thus, the aim of this study was to investigate factors influencing elderly people's handling of their medicines. METHODS Cross-sectional population-based study. Participants were 333, aged 84+ years, living in their own homes. Information on regular drug use was obtained from interviews. Descriptive statistics were used to describe the population, and logistic regression models were used to investigate the factors associated with receiving help in handling medicines. The Mini-Mental State Examination (MMSE) measured cognitive status, and the basic Activities of Daily Living (ADL) assessed functional status. RESULTS Most participants were women living alone. 88% of this population took medicines on a regular basis and 23% of them received help with medicine handling. Using logistic regression models controlling for sociodemographic variables, cognitive and functional status, female (OR=2.8, 95% CI=1.2-6.5) was the only variable associated with regular use of medicines. Older age and functional disability in ADL increased the risk of receiving help with medicines, while higher cognitive status decreased the odds of receiving help. The only factor related to receiving help from a family member was living alone (OR=0.05; 95% CI=0.01-0.40). CONCLUSIONS This study indicates that cognitive and functional problems require increased help with handling medicines. These results stress the need for ongoing vigilance of, and support for, people with this high-risk profile.
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Henderson G, Ifeachor E, Hudson N, Goh C, Outram N, Wimalaratna S, Del Percio C, Vecchio F. Development and assessment of methods for detecting dementia using the human electroencephalogram. IEEE Trans Biomed Eng 2006; 53:1557-68. [PMID: 16916090 DOI: 10.1109/tbme.2006.878067] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This paper makes an outline case for the need for a low-cost, easy to administer method for detecting dementia within the growing at risk population. It proposes two methods for electroencephalogram (EEG) analysis for detecting dementia that could fulfil such a need. The paper describes a fractal dimension-based method for analyzing the EEG waveforms of subjects with dementia and reports on an assessment which demonstrates that an appropriate fractal dimension measure could achieve 67% sensitivity to probable Alzheimer's disease (as suggested by clinical psychometric testing and EEG findings) with a specificity of 99.9%. An alternative method based on the probability density function of the zero-crossing intervals is shown to achieve 78% sensitivity to probable Alzheimer's disease and an estimated sensitivity to probable Vascular (or mixed) dementia of 35% (as suggested by clinical psychometric testing and EEG findings) with a specificity of 99.9%. This compares well with other studies, reported by the American Academy of Neurology, which typically provide a sensitivity of 81% and specificity of 70%. The EEG recordings used to assess these methods included artefacts and had no a priori selection of elements "suitable for analysis." This approach gives a good prediction of the usefulness of the methods, as they would be used in practice. A total of 39 patients (30 probable Alzheimer's Disease, six Vascular Dementia and three mixed dementia) and 42 healthy volunteers were involved in the study. However, although results from the preliminary evaluation of the methods are promising, there is a need for a more extensive study to validate the methods using EEGs from a larger and more varied patient cohorts with neuroimaging results, to exclude other causes and cognitive scores to correlate results with severity of cognitive status.
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Affiliation(s)
- Geoffrey Henderson
- School of Computing, Communications and Electronics, University of Plymouth, UK
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Affiliation(s)
- Katherine M Shea
- Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina, USA
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Shapo L, Pomerleau J, McKee M, Coker R, Ylli A. Body weight patterns in a country in transition: a population-based survey in Tirana City, Albania. Public Health Nutr 2003; 6:471-7. [PMID: 12943563 DOI: 10.1079/phn2002451] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This paper reports the distribution and determinants of body mass index (BMI) and obesity in Tirana City (Albania). DESIGN Cross-sectional survey conducted in mid-2001. SETTING Tirana City. SUBJECTS One thousand one hundred and twenty adults aged 25 years and over (response rate 72.7%), selected using multi-stage cluster sampling. RESULTS Over three-quarters of male and female respondents had an excess body weight. The overall population prevalence of obesity in Tirana was estimated to be 22.0% in men and 30.9% in women. Obesity affected both genders (age-standardised prevalence in males 22.0%, females 30.9%; age-adjusted odds ratio (OR) 1.89; 99% confidence interval (CI) 1.33-2.67) and all age groups, but most particularly middle-aged women. The age-standardised overall prevalence of central obesity was 21.6% in men and 29.4% in women (age-adjusted OR 1.58; 99% CI 1.11-2.25), increasing with age (P<0.01). In women, the likelihood of being obese was inversely related to educational achievement (trend P=0.001) and alcohol consumption (trend P=0.009). Income, smoking and leisure-time physical activity were not associated with obesity. CONCLUSIONS Excess weight and obesity are major public health problems in the adult population of Tirana, but most particularly in middle-aged women. The high obesity prevalence observed along with the recent decrease in physical activity, dietary changes and increase in smoking prevalence make it probable that there will be substantial increases in many non-communicable diseases in Albania in the coming decades. Health promotion strategies are needed that prevent excess weight gain in the Albanian population.
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Affiliation(s)
- Laidon Shapo
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, UK.
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International Influences on Public Health. PUBLIC HEALTH IN PRACTICE 2003. [DOI: 10.1007/978-0-230-21421-7_3] [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] Open
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