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Syddall HE, Ntani G, Bevilacqua G, Zaballa E, D'Angelo S, Walker-Bone K. Slow walking speed and health-related exit from employment among older workers over 5 years of follow-up: evidence from the Health and Employment After Fifty (HEAF) cohort study. BMJ Open 2024; 14:e081509. [PMID: 39032930 PMCID: PMC11288146 DOI: 10.1136/bmjopen-2023-081509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 06/30/2024] [Indexed: 07/23/2024] Open
Abstract
INTRODUCTION With demographic changes, there is increasing demand for individuals and governments to lengthen working lives. Jobs that are very physically demanding are likely to be more difficult to sustain at older ages. If workers at risk of mismatch of demand and capability could be identified early, there would be opportunities for intervention for health or lifestyle and/or re-training or redeployment. OBJECTIVE To investigate whether self-reported walking speed (a good measure of function in elderly people) predicted health-related job loss (HRJL) longitudinally over 5 years of follow-up among middle-aged workers. DESIGN Data came from the Health and Employment After Fifty (HEAF) prospective cohort study of middle-aged people (aged 50-64 years) in UK. SETTING General population survey (sampling frame was 24 General Practice registers). PARTICIPANTS The cohort included 8134 people recruited in 2013-2014. For the current analyses, 5217 people who ever worked and completed at least one follow-up questionnaire were eligible. PRIMARY OUTCOME Exit from employment mainly or partly for health reasons (HRJL). RESULTS At baseline, very slow walking speed was associated with: obesity, physical inactivity, smoking (men), financial hardship, lower educational attainment and not being in professional occupations. In total, 527 people (10%) reported at least one HRJL during follow-up. After adjustment, the HR for HRJL among men with very slow walking-speed was 4.32, 95% CI 2.72 to 6.87 and among women was 4.47, 95% CI 3.04 to 6.57. After further adjustment for 'difficulty coping with physical demands at work', hazards remained doubled in men and women. CONCLUSIONS Self-reported walking speed could help identify older workers who are at increased risk of HRJL. This could provide opportunities for intervention through optimising health and lifestyle, restricting physical workload, retraining or redeployment. Early appropriate intervention could enable longer working lives and promote healthier, more equal ageing.
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Affiliation(s)
- Holly E Syddall
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - G Ntani
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton Faculty of Medicine, Southampton, UK
| | - Gregorio Bevilacqua
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton Faculty of Medicine, Southampton, UK
| | - Elena Zaballa
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton Faculty of Medicine, Southampton, UK
| | - Stefania D'Angelo
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton Faculty of Medicine, Southampton, UK
| | - Karen Walker-Bone
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton Faculty of Medicine, Southampton, UK
- Monash Centre for Occupational and Environmental Health, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
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Morera Á, Calatayud J, Casaña J, Núñez-Cortés R, Andersen LL, López-Bueno R. Handgrip strength and work limitations: A prospective cohort study of 70,820 adults aged 50 and older. Maturitas 2023; 177:107798. [PMID: 37481913 DOI: 10.1016/j.maturitas.2023.107798] [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: 03/28/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
The purpose of the study was to investigate the association between handgrip strength and the incidence of work limitations in European adults aged 50 and older. We conducted a prospective cohort study among adults aged 50 and older from 27 European countries and Israel. Data were collected from the Survey of Health, Ageing and Retirement in Europe (SHARE) waves 1, 2, 4, 5, 6, and 7. Handgrip strength was measured using a hand dynamometer (Smedley, S Dynamometer, TTM) and participants replied to questions about work limitations. Cox regression was conducted for statistical analyses. A total of 70,820 older adults (mean age 61 ± 7.7 years; 54.3 % women) were followed during a mean of 3.8 ± 2.9 years. The fully adjusted model showed that participants with low handgrip strength (<16 kg in women and <27 kg in men) had a significantly higher risk of work limitations compared with participants with normal values of handgrip strength (hazard ratio: 1.36; 95 % confidence interval: 1.28-1.44). Kaplan-Meier trajectories revealed that the survival probability to experience work limitations in the normal handgrip category was 20 % lower than in the low handgrip category in most of the follow-up period. We identified low level of handgrip strength as a risk factor for work limitations in adults aged 50 years or older. This could be used as an accessible measure to screen workers at risk of developing work limitations.
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Affiliation(s)
- Álvaro Morera
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Rubén López-Bueno
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
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Kim MJ, Lee S, Cheong HK, Jang SY, Kim HS, Oh IH. Healthcare Utilization and Costs According to Frailty Transitions After Two Years: A Korean Frailty and Aging Cohort Study. J Korean Med Sci 2023; 38:e191. [PMID: 37337810 DOI: 10.3346/jkms.2023.38.e191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/03/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Korea's aging population has raised several challenges, especially concerning healthcare costs. Consequently, this study evaluated the association of frailty transitions with healthcare utilization and costs for older adults aged 70 to 84. METHODS This study linked the frailty status data of the Korean Frailty and Aging Cohort Study to the National Health Insurance Database. We included 2,291 participants who had frailty measured by Fried Frailty phenotype at baseline in 2016-2017 and follow-up in 2018-2019. We conducted a multivariate regression analysis to determine the association between their healthcare utilization and costs by frailty transition groups. RESULTS After 2 years, changes from "pre-frail" to "frail" (Group 6) and "frail" to "pre-frail" (Group 8) were significantly associated with increased inpatient days (P < 0.001), inpatient frequency (P < 0.001), inpatient cost (P < 0.001 and P < 0.01, respectively), and total healthcare cost (P < 0.001) than "robust" to "robust" (Group 1) older adults. A transition to frailty from "pre-frail" to "frail" (Group 6) resulted in a $2,339 total healthcare cost increase, and from "frail" to "pre-frail" (Group 8), a $1,605, compared to "robust" to "robust" older adults. CONCLUSION Frailty among community-dwelling older adults is economically relevant. Therefore, it is crucial to study the burden of medical expenses and countermeasures for older adults to not only provide appropriate medical services but also to prevent the decline in their living standards due to medical expenses.
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Affiliation(s)
- Moon Jung Kim
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Seoyoon Lee
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul, Korea
| | - Hyeon-Kyoung Cheong
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Su Yeon Jang
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Hee-Sun Kim
- Department of Health Policy Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea.
| | - In-Hwan Oh
- Department of Medicine (AgeTech-Service Convergence Major), Kyung Hee University, Seoul, Korea.
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van Atteveld JE, de Winter DTC, Pluimakers VG, Fiocco M, Nievelstein RAJ, Hobbelink MGG, Kremer LCM, Grootenhuis MA, Maurice-Stam H, Tissing WJE, de Vries ACH, Loonen JJ, van Dulmen-den Broeder E, van der Pal HJH, Pluijm SMF, van der Heiden-van der Loo M, Versluijs AB, Louwerens M, Bresters D, van Santen HM, Hoefer I, van den Berg SAA, den Hartogh J, Hoeijmakers JHJ, Neggers SJCMM, van den Heuvel-Eibrink MM. Frailty and sarcopenia within the earliest national Dutch childhood cancer survivor cohort (DCCSS-LATER): a cross-sectional study. THE LANCET HEALTHY LONGEVITY 2023; 4:e155-e165. [PMID: 37003274 DOI: 10.1016/s2666-7568(23)00020-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/20/2023] [Accepted: 02/06/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Childhood cancer survivors appear to be at increased risk of frailty and sarcopenia, but evidence on the occurrence of and high-risk groups for these aging phenotypes is scarce, especially in European survivors. The aim of this cross-sectional study was to assess the prevalence of and explore risk factors for pre-frailty, frailty, and sarcopenia in a national cohort of Dutch childhood cancer survivors diagnosed between 1963 and 2001. METHODS Eligible individuals (alive at the time of study, living in the Netherlands, age 18-45 years, and had not previously declined to participate in a late-effects study) from the Dutch Childhood Cancer Survivor Study (DCCSS-LATER) cohort were invited to take part in this cross-sectional study. We defined pre-frailty and frailty according to modified Fried criteria, and sarcopenia according to the European Working Group on Sarcopenia in Older People 2 definition. Associations between these conditions and demographic and treatment-related as well as endocrine and lifestyle-related factors were estimated with two separate multivariable logistic regression models in survivors with any frailty measurement or complete sarcopenia measurements. FINDINGS 3996 adult survivors of the DCCSS-LATER cohort were invited to participate in this cross-sectional study. 1993 non-participants were excluded due to lack of response or a decline to participate and 2003 (50·1%) childhood cancer survivors aged 18-45 years were included. 1114 (55·6%) participants had complete frailty measurements and 1472 (73·5%) participants had complete sarcopenia measurements. Mean age at participation was 33·1 years (SD 7·2). 1037 (51·8%) participants were male, 966 (48·2%) were female, and none were transgender. In survivors with complete frailty measurements or complete sarcopenia measurements, the percentage of pre-frailty was 20·3% (95% CI 18·0-22·7), frailty was 7·4% (6·0-9·0), and sarcopenia was 4·4% (3·5-5·6). In the models for pre-frailty, underweight (odds ratio [OR] 3·38 [95% CI 1·92-5·95]) and obesity (OR 1·67 [1·14-2·43]), cranial irradiation (OR 2·07 [1·47-2·93]), total body irradiation (OR 3·17 [1·77-5·70]), cisplatin dose of at least 600 mg/m2 (OR 3·75 [1·82-7·74]), growth hormone deficiency (OR 2·25 [1·23-4·09]), hyperthyroidism (OR 3·72 [1·63-8·47]), bone mineral density (Z score ≤-1 and >-2, OR 1·80 [95% CI 1·31-2·47]; Z score ≤-2, OR 3·37 [2·20-5·15]), and folic acid deficiency (OR 1·87 [1·31-2·68]) were considered significant. For frailty, associated factors included age at diagnosis between 10-18 years (OR 1·94 [95% CI 1·19-3·16]), underweight (OR 3·09 [1·42-6·69]), cranial irradiation (OR 2·65 [1·59-4·34]), total body irradiation (OR 3·28 [1·48-7·28]), cisplatin dose of at least 600 mg/m2 (OR 3·93 [1·45-10·67]), higher carboplatin doses (per g/m2; OR 1·15 [1·02-1·31]), cyclophosphamide equivalent dose of at least 20 g/m2 (OR 3·90 [1·65-9·24]), hyperthyroidism (OR 2·87 [1·06-7·76]), bone mineral density Z score ≤-2 (OR 2·85 [1·54-5·29]), and folic acid deficiency (OR 2·04 [1·20-3·46]). Male sex (OR 4·56 [95%CI 2·26-9·17]), lower BMI (continuous, OR 0·52 [0·45-0·60]), cranial irradiation (OR 3·87 [1·80-8·31]), total body irradiation (OR 4·52 [1·67-12·20]), hypogonadism (OR 3·96 [1·40-11·18]), growth hormone deficiency (OR 4·66 [1·44-15·15]), and vitamin B12 deficiency (OR 6·26 [2·17-1·81]) were significantly associated with sarcopenia. INTERPRETATION Our findings show that frailty and sarcopenia occur already at a mean age of 33 years in childhood cancer survivors. Early recognition and interventions for endocrine disorders and dietary deficiencies could be important in minimising the risk of pre-frailty, frailty, and sarcopenia in this population. FUNDING Children Cancer-free Foundation, KiKaRoW, Dutch Cancer Society, ODAS Foundation.
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Affiliation(s)
| | | | | | - Marta Fiocco
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Medical Statistics Section, Department of Biomedical Data Science, Leiden University Medical Center, Leiden, Netherlands; Mathematical Institute, Leiden University, Leiden, Netherlands
| | - Rutger A J Nievelstein
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, Netherlands
| | - Monique G G Hobbelink
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, Netherlands
| | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands; Emma Children's Hospital, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | | | | | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Oncology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Andrica C H de Vries
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Oncology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
| | - Jacqueline J Loonen
- Department of Hematology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Eline van Dulmen-den Broeder
- Department of Pediatric Oncology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | | | | | | | | | - Marloes Louwerens
- Department of Internal Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Dorine Bresters
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatrics, Willem Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands
| | - Hanneke M van Santen
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Endocrinology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Imo Hoefer
- Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht, Netherlands
| | - Sjoerd A A van den Berg
- Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, Netherlands; Department of Internal Medicine, Section Endocrinology, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - Jan H J Hoeijmakers
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Oncode Institute and Department of Molecular Genetics, Erasmus Medical Center, Rotterdam, Netherlands
| | - Sebastian J C M M Neggers
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Internal Medicine, Section Endocrinology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Marry M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
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Cohen AB, McAvay GJ, Geda M, Chattopadhyay S, Lee S, Acampora D, Araujo K, Charpentier P, Gill TM, Hajduk AM, Ferrante LE. Rationale, Design, and Characteristics of the VALIANT (COVID-19 in Older Adults: A Longitudinal Assessment) Cohort. J Am Geriatr Soc 2023; 71:832-844. [PMID: 36544250 PMCID: PMC9877652 DOI: 10.1111/jgs.18146] [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: 06/25/2022] [Revised: 10/08/2022] [Accepted: 10/29/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Most older adults hospitalized with COVID-19 survive their acute illness. The impact of COVID-19 hospitalization on patient-centered outcomes, including physical function, cognition, and symptoms, is not well understood. To address this knowledge gap, we collected longitudinal data about these issues from a cohort of older survivors of COVID-19 hospitalization. METHODS We undertook a prospective study of community-living persons age ≥ 60 years who were hospitalized with COVID-19 from June 2020-June 2021. A baseline interview was conducted during or up to 2 weeks after hospitalization. Follow-up interviews occurred at one, three, and six months post-discharge. Participants completed comprehensive assessments of physical and cognitive function, symptoms, and psychosocial factors. An abbreviated assessment could be performed with a proxy. Additional information was collected from the electronic health record. RESULTS Among 341 participants, the mean age was 71.4 (SD 8.4) years, 51% were women, and 37% were of Black race or Hispanic ethnicity. Median length of hospitalization was 8 (IQR 6-12) days. All but 4% of participants required supplemental oxygen, and 20% required care in an intensive care unit or stepdown unit. At enrollment, nearly half (47%) reported at least one preexisting disability in physical function, 45% demonstrated cognitive impairment, and 67% were pre-frail or frail. Participants reported a mean of 9 of 14 (SD 3) COVID-19-related symptoms. At the six-month follow-up interview, more than a third of participants experienced a decline from their pre-hospitalization function, nearly 20% had cognitive impairment, and burdensome symptoms remained highly prevalent. CONCLUSIONS We enrolled a diverse cohort of older adults hospitalized with COVID-19 and followed them after discharge. Functional decline was common, and there were high rates of persistent cognitive impairment and symptoms. Future analyses of these data will advance our understanding of patient-centered outcomes among older COVID-19 survivors.
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Affiliation(s)
- Andrew B. Cohen
- Department of MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Gail J. McAvay
- Department of MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Mary Geda
- Department of MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Sumon Chattopadhyay
- Clinical and Translational Science InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Seohyuk Lee
- Department of MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Denise Acampora
- Department of MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Katy Araujo
- Department of MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Peter Charpentier
- Department of MedicineYale School of MedicineNew HavenConnecticutUSA
- CRI Web ToolsDurhamConnecticutUSA
| | - Thomas M. Gill
- Department of MedicineYale School of MedicineNew HavenConnecticutUSA
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Molfenter SM. The relationship between sarcopenia, dysphagia, malnutrition, and frailty: making the case for proactive swallowing exercises to promote healthy aging. Curr Opin Otolaryngol Head Neck Surg 2022; 30:400-405. [PMID: 36004774 DOI: 10.1097/moo.0000000000000835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize current evidence regarding the relationship between sarcopenia of the swallowing muscles, dysphagia, malnutrition, and frailty in the context of aging. Further, this review will provide preliminary support for proactive swallowing exercises to reverse and/or prevent sarcopenia of the swallowing muscles. RECENT FINDINGS Recent studies lend support to a cyclic relationship between sarcopenia of the swallowing muscles, dysphagia, malnutrition, and frailty. Unfortunately, all studies are limited by their study design and lack instrumental imaging of swallowing function. Research (in the limbs) supports the use of proactive exercises and protein supplementation to reverse sarcopenia, especially in prefrail individuals. This provides a foundation to design and test similar preventive exercises for the swallowing muscles. SUMMARY As the population is rapidly aging, it is vital to understand how the natural loss of muscle in aging impacts swallowing function and the downstream impact on nutritional and physical function. Prospective, longitudinal research with sophisticated outcome measures are required to fully understand this cycle and provide an opportunity to test methods for interrupting the cycle.
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Affiliation(s)
- Sonja M Molfenter
- Communicative Sciences and Disorders, NYU Steinhardt, Rusk Rehabilitation, NYU Langone Health, New York, USA
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Lipponen H, Hirvensalo M, Salin K. Older Physical Education Teachers' Wellbeing at Work and Its Challenges. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14250. [PMID: 36361128 PMCID: PMC9658279 DOI: 10.3390/ijerph192114250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/24/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
This article examines older physical education (PE) teachers' wellbeing over the course of their career in Finland. The study highlights challenges to physical and mental functioning as well as how teachers respond to these challenges. The six interviewees were over 55-year-old PE teachers, whose career had lasted for more than 30 years. Qualitative methods were used in the collection, transcription and analysis of the research data. The qualitative analysis consisted of a series of interpretations that visualised the world described by the interviewees. All the research participants had physical problems that affected their teaching and make teachers consider a potential career change. To be able to teach, teachers adapted their ways of working according to the challenges brought by age and injuries. The research participants found that the challenges caused by musculoskeletal problems and ageing were an inevitable part of the profession. They emphasised the positive sides of the work: the profession permits varied workdays. In addition, the teachers noted that their work provides them with opportunities to remain physically fit. Teaching health education is a means to lighten the workload of older teachers. PE teachers enjoy their profession and are dedicated to it, despite all the challenges. The interviewed participants clearly experienced work engagement. Our development proposal for teacher education is that future PE teachers be informed about the risks involved in the profession. Such activity helps young teachers reflect proactively on the measures taken to maintain their functioning during their career and on perspectives related to the ways of working.
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Norheim KL, Bøggild H, Andersen JH, Omland Ø, Bønløkke JH, Madeleine P. Retirement status and frailty: a cross-sectional study of the phenotype of manual workers aged 50-70 years. Eur J Public Health 2021; 31:116-121. [PMID: 33164046 DOI: 10.1093/eurpub/ckaa188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The frailty phenotype is predictive of mortality and has been identified in the working population. This cross-sectional study aimed to investigate the prevalence of frailty and individual frailty symptoms among active and retired Danish manual workers and to delineate the relationship between frailty and lifestyle factors. METHODS Manual workers aged 50-70 years answered questions relating to the Fried criteria for frailty (weight loss, exhaustion, slowness, weakness and inactivity). Only men were included in the analyses and respondents were stratified according to work status: active workers (n = 1555), early retirees (n = 289) and workers retired at or after normal pension age (n = 291). Associations between pre-frailty/frailty, work status and various lifestyle factors were estimated using binomial logistic regression. RESULTS Overall, the prevalence of pre-frailty (one or two symptoms) and frailty (three or more symptoms) was 33.3% and 1.5%, respectively. Those who had retired early were more likely to be pre-frail/frail compared with active workers (odds ratio 2.20, 95% CI 1.61-3.01). Exhaustion was the most prominent symptom reported by 22.2% of active workers, 34.6% of early retirees and 16.5% of workers retired at normal retirement age. Lifestyle factors including obesity, physical inactivity and smoking but not alcohol intake were associated with pre-frailty/frailty. CONCLUSION Symptoms of frailty are identifiable and present among both active and retired manual workers. Data suggest discrepancies among Danish manual workers, with some having unhealthy lifestyles and being more prone to develop pre-frailty and frailty already in their sixth decade of life.
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Affiliation(s)
- Kristoffer L Norheim
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.,Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Henrik Bøggild
- Public Health and Epidemiology Group, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Herning, Denmark
| | - Øyvind Omland
- Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Jakob H Bønløkke
- Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Pascal Madeleine
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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Viviani CA, Bravo G, Lavallière M, Arezes PM, Martínez M, Dianat I, Bragança S, Castellucci HI. Productivity in older versus younger workers: A systematic literature review. Work 2021; 68:577-618. [PMID: 33612506 DOI: 10.3233/wor-203396] [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] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Worldwide ageing and thus, workforce ageing, is a concern for both developed and developing nations. OBJECTIVE The aim of the current research was to determine, through a systematic literature review, the effects of age in three dimensions that are often used to define or assess productivity at work. METHODS PICO framework was used to generate search strategies, inclusion criteria and terms. Scopus and PubMed databases were used. Peer-reviewed journal papers written in English and published (or in press) between January 2014 and December 2018 were included. RESULTS After filtering through inclusion criteria, 74 papers were included in the review. Considering productivity, 41%of the findings showed no differences between younger and older workers, 31%report better productivity of younger workers and 28%reported that older workers had better productivity than younger workers. Performance was better in older workers (58%), presenteeism generally showed no significant differences between age groups (61%). Absenteeism was the only outcome where younger workers outperformed older workers (43%). CONCLUSION Overall, there was no difference in productivity between older and younger workers. Older workers performed better than younger workers, but had more absenteeism, while presenteeism showed no differences. As ageing has come to workplaces, holistic approaches addressing total health are suggested to overcome the worldwide workforce ageing phenomenon.
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Affiliation(s)
- C A Viviani
- Pontificia Universidad Católica de Valparaíso, Facultad de Ciencias, Escuela de Kinesiología, Chile
| | - G Bravo
- Facultad de Salud y Ciencias Sociales, Universidad de Las Américas, Chile
| | - M Lavallière
- Module de Kinésiologie, Département des Sciences de la Santé, Université du Québec á Chicoutimi (UQAC), Saguenay (QC), Canada
| | - P M Arezes
- ALGORITMI Centre, School of Engineering of the University of Minho, Guimarães, Portugal
| | - M Martínez
- Mutual de Seguridad de la Cámara Chilena de la Construcción, Santiago, Chile
| | - I Dianat
- Department of Ergonomics, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - S Bragança
- Research Innovation and Enterprise, Solent University, Southampton, United Kingdom
| | - H I Castellucci
- Centro de Estudio del Trabajo y Factores Humanos, Escuela de Kinesiología, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
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10
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Rodwin RL, Chen Y, Yasui Y, Leisenring WM, Gibson TM, Nathan PC, Howell RM, Krull KR, Mohrmann C, Hayashi RJ, Chow EJ, Oeffinger KC, Armstrong GT, Ness KK, Kadan-Lottick NS. Longitudinal Evaluation of Neuromuscular Dysfunction in Long-term Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study. Cancer Epidemiol Biomarkers Prev 2021; 30:1536-1545. [PMID: 34099519 DOI: 10.1158/1055-9965.epi-21-0154] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/27/2021] [Accepted: 06/02/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Children treated for cancer are at risk for neuromuscular dysfunction, but data are limited regarding prevalence, longitudinal patterns, and long-term impact. METHODS Longitudinal surveys from 25,583 childhood cancer survivors ≥5 years from diagnosis and 5,044 siblings from the Childhood Cancer Survivor Study were used to estimate the prevalence and cumulative incidence of neuromuscular dysfunction. Multivariable models adjusted for age, sex, race, and ethnicity estimated prevalence ratios (PR) of neuromuscular dysfunction in survivors compared with siblings, and associations with treatments and late health/socioeconomic outcomes. RESULTS Prevalence of neuromuscular dysfunction was 14.7% in survivors 5 years postdiagnosis versus 1.5% in siblings [PR, 9.9; 95% confidence interval (CI), 7.9-12.4], and highest in survivors of central nervous system (CNS) tumors (PR, 27.6; 95% CI, 22.1-34.6) and sarcomas (PR, 11.5; 95% CI, 9.1-14.5). Cumulative incidence rose to 24.3% in survivors 20 years postdiagnosis (95% CI, 23.8-24.8). Spinal radiotherapy and increasing cranial radiotherapy dose were associated with increased prevalence of neuromuscular dysfunction. Platinum exposure (vs. none) was associated with neuromuscular dysfunction (PR, 1.8; 95% CI, 1.5-2.1), even after excluding survivors with CNS tumors, cranial/spinal radiotherapy, or amputation. Neuromuscular dysfunction was associated with concurrent or later obesity (PR, 1.1; 95% CI, 1.1-1.2), anxiety (PR, 2.5; 95% CI, 2.2-2.9), depression (PR, 2.1; 95% CI, 1.9-2.3), and lower likelihood of graduating college (PR, 0.92; 95% CI, 0.90-0.94) and employment (PR, 0.8; 95% CI, 0.8-0.9). CONCLUSIONS Neuromuscular dysfunction is prevalent in childhood cancer survivors, continues to increase posttherapy, and is associated with adverse health and socioeconomic outcomes. IMPACT Interventions are needed to prevent and treat neuromuscular dysfunction, especially in survivors with platinum and radiation exposure.
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Affiliation(s)
- Rozalyn L Rodwin
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut.
| | - Yan Chen
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Wendy M Leisenring
- Clinical Research and Public Health Sciences Divisions, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Todd M Gibson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Paul C Nathan
- Division of Hematology-Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rebecca M Howell
- Division of Radiation Oncology, Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Caroline Mohrmann
- Division of Pediatric Hematology/Oncology, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, Missouri
| | - Robert J Hayashi
- Division of Pediatric Hematology/Oncology, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, Missouri
| | - Eric J Chow
- Clinical Research and Public Health Sciences Divisions, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Nina S Kadan-Lottick
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut.,Yale Cancer Center, New Haven, Connecticut
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11
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Nahum-Henry S, Descatha A. Proposition d’un outil de repérage de facteurs de vulnérabilité des salariés par l’infirmier en Santé au travail. ARCH MAL PROF ENVIRO 2021. [DOI: 10.1016/j.admp.2020.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Chu WM, Ho HE, Yeh CJ, Tsan YT, Lee SH, Lee MC. Late-career unemployment and risk of frailty among older adults in Taiwan: An 8-year population-based cohort study. Geriatr Gerontol Int 2021; 21:353-358. [PMID: 33590668 DOI: 10.1111/ggi.14136] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/23/2020] [Accepted: 01/07/2021] [Indexed: 01/11/2023]
Abstract
AIM To evaluate whether late-career unemployment is associated with increased physical frailty among older adults in Taiwan by the design of a population-based cohort study. METHODS Data were retrieved from the Taiwan Longitudinal Study on Aging. The study examined data from the period 1999 to 2007. A total of 652 subjects were included in the final analysis, and they were categorized as normally employed or unemployed depending on their employment status in 1999. Frailty was defined using the Fried criteria. Multiple confounding factors were adjusted in a multilevel analysis. RESULTS The average age of the participants in 1999 was 59.0 years. A total of 491 participants were normally employed, and 161 participants were unemployed. After adjustment for gender, age, level of education, income, marital status, and number of chronic diseases, late-career unemployment was associated with increased frailty [odds ratio (OR) = 1.61; 95% confidence interval (CI) = 1.00-2.59]. The risk of developing frailty was higher for participants who were unemployed during late career and had poor self-rated health [OR = 3.54; 95% CI = 1.37-9.20]. CONCLUSIONS Late-career unemployment is associated with increased frailty, especially for those who also have poor self-rated health. Older adults should be encouraged to maintain normal employment during the later stages of their career before retirement. Employers should apply strategies to prevent possible late-career unemployment, and the government should provide resources and help to unemployed older workers so that they can minimize poor health outcomes in late life. Geriatr Gerontol Int 2021; 21: 353-358.
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Affiliation(s)
- Wei-Min Chu
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Occupational Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsin-En Ho
- Department of Family Medicine, Taichung Armed Force General Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,National Defense Medical Center, Taipei, Taiwan
| | - Chih-Jung Yeh
- School of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Tse Tsan
- Department of Occupational Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shu-Hsin Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,School of Nursing, Chung Shan Medical University, Taichung, Taiwan
| | - Meng-Chih Lee
- Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan.,Institute of Population Sciences, National Health Research Institutes, Zhunan, Taiwan.,College of Management, Chaoyang University of Technology, Taichung, Taiwan.,Study Group of Integrated Health and Social Care Project, Ministry of Health and Welfare, Taiwan
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13
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Haapanen MJ, von Bonsdorff MB, Perttilä NM, Törmäkangas T, von Bonsdorff ME, Strandberg AY, Strandberg TE. Retirement age and type as predictors of frailty: a retrospective cohort study of older businessmen. BMJ Open 2020; 10:e037722. [PMID: 33334827 PMCID: PMC7747567 DOI: 10.1136/bmjopen-2020-037722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To study the association between retirement characteristics and frailty in a homogenous population of former business executives. DESIGN Cross-sectional cohort study using data from the Helsinki Businessmen Study. SETTING Helsinki, Finland. PARTICIPANTS 1324 Caucasian men, born in 1919-1934, who had worked as business executives and managers and of whom 95.9% had retired by the year 2000. Questions on age at and type of retirement, lifestyle and chronic conditions were embedded in questionnaires. PRIMARY AND SECONDARY OUTCOME MEASURES Frailty assessed according to a modified phenotype definition at mean age 73.3 years. RESULTS Mean age at retirement was 61.3 years (SD 4.3) and 37.1% had retired due to old age. The prevalence of frailty was lowest among men retiring at ages 66-67 years but increased among those who worked up to age 70 years or older. Compared with men who retired before age 55 years, those retiring at ages 58-69 years were at decreased risk of frailty in old age relative to non-frailty (adjusted ORs 0.07-0.29, p<0.05). Compared with men who transitioned into old age retirement, those who retired due to disability were at increased risk of prefrailty (adjusted OR 1.53, 95% CI 1.01 to 2.32) and frailty (adjusted OR 3.52, 95% CI 1.97 to 6.29), relative to non-frailty. CONCLUSION Exiting working life early and continuing to be occupationally active until age 70 years and older were both associated with increased risk of frailty among the men. Promotion of longer work careers could, however, promote healthier ageing, as the lowest prevalence of frailty was observed in former business executives who retired at ages 66-67 years.
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Affiliation(s)
- Markus J Haapanen
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
| | - Mikaela B von Bonsdorff
- Folkhälsan Research Centre, Helsinki, Finland
- Department of Health Sciences, Gerontology Research Centre, University of Jyväskylä Faculty of Sport and Health Sciences, Jyvaskyla, Finland
| | - Niko M Perttilä
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Törmäkangas
- Department of Health Sciences, Gerontology Research Centre, University of Jyväskylä Faculty of Sport and Health Sciences, Jyvaskyla, Finland
| | - Monika E von Bonsdorff
- School of Business and Kokkola University Consorium Chydenius, University of Vaasa, Vaasa, Finland
- Department of Management and Leadership, Jyväskylä University School of Business and Economics, Jyväskylä, Finland
| | - Arto Y Strandberg
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo E Strandberg
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
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14
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Normative reference values of the handgrip strength for the Portuguese workers. PLoS One 2020; 15:e0236555. [PMID: 32756598 PMCID: PMC7406054 DOI: 10.1371/journal.pone.0236555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 07/08/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction The active workforce is increasingly aging. However workload, as well as working time and intensity, sometimes remains unchanged. This can be an even more critical situation in older people, since occupational exposure associated with aging, will further reduce the muscle's ability to generate energy, which in turn facilitates the development of these age-related syndromes. This study aims to identify the normative values of handgrip strength for Portuguese workers in the automotive industry. Methods About 1225 employees were invited to participate in the study. The final sample consisted of 656 employees in the assembly area. The handgrip strength was measured in kilograms (kg) using the Jamar digital dynamometer. Sex-specific profiles of handgrip strength were designed by the Ordinary Least Square regression (OLS) analysis, where height, age, age squared, and height squared are entered into the models as determining factors of the maximum grip strength in both female and male groups. Results The peak mean values of handgrip strength in the group of women was 34 kg in the age group of 35–39 years, and in the group of men the peak mean was 52 kg in the age group of 25–34 years. The most pronounced decline in the female group appears in the age of 30–34 years of about 4 kg and the male group the decline occurs at 2kg below the peak force, in the age group of 40–57 year-olds. This study used a cut-off at 2 SD below by the sex-specific peak mean. Conclusion Normative values can help delineate the career path of workers because they portray risk values according to age, height, and gender. The normative values assist health and engineering professionals and ergonomists in adjusting task demands to the morphological and strength characteristics of the workers.
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15
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Wang SP, Wang JD, Chang JH, Wu BJ, Chern JS, Wang TJ. Frailty affects employment outcomes in patients with schizophrenia in noncompetitive employment: A 4-year longitudinal study. Schizophr Res 2020; 222:375-381. [PMID: 32402607 DOI: 10.1016/j.schres.2020.04.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 01/13/2020] [Accepted: 04/19/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Employment status is considered a crucial predictor of improved functioning for patients with psychotic disorders. Frailty affects not only physical well-being but also employment outcomes, but few studies have explored the association between frailty and employment outcomes in patients with schizophrenia. This study is a longitudinal follow-up study that aimed to determine whether frailty is associated with employment outcomes in schizophrenia. METHODS All 561 stable patients with schizophrenia in a therapeutic community in Taiwan were recruited. Employment outcomes, defined as the cumulative annual work duration (months per year) and income (USD per year), were investigated repeatedly at the end of 1-, 2-, 3-, and 4-year follow-ups after enrollment. Generalized estimating equation models were constructed to determine the association between frailty and employment outcomes after controlling for variables, including age, sex, education, antipsychotic medication and daily dose, cognitive function, instrumental activities of daily living, medical comorbidity, and initial employment state at the beginning year. RESULTS The average age was 53.78 years, and 64.7% were men. Among them, 57 patients (10.2%) met the frailty criteria at the baseline. After controlling for other factors, we found that patients with frailty were employed 1.01 month less (p = 0.004) and earned 17.2 USD less (p = 0.029) per year than those without frailty. CONCLUSIONS Frailty may reduce duration of employment and income for patients with schizophrenia. The biopsychosocial care model for these patients should include development of strategies to prevent or reverse preexisting frailty to improve and preserve employment outcomes.
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Affiliation(s)
- San-Ping Wang
- Institute of Allied Health Science, College of Medicine, National Cheng-Kung University, Tainan, Taiwan; Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng-Kung University, Tainan, Taiwan; Department of Occupational Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Jer-Hao Chang
- Institute of Allied Health Science, College of Medicine, National Cheng-Kung University, Tainan, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng-Kung University, Tainan, Taiwan.
| | - Bo-Jian Wu
- Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan
| | - Jen-Suh Chern
- Graduate Institute of Rehabilitation Counseling, National Taiwan Normal University, Taipei, Taiwan
| | - Tso-Jen Wang
- Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan
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16
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Bravo G, Viviani C, Lavallière M, Arezes P, Martínez M, Dianat I, Bragança S, Castellucci H. Do older workers suffer more workplace injuries? A systematic review. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2020; 28:398-427. [DOI: 10.1080/10803548.2020.1763609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Gonzalo Bravo
- Facultad de Ciencias de la Salud, Universidad de Las Américas, Chile
| | - Carlos Viviani
- Escuela de Kinesiología, Pontificia Universidad Católica de Valparaíso, Chile
| | - Martin Lavallière
- Département des Sciences de la Santé, Université du Québec à Chicoutimi (UQAC), Canada
| | - Pedro Arezes
- School of Engineering, University of Minho, Portugal
| | - Marta Martínez
- Mutual de Seguridad de la Cámara Chilena de la Construcción, Chile
| | - Iman Dianat
- Faculty of Health, Tabriz University of Medical Sciences, Iran
| | - Sara Bragança
- Research Innovation and Enterprise, Solent University, UK
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17
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Gordon SJ, Baker N, Kidd M, Maeder A, Grimmer KA. Pre-frailty factors in community-dwelling 40-75 year olds: opportunities for successful ageing. BMC Geriatr 2020; 20:96. [PMID: 32143634 PMCID: PMC7060633 DOI: 10.1186/s12877-020-1490-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 02/24/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND There is little known about pre-frailty attributes or when changes which contribute to frailty might be detectable and amenable to change. This study explores pre-frailty and frailty in independent community-dwelling adults aged 40-75 years. METHODS Participants were recruited through local council networks, a national bank and one university in Adelaide, Australia. Fried frailty phenotype scores were calculated from measures of unintentional weight loss, exhaustion, low physical activity levels, poor hand grip strength and slow walking speed. Participants were identified as not frail (no phenotypes), pre-frail (one or two phenotypes) or frail (three or more phenotypes). Factor analysis was applied to binary forms of 25 published frailty measures Differences were tested in mean factor scores between the three Fried frailty phenotypes and ROC curves estimated predictive capacity of factors. RESULTS Of 656 participants (67% female; mean age 59.9 years, SD 10.6) 59.2% were classified as not frail, 39.0% pre-frail and 1.8% frail. There were no gender or age differences. Seven frailty factors were identified, incorporating all 25 frailty measures. Factors 1 and 7 significantly predicted progression from not-frail to pre-frail (Factor 1 AUC 0.64 (95%CI 0.60-0.68, combined dynamic trunk stability and lower limb functional strength, balance, foot sensation, hearing, lean muscle mass and low BMI; Factor 7 AUC 0.55 (95%CI 0.52-0.59) comprising continence and nutrition. Factors 3 and 4 significantly predicted progression from pre-frail to frail (Factor 3 AUC 0.65 (95% CI 0.59-0.70)), combining living alone, sleep quality, depression and anxiety, and lung function; Factor 4 AUC 0.60 (95%CI 0.54-0.66) comprising perceived exertion on exercise, and falls history. CONCLUSIONS This research identified pre-frailty and frailty states in people aged in their 40s and 50s. Pre-frailty in body systems performance can be detected by a range of mutable measures, and interventions to prevent progression to frailty could be commenced from the fourth decade of life.
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Affiliation(s)
- S. J. Gordon
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia 5005 Australia
- Digital Health Research Centre, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia 5005 Australia
| | - N. Baker
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia 5005 Australia
- Digital Health Research Centre, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia 5005 Australia
| | - M. Kidd
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, South Australia 5005 Australia
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada
| | - A. Maeder
- Digital Health Research Centre, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia 5005 Australia
| | - K. A. Grimmer
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia 5005 Australia
- Physiotherapy Department, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7500 South Africa
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Newman-Griffis D, Porcino J, Zirikly A, Thieu T, Camacho Maldonado J, Ho PS, Ding M, Chan L, Rasch E. Broadening horizons: the case for capturing function and the role of health informatics in its use. BMC Public Health 2019; 19:1288. [PMID: 31615472 PMCID: PMC6794808 DOI: 10.1186/s12889-019-7630-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 09/16/2019] [Indexed: 12/18/2022] Open
Abstract
Background Human activity and the interaction between health conditions and activity is a critical part of understanding the overall function of individuals. The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) models function as all aspects of an individual’s interaction with the world, including organismal concepts such as individual body structures, functions, and pathologies, as well as the outcomes of the individual’s interaction with their environment, referred to as activity and participation. Function, particularly activity and participation outcomes, is an important indicator of health at both the level of an individual and the population level, as it is highly correlated with quality of life and a critical component of identifying resource needs. Since it reflects the cumulative impact of health conditions on individuals and is not disease specific, its use as a health indicator helps to address major barriers to holistic, patient-centered care that result from multiple, and often competing, disease specific interventions. While the need for better information on function has been widely endorsed, this has not translated into its routine incorporation into modern health systems. Purpose We present the importance of capturing information on activity as a core component of modern health systems and identify specific steps and analytic methods that can be used to make it more available to utilize in improving patient care. We identify challenges in the use of activity and participation information, such as a lack of consistent documentation and diversity of data specificity and representation across providers, health systems, and national surveys. We describe how activity and participation information can be more effectively captured, and how health informatics methodologies, including natural language processing (NLP), can enable automatically locating, extracting, and organizing this information on a large scale, supporting standardization and utilization with minimal additional provider burden. We examine the analytic requirements and potential challenges of capturing this information with informatics, and describe how data-driven techniques can combine with common standards and documentation practices to make activity and participation information standardized and accessible for improving patient care. Recommendations We recommend four specific actions to improve the capture and analysis of activity and participation information throughout the continuum of care: (1) make activity and participation annotation standards and datasets available to the broader research community; (2) define common research problems in automatically processing activity and participation information; (3) develop robust, machine-readable ontologies for function that describe the components of activity and participation information and their relationships; and (4) establish standards for how and when to document activity and participation status during clinical encounters. We further provide specific short-term goals to make significant progress in each of these areas within a reasonable time frame.
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Affiliation(s)
- Denis Newman-Griffis
- Rehabilitation Medicine Department, National Institutes of Health, Mark O. Hatfield Clinical Research Center, 6707 Democracy Boulevard, Suite 856, MSC 5493, Bethesda, MD, 20892, USA. .,Department of Computer Science and Engineering, The Ohio State University, 2015 Neil Avenue, DL 395, Columbus, OH, 43210, USA.
| | - Julia Porcino
- Rehabilitation Medicine Department, National Institutes of Health, Mark O. Hatfield Clinical Research Center, 6707 Democracy Boulevard, Suite 856, MSC 5493, Bethesda, MD, 20892, USA
| | - Ayah Zirikly
- Rehabilitation Medicine Department, National Institutes of Health, Mark O. Hatfield Clinical Research Center, 6707 Democracy Boulevard, Suite 856, MSC 5493, Bethesda, MD, 20892, USA
| | - Thanh Thieu
- Department of Computer Science, Oklahoma State University, 116-A MSCS, Stillwater, OK, 74078, USA
| | - Jonathan Camacho Maldonado
- Rehabilitation Medicine Department, National Institutes of Health, Mark O. Hatfield Clinical Research Center, 6707 Democracy Boulevard, Suite 856, MSC 5493, Bethesda, MD, 20892, USA
| | - Pei-Shu Ho
- Rehabilitation Medicine Department, National Institutes of Health, Mark O. Hatfield Clinical Research Center, 6707 Democracy Boulevard, Suite 856, MSC 5493, Bethesda, MD, 20892, USA
| | - Min Ding
- Information Technology Laboratory, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD, 20899, USA
| | - Leighton Chan
- Rehabilitation Medicine Department, National Institutes of Health, Mark O. Hatfield Clinical Research Center, 6707 Democracy Boulevard, Suite 856, MSC 5493, Bethesda, MD, 20892, USA
| | - Elizabeth Rasch
- Rehabilitation Medicine Department, National Institutes of Health, Mark O. Hatfield Clinical Research Center, 6707 Democracy Boulevard, Suite 856, MSC 5493, Bethesda, MD, 20892, USA
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Sewdas R, van der Beek AJ, Boot CRL, D'Angelo S, Syddall HE, Palmer KT, Walker-Bone K. Poor health, physical workload and occupational social class as determinants of health-related job loss: results from a prospective cohort study in the UK. BMJ Open 2019; 9:e026423. [PMID: 31300496 PMCID: PMC6629425 DOI: 10.1136/bmjopen-2018-026423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The aims of the present study were to assess the association and interactions of physical workload and poor health with health-related job loss (HRJL) among older workers, and the association and interactions of occupational social class and poor health with HRJL. METHODS Data were used from an existing prospective cohort study, Health and Employment after Fifty, where employed or self-employed workers aged 50-64 years (n=4909) were followed-up between 2014 and 2016. Associations between potential determinants (self-perceived health status, physical workload and occupational social class) and 2-year HRJL were examined by Cox regression analyses. To study whether physical workload or occupational social class moderates the influence of poor health on HRJL, additive and multiplicative interactions were calculated. RESULTS Older workers with poor self-perceived health status had increased risk of HRJL during the 2-year follow-up period (men: HR 2.57 (95%CI: 1.68 to 3.92); women: HR 3.26 (95%CI: 2.33 to 4.55)). Furthermore, men with high physical workload were at increased risk for HRJL (HR 1.63 (95%CI: 1.09 to 2.43)). No significant interactions (p<0.05) were identified between poor health and high physical workload, nor between poor health and lower occupational social class. CONCLUSION Our study indicates that older workers in poor health, and older workers with a physically demanding job, are at increased risk of HRJL. Having a physically demanding job or working in routine/manual occupations does not moderate the association between poor health and HRJL.
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Affiliation(s)
- Ranu Sewdas
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Cecile R L Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, Hampshire, The United Kingdom
| | - Holly E Syddall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, Hampshire, The United Kingdom
| | - Keith T Palmer
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, Hampshire, The United Kingdom
| | - Karen Walker-Bone
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, Hampshire, The United Kingdom
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Nordgren L, Söderlund A. Social support, self-rated health and low mood in people on sick leave due to heart failure: a cross-sectional study. Scand J Public Health 2017; 46:606-612. [PMID: 29160157 DOI: 10.1177/1403494817718070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AIMS The aim of this study was to investigate social support in relation to self-rated health and the prevalence of low mood in people on sick leave due to heart failure. METHODS A cross-sectional design was used, and 590 individuals on sick leave due to heart failure in Sweden responded to the postal questionnaire. The questions therein concerned received and needed functional and structural support from managers, work colleagues, families and friends. Multivariate analyses were conducted. RESULTS The variables of income and needed support from family contributed significantly and negatively to self-rated health. Those who perceived that they needed more support from their manager reported experiencing low mood more frequently. CONCLUSIONS The results showed a negative relation between manager support and low mood. Thus, support from managers and perceptions of low mood during sick leave are negatively associated, however, we do not know anything about the causality of this association. The results also indicated that needed support from family was negatively associated with self-rated health. The results also highlighted a multidimensional frailty in people with heart failure that needs to be recognized in future research as well as in clinical practice.
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Affiliation(s)
- Lena Nordgren
- 1 Centre for Clinical Research Sörmland, Uppsala University, Sweden.,2 Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Anne Söderlund
- 3 School of Health, Care and Social Welfare, Mälardalen University, Sweden
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Nygård CH, Rantanen T. The need for methods to measure capacity and incapacity from working life to old age. Occup Environ Med 2017; 74:467. [DOI: 10.1136/oemed-2017-104291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 03/17/2017] [Accepted: 04/17/2017] [Indexed: 11/04/2022]
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