Do quality of life, participation and environment of older adults differ according to level of activity?

Does the community service environment affect the willingness of older adults people to socialize for older adults care?

Population ageing is a significant trend in social development and will remain a fundamental national condition in China for the foreseeable future. Socialized older adults care has become a crucial strategy for China to address population ageing. However, the current levels of acceptance and willingness to seek socialized older adults care among older adults are relatively low. This study focuses on examining how the community environment and services influence older adults people's willingness to engage in social activities related to older adults care. Using data from the China Longitudinal Ageing Social Survey (CLASS) (N = 9,657), this study investigated the impact of the community service environment on older adults people's willingness to participate in social activities related to older adults care through a logit model. The study revealed that 9.15% of older adults (N = 9,657) in China are willing to engage in social activities related to older adults care. Furthermore, the individual characteristics and family support of older adults play a significant role in shaping their willingness to engage in older adults care. The provision of medical services, daily care services, and entertainment venues by the community positively influence older adults people's willingness to participate in social activities related to older adults care (p < 0.01), whereas psychological counselling services have a negative impact (p < 0.01). The impact of community services on older adults people's willingness to engage in social activities related to older adults care varies due to factors such as smoking and chronic diseases. These findings provide valuable insights for improving older adults' social engagement in China.

Longitudinal mediation effects of activity meaning on the association between activity performance and quality of life among older adults with disabilities

BACKGROUND

Physical limitations may hinder older adults with physical disabilities' capability to perform various activities, which can affect their quality of life (QOL). Accomplishing meaningful activities may mitigate the impact of limited activity performance on their QOL. This longitudinal study aims to investigate how activity meaning mediates the relationship between activity performance and QOL among older adults with disabilities.

METHODS

Data for this longitudinal study was collected from 813 community-dwelling older adults aged 60 and above who had physical disabilities, over a two year interval. Path analysis was used to examine the cross-sectional and longitudinal mediation effects from activity performance, through activity meaning, to QOL.

RESULTS

At the same wave, high IADL performance or social activity performance, and high QOL was indirectly associated through high IADL meaning or social meaning. As for longitudinal association, high T1 IADL performance was associated with better T2 QOL through high T1 and T2 IADL meaning. Similarly, high T1 social activity performance also contributed to T2 QOL through high T1 and T2 social activity meaning. Additionally, social activity performance exhibited higher influence on QOL than that of IADL.

CONCLUSIONS

Both IADL and social activities have distinct impacts on the QOL of older adults with disabilities. To improve the current and future QOL of older adults with disabilities, professionals must prioritize their involvement in the most meaningful activities while being sensitive to and supportive of their preferences and valued lifestyles.

Kihon Checklist items associated with the development of frailty and recovery to robust status during the COVID-19 pandemic

AIM

The Kihon Checklist (KCL) is used to assess frailty in daily life. We aimed to identify KCL items associated with the development of frailty and recovery to robust status during the COVID-19 pandemic.

METHODS

We conducted a 1-year prospective cohort study of community-dwelling adults aged 70 and 75 years in Otawara City, Tochigi Prefecture, Japan. Information regarding age, sex, presence of disease and KCL items was collected in May 2020 (baseline) and June 2021 (follow-up) using a mailed questionnaire. Changes in frailty status as determined by the KCL at baseline and follow-up were evaluated. To clarify factors related to changes in the frailty status, we conducted two sets of binomial logistic regression analyses with the presence/absence of development of frailty and presence/absence of recovery to robust status at follow-up as the dependent variables and the KCL items as the independent variables.

RESULTS

The analysis included 716 participants who provided complete responses to both questionnaires. The KCL Items 6, 10, 20, 23 and 24 were related to the development of frailty, and the KCL Items 6, 15, 21 and 23 were associated with the recovery to robust status.

CONCLUSIONS

The baseline KCL items regarding physical function and associated mental aspects were related to both development of frailty and recovery to robust status during the COVID-19 pandemic. Cognitive and depressive declines were associated with the development of frailty, while good oral environment and sense of fulfillment in life were associated with the recovery to robust status. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2022; ••: ••-••.

Role of Participation in Activities and Perceived Accessibility on Quality of Life among Nondisabled Older Adults and Those with Disabilities in Israel during COVID-19

During the COVID-19 pandemic, quality of life (QoL) was reduced among many groups, including Israeli older adults. This study investigated perceived QoL, perceived accessibility of the living environment, and participation in activities among nondisabled older adults and those with disabilities in the community. It also examined whether the perceived accessibility's effect on QoL occurs directly and/or indirectly via mediators of participation in community activities. A voluntary and anonymous survey was administered from February to May 2021 to 495 participants aged 60 and older. Respondents completed three questionnaires: WHOQOL-BREF, Community Integration Questionnaire-Revised (CIQ-R), and Perceived Accessibility of Living Environment (PALE). The main finding was that participation in activities in the community had a direct positive impact on QoL. Perceived accessibility of the living environment also had indirect positive effects on QoL through participation in activities in the community, for those without disabilities but, interestingly, not for those with disabilities. Hierarchal linear regressions revealed that participation in activities explained 53.3% of the variance for both groups while perceived accessibility added 1.1% for the nondisabled. We conclude that accessibility of living environment is a good indicator of positively perceived QoL through participation in various activities in the community for nondisabled older adults. This may be especially important during a pandemic.

Importance of collaboration and contextual factors in the development and implementation of social participation initiatives for older adults living in rural areas

INTRODUCTION

To encourage isolated and vulnerable older adults to accomplish meaningful social activities, occupational therapists and other healthcare workers must collaborate with community organisations and municipalities to develop and implement initiatives fostering social participation. In a rural Regional County Municipality in Quebec (Canada), four social participation initiatives were selected and implemented: (1) Benevolent Community, (2) urban transportation system, (3) creation of a website on social participation activities, and (4) social participation workshop. Little is known about contextual factors such as the structures and organisations, stakeholders, and physical environment that influence the development and implementation of such initiatives.

METHODS

Led by an academic occupational therapist, an action research to implement social participation initiatives was initiated by community stakeholders. The 26 stakeholders were involved in a Management and Partnership Committee, two focus groups and an interview with a trainer, which documented and analysed contextual factors and the implementation process.

FINDINGS AND DISCUSSION

Development and implementation were facilitated by stakeholder collaboration, mission of the community organisations, and stakeholders' shared desire to reduce older adults' isolation and vulnerability. The established partnerships and predefined orientations as well as the leadership, motivation, and professional skills of the stakeholders also fostered the initiatives. Among the challenges encountered, the stakeholders' limited involvement in implementation tasks was attributable to important changes in the key stakeholders' organisations and structures and the number of organisations involved. Difficulty reaching a consensus resulting from the different attitudes, vision, and understanding of the stakeholders delayed the development and implementation of some initiatives. Despite regular meetings between stakeholders, geographic distance limited spontaneous exchanges.

CONCLUSION

This action research highlighted the importance of collaboration and contextual factors in developing and implementing social participation initiatives with community organisations and municipalities.

Barriers and Facilitators to Social Participation in Older Adults: A Systematic Literature Review

Objectives: Social participation has been shown to improve health, well-being, and quality of life in older adults. Previous reviews on social participation have been limited to identifying logistical barriers. The current review sought to examine barriers of social participation more broadly, as well as potential facilitators.Methods: We conducted a systematic review to collate identified barriers and facilitators to social participation in older adults. Seventy-six studies were eligible for inclusion.Results: Four main themes of barriers and facilitators to social participation associated with aging emerged: Demographic factors (such as age and socioeconomic status), Individual/Internal factors (such as motivations and health), Environmental/Infrastructure (such as accessibility, transport, and neighborhood cohesion), and Social Networks (particularly preexisting network size).Conclusions: These findings extended previous reviews to show that personal motivations, preexisting social networks, and neighborhood cohesion play vital roles in improving and maintaining quality social participation. The ability to facilitate this can occur at the individual therapeutic level and at the community level.Clinical implications: The findings highlight the need to consider barriers beyond logistical issues. In particular, healthy aging initiatives may benefit from matching social activities with individual motivations, and preventive measures to establish social networks early in the aging process are important.

Physical Activity and Quality of Life of University Students, Their Parents, and Grandparents in Poland-Selected Determinants

Physical activity is one of the factors conditioning human health. Research shows a positive impact of regular physical activity on the quality of human life. The aim of the study was to determine the relationship between the physical activity of university students, their parents, and their grandparents, and the overall quality of their lives in individual domains (physical, mental, social, environmental), as well as the perceived state of health in relation to selected determinants. The research included 1001 participants, including 253 students related to physical culture and health promotion studying at the University of Szczecin (faculties: physical education, tourism and recreation, public health, sports diagnostics), and their 336 parents and 412 grandparents. Purposive sampling was used to outline the determinants of quality of life and family factors in physical activity. The diagnostic survey was carried out based on the standardized WHOQOL-BREF (World Health Organization Quality of Life) questionnaire. Statistically significant differences were shown in the studied generations regarding the assessment of quality of life and satisfaction with health in the physical, psychological, social, and environmental domains. The oldest generation gave the lowest assessment of quality of life and was the least satisfied with their health regarding particular domains. Female students were more satisfied with their health compared to grandmothers and grandfathers, whereas male students compared to mothers and fathers. Fathers achieved the highest scores in the psychological and social domains, but, in case of the latter, differences were found between mothers’ and fathers’ assessments. Intergenerational differences were found in quality of life and the assessment of health status. Current participation in broadly understood physical culture was often a result of positive attitudes towards physical education and doing sport in the past, which meant higher scores in the physical domain each time. The study demonstrated that taking up physical activity impacted the quality of life and assessment of health in the past and currently.

Social Participation in the Daily Lives of Frail Older Adults: Types of Participation and Influencing Factors

OBJECTIVES

The advantages of social participation for older adults are well established and have been adopted in aging policy frameworks. However, little is known about the social participation of frail older adults. This research examined the types of social interaction of very frail older adults and the factors influencing this participation.

METHOD

Interviews with 38 very frail older adults were analyzed using Levasseur and colleagues' (Levasseur, Richard, Gauvin, & Raymond (2010). Inventory and analysis of definitions of social participation found in the aging literature: Proposed taxonomy of social activities. Social Science and Medicine (1982), 71, 2141-2149) taxonomy activity levels of involvement with others. A qualitative hybrid approach with inductive and deductive thematic analyses was used.

RESULTS

Participants often disengaged from activities with high involvement with others, preferring activities with less involvement. Low-key participation emerged as an important type of social participation enabling frail older adults to remain engaged in society. Key factors that influenced social participation were functional decline, and the physical (e.g., traffic, the disappearance of local stores) and social environment (e.g., social networks and the presence of meeting places such as community centers).

DISCUSSION

Findings advance our knowledge and recognition of the different ways frail older adults participate in society. Despite their frailty, older adults wish to stay socially active. Focusing on the social environment in the frameworks and policies of Age-Friendly Cities and Communities will benefit these individuals.

Biopsychosocial characteristics associated with engagement in art making among older adults

In order to design patient-centered art making interventions for health and well-being, investigators need to understand the population of interest regarding their relationship to engagement in art making activities. This study, therefore, aimed to examine older adults' characteristics that were associated with engagement in art making activities, and to provide practical examples of how to use the identified characteristics. We conducted correlation analyses to evaluate such associations, using cross-sectional survey data from the 2014 Health and Retirement Study (n=731). Female sex, higher education, personality traits, positive attitude toward the arts, and a larger social network size were positively associated with engagement in art making activities (p<.05). Males and those with lower education could be targeted, while the type of art making activity could be tailored based on personality traits for patient-centered art making interventions. Future studies can use this information to empirically study art making interventions for older adults.

Age-friendly environments and psychosocial wellbeing: a study of older urban residents in Ireland

OBJECTIVE

This article aims to estimate the association between age-friendly urban environments and psychosocial wellbeing in adults aged 55+ living in four Irish cities.

METHOD

Data is from the Healthy and Positive Ageing Initiative 'Age-friendly Cities and Counties Survey' from four cities; Dublin, Cork, Limerick, and Galway (n = 2,094). The Age-friendly Urban Index (AFUI), a perception-based measure of safety, access to services, and walkability, is used to measure urban environment quality on a scale of 35 (least favourable) to 105 (most favourable). Wellbeing was estimated using the following composite measures: quality of life (comprising hedonic (pleasure) and eudaimonic (control, autonomy, self-realisation) wellbeing); affective (depressive mood); and social (loneliness). Multivariate regression analyses (negative binomial and Poisson regression) were used to investigate the association between the AFUI and each wellbeing indicator. Models were fully adjusted for known demographic (age, gender, household structure, marital status), socio-economic (material deprivation, employment/occupation, education), social (social engagement, community activities) and health (self-rated health, mobility limitations) correlates of psychosocial wellbeing.

RESULTS

Older people living in cities with higher AFUI score were more likely to report higher quality of life overall, and higher hedonic and eudaimonic wellbeing. These adults also had lower depressive mood scores and reported lower loneliness levels. Results remain significant in the fully adjusted model.

LIMITATIONS

Causal conclusions cannot be made because of cross-sectional data.

CONCLUSION

This study provides evidence of the relationship between the age-friendliness (safety, services, and walkability) of urban environments and multiple aspects of psychosocial wellbeing for older adults in Ireland.

Network Analysis of the Participation and Activity Inventory for Children and Youth (PAI-CY) 7-12 Years with Visual Impairment

Purpose

Children with visual impairment often experience more difficulties regarding participation compared to sighted peers. The Participation and Activity Inventory for Children and Youth (PAI-CY) has recently been developed to assess their participation needs. A novel application in the field of questionnaires is the use of network analysis to explore interrelations between items in order to capture their complex interactions as a reflection of the overall construct of measurement. This study aimed to apply network modeling for the PAI-CY 7–12 from the perspectives of children and their parents.

Methods

Children and their parents (n = 195) completed the 55-item PAI-CY via face-to-face interviews and a web-based survey, respectively. Internal consistency, test-retest reliability, and concordance between children and parents were investigated. Two networks were created, along with visualizations of shared and differential connections between children and parents.

Results

Eight items were deleted. Network structures were dissimilar; for children, connections evolved around social contacts and school items, whereas for parents, mobility, leisure time, acceptance, self-reliance, and communication items prevailed. In the children's network, playing imaginary games, inviting a friend to play at home, and estimating the distance from others were most connected to other items.

Conclusions

This study uniquely identifies connections between items of the PAI-CY 7–12, highlighting the different perspectives parents and children have on what defines participation, possibly implying that they perceive the relevance of various rehabilitation programs differently.

Translational Relevance

Rehabilitation programs aimed at improving the most connected items might positively affect other items in the network, possibly improving children's participation.

Change in Depression, Confidence, and Physical Function Among Older Adults With Mild Cognitive Impairment

BACKGROUND AND PURPOSE

Nearly a quarter of those in the United States older than 71 years experience mild cognitive impairment. Persons with mild cognitive impairment battle depression and progressive disengagement from daily activities, which contribute to participation restriction and activity limitation. Daily engagement in meaningful activity (DEMA) is a tailored intervention designed to benefit persons with mild cognitive impairment and their caregivers through preserved engagement and supported adjustment to cognitive changes. This secondary analysis was guided by the International Classification of Functioning, Disability and Health (ICF) model. Aims were to (i) explore the extent to which change in self-rated activity performance and physical function can predict change in depressive symptoms, (ii) evaluate for difference in confidence and depressive symptoms at ICF levels of activity and participation, and (iii) quantify the impact of daily engagement at the ICF level of participation on physical function.

METHODS

A secondary analysis was conducted using data from the parent study, which was a 2-group randomized trial involving persons with mild cognitive impairment and their informal caregivers participating in the Indiana Alzheimer Disease Center DEMA program. Quantitative analysis (dyads: DEMA N = 20, Information Support N = 20) examined outcomes at posttest and follow-up. Analysis employed linear regression to model the relationship between explanatory and dependent variables and independent t test to examine for difference in confidence, depression, and physical function.

RESULTS AND DISCUSSION

At posttest, change in self-rated performance predicted change in depressive symptoms. Those in the DEMA group who engaged in activity at the ICF level of participation demonstrated a significant increase in confidence and physical function. Although not significant, the control group posttest results showed a mean decrease in confidence.

CONCLUSIONS

Results demonstrate a positive impact of DEMA on depressive symptoms, confidence, and physical function. Change in occupational performance predicted change in depressive symptoms. Confidence significantly improved among those who engaged at the ICF participation level. A larger, randomized controlled longitudinal trial is needed to better assess the impact of DEMA on physical function, activity, participation restriction, and quality of life.

Well-being and thriving in sheltered housing versus ageing in place: Results from the U-age sheltered housing study

AIMS

To explore to what extent type of residence (sheltered housing or ageing in place) contributes to thriving and well-being in older adults, when controlling for age, sex, living alone, being a widow and adjusting for functional status, self-rated health, and depressive mood.

DESIGN

A matched cohort study.

METHODS

A self-report survey was sent out to a total population of residents in all sheltered housings in Sweden and a matched control group ageing in place (N = 3,805). The data collection took place between October 2016-January 2017.

RESULTS

The interaction analyses related to thriving showed that with increasing level of depressive mood and decreasing levels of self-rated health and functional status, those residing in sheltered housing generally reported higher levels of thriving, as compared with those ageing in place. Well-being was not found to be significantly associated with type of accommodation.

CONCLUSION

There may be features in sheltered housing that are associated with resident thriving especially among individuals with impairments of function, health or mood, although further studies are required to identify these specific features.

IMPACT

This study informs staff and policymakers about thriving and well-being in sheltered housing accommodations. These findings may be used to further the development of sheltered housing accommodations.

Validation of the Chinese version of the Life-Space Assessment in community-dwelling older adults

The Life-Space Assessment (LSA) is a comprehensive tool for assessing mobility in older adults, but the evidence of its psychometric properties in Chinese older adults is lacking. The aim was to adapt and validate the psychometric properties of the Chinese version of the Life-Space Assessment (LSA-C) in community-dwelling older adults. A cross-sectional study was designed with 225 community-dwelling older adults. The content validity of the LSA-C was satisfactory. The criterion validity was supported by significant correlation between the LSA-C and the Multidimensional Functional Assessment Questionnaire (MFAQ). Additionally, the LSA-C was negatively correlated with the 10-item Center for Epidemiological Studies Depression Scale (CESD-10) and positively correlated with the General Health subscale of the Short-Form-36 Health Survey (GH of the SF-36), implying good construct validity. Finally, the LSA-C showed excellent stability (intraclass correlation coefficient = 0.88). The LSA-C demonstrates adequate psychometric properties, supporting its use in future research in the Chinese context.

Development and assessment of a home environment checklist to evaluate mismatch between patients' ability and home environment

BACKGROUND

Modification of the home environment, together with rehabilitative interventions, is important for maximizing the level of functioning after an individual with disability undergoes rehabilitation in the hospital.

OBJECTIVES

We developed a simple screening scale - the home environment checklist (HEC) - to identify any mismatch between an individual's abilities and their home environment to help clinicians monitor the appropriateness of the home environment to which individuals with disability will be discharged. We also examined the psychometric properties of the HEC.

METHODS

The HEC was developed by a multidisciplinary panel of rehabilitation experts using information routinely collected in rehabilitation clinics before discharge. The reliability of the checklist was assessed in 60 individuals undergoing rehabilitation. The inter-rater agreement and internal consistency of the scale were assessed by weighted kappa statistics and Cronbach's alpha, respectively. Rasch analysis was performed with 244 rehabilitation individuals to evaluate the internal construct validity, and the known-groups validity was confirmed by a comparison of the daily activity levels of 30 individuals with disabilities under rehabilitation to the HEC score.

RESULTS

The HEC was developed as a simple, 10-item checklist. The weighted kappa statistics ranged from 0.73 to 0.93, indicating excellent inter-rater reliability. Cronbach's alpha was 0.92, indicating high internal consistency. Rasch analysis with a testlet approach on 3 subscales demonstrated a good fit with the Rasch model (χ²=13.2, P=0.153), and the demonstrated unidimensionality and absence of differential item functioning supported the internal construct validity of the HEC. HEC scores were significantly different (P<.01) among individuals with disability and 3 levels of restrictions in their activities (no limitation, home-bound, and bed-bound), which demonstrates the known-groups validity of the HEC.

CONCLUSIONS

The HEC has good reliability and validity, which supports its utility in rehabilitation clinics.

Residing in sheltered housing versus ageing in place - Population characteristics, health status and social participation

Sheltered housing is a housing model that provides accessible apartments with elevated social possibilities for older people, which is expected to increase resident health and independence, reducing the need for care. As previous research on sheltered housing is scarce, the aim of this study was to explore the characteristics, health status and social participation of older people living in sheltered housing, compared to ageing in place. The study utilised baseline data from a matched cohort study survey on a nationally representative total population of residents in all sheltered housings in Sweden, and a matched control group (n = 3,805). The data collection took place between October 2016 and January 2017. The survey assessed functional capability using the Katz ADL and Lawton IADL scale, self-rated health using the EQ5D scale, and depressive mood using the GDS-4 scale. Descriptive statistics, frequencies, mean scores, independent t tests, p-values and effect sizes were utilised to compare the two groups. The results of the study show that older people living in sheltered housing, compared to ageing in place, had lower self-reported health (M = 64.68/70.08, p = <0.001), lower self-reported quality of life (M = 0.73/0.81, p = <0.001), lower functional status concerning activities of daily living (M = 5.19/5.40, p = <0.001), lower functional status concerning instrumental activities of daily living (M = 4.98/5.42 p = <0.001,), and higher probability of depressive mood (M = 0.80/0.58, p = <0.001). The results imply that residents in sheltered housing may have more care needs than those ageing in place. Further longitudinal comparative studies are needed to explore the impact residence in sheltered housing has on resident health and well-being.

Effects of environmental modification on activities of daily living, social participation and quality of life in the older adults: a meta-analysis of randomized controlled trials

Purpose: This study aims to provide evidence of the benefits and effects of environmental modification intervention on activities of daily living, quality of life and social participation in older adults.Methods: This study searched and used randomized controlled trial research studies from the databases of MEDLINE, CINAHL and the Cochrane Library. A systematic review and meta-analysis were conducted using the Jadad scale, risk of bias and the patient, intervention, comparison, outcome (PICO) process. The domains of impact considered in this meta-analysis were activities of daily living, quality of life and social participation. The analysis was completed with the Review Manager software 5.3.Results: Jadad scores of collected studies were 3-4 in seven studies and 2 in one study, which means that most studies had high levels of quality. This study comprised of 733 subjects in the experimental group and 672 subjects in the control group. The effect size of environmental interventions on basic activities of daily living, instrumental activities of daily living and overall activities of daily living were 0.37, 0.65 and 0.47, respectively. Meanwhile, the environmental intervention was neither effective on quality of life nor social participation.Conclusions: Environmental modifications are effective in facilitating the daily life activities of older adults. This kind of intervention is shown to be useful for enhancing life performance. In order to confirm intervention effects on the quality of life and social participation of older adults, studies should conduct environmental modifications interventions that take into account contexts such as individual characteristics, lifestyle and physical activities.Implications for rehabilitationEnvironmental modifications are effective in improving older adults' performance of daily activities (ADL).Appropriate environmental modification interventions should be considered before the quality of life (QoL) and levels of social participation of older adults decline.

Viewpoints of pedestrians with and without cognitive impairment on shared zones and zebra crossings

Background

Shared zones are characterised by an absence of traditional markers that segregate the road and footpath. Negotiation of a shared zone relies on an individual’s ability to perceive, assess and respond to environmental cues. This ability may be impacted by impairments in cognitive processing, which may lead to individuals experiencing increased anxiety when negotiating a shared zone.

Method

Q method was used in order to identify and explore the viewpoints of pedestrians, with and without cognitive impairments as they pertain to shared zones.

Results

Two viewpoints were revealed. Viewpoint one was defined by “confident users” while viewpoint two was defined by users who “know what [they] are doing but drivers might not”.

Discussion

Overall, participants in the study would not avoid shared zones. Pedestrians with intellectual disability were, however, not well represented by either viewpoint, suggesting that shared zones may pose a potential barrier to participation for this group.

Are the Domains Considered by ICF Comprehensive Enough to Conceptualize Participation in the Patient with Hand Injuries?

Background  Although participation is a core concept in multiple models of disability, there is no consensus on its definition. Objective  The aim of this study was to extract participation domains based on review of theories, available outcome measures, and interviews with experts and the person with hand injuries to compare with the ICF domains of participation. Methods  A qualitative approach using a deductive content analysis was employed to extend definitions of participation from theories. Later on, inductive qualitative method using semistructured interview with five experts in different fields and 30 patients with different hand injuries was used. Coding was performed with extracted domains from the content of data, and finally, the extracted domains were compared with the ICF domains of participation. Results  Some of the extracted domains were not considered in ICF. Conclusion  Subjective participation is the main forbearance part. Role, leisure, domestic life, environment, and others are also main missing meanings. This limitation can hinder measuring disability and health.

Retirement homes: Social participation and quality of life

Introduction

Social participation is considered as a means of improving one’s quality of life, thus the study aimed at assessing the association between the quality of life and social participation in the elderly.

Methods

This cross-sectional study was conducted in 2016. The study population was selected from among the residents of a retirement home (an elderly residential home) in one of the Northwestern provinces of Iran, and the required data was collected via three questionnaires related to the demographic data, the specific quality of life for the elderly (LEIPAD), and the extent of social participation. Data was analyzed using mean, standard deviation, Spearman correlation coefficient, Mann-Whitney, Chi-square and Kruskal-Wallis test in SPSS software.

Results

The social participation level of the population under study was estimated as being appropriate (mean score: 3.81±0.32); whereas, the respondents’ quality of life was estimated as being relatively inappropriate (mean score: 2.78±0.41). The “art, sport and leisure activities” subscale showed a significant relationship with the subscales related to the total quality of life and those of “Physical Performance” (r=0.128, p=0.46), “depression and anxiety”(r=0.114, p=0.051), “sexual performance”(r=0.213, p=0.21), and “life satisfaction”(r=0.272, p=0.11); furthermore, there was a significant relationship between total social participation and “life satisfaction” and the subscales related to “depression and anxiety”(r=0.263, p=0.12).

Conclusions

It seems that activities that involve the art, sport and leisure subscale of social participation can result in quality of life improvement for the elderly.

Combined Associations of Physical Activity and Sedentary Behavior With Depressive Symptoms in Older Adults

The aim of this study was to analyze the association of combined physical activity (PA)/sedentary behaviour (SB) with depressive symptoms (DS) in older adults. A cross-sectional study was conducted with 622 individuals ≥ 60 years old. After adjusting for gender, years of study, and monthly household income, prevalence ratios for presence of DS were statistically significant for older adults with <150 min/week in PA and ≥75th percentile of SB on weekdays (PR = 2.11,95%CI: 1.54-2.90) and on weekends (PR = 2.20,95%CI:1.57-3.09). Older adults who do not meet the PA guidelines and spend more time in SB on weekdays or weekend days are more likely to present with DS compared to those who meet the recommendations of PA and spend less time in SB during the day.

How does playing adapted sports affect quality of life of people with mobility limitations? Results from a mixed-method sequential explanatory study

BACKGROUND

Occupations, including physical activity, are a strong determinant of health. However, mobility limitations can restrict opportunities to perform these occupations, which may affect quality of life. Some people will turn to adapted sports to meet their need to be involved in occupations. Little is known, however, about how participation in adapted sports affects the quality of life of people with mobility limitations. This study thus aimed to explore the influence of adapted sports on quality of life in adult wheelchair users.

METHODS

A mixed-method sequential explanatory design was used, including a quantitative and a qualitative component with a clinical research design. A total of 34 wheelchair users aged 18 to 62, who regularly played adapted sports, completed the Quality of Life Index (/30). Their scores were compared to those obtained by people of similar age without limitations (general population). Ten of the wheelchair users also participated in individual semi-structured interviews exploring their perceptions regarding how sports-related experiences affected their quality of life.

RESULTS

The participants were 9 women and 25 men with paraplegia, the majority of whom worked and played an individual adapted sport (athletics, tennis or rugby) at the international or national level. People with mobility limitations who participated in adapted sports had a quality of life comparable to the group without limitations (21.9 ± 3.3 vs 22.3 ± 2.9 respectively), except for poorer family-related quality of life (21.0 ± 5.3 vs 24.1 ± 4.9 respectively). Based on the interviews, participants reported that the positive effect of adapted sports on the quality of life of people with mobility limitations operates mainly through the following: personal factors (behavior-related abilities and health), social participation (in general and through interpersonal relationships), and environmental factors (society's perceptions and support from the environment). Some contextual factors, such as resources and the accessibility of organizations and training facilities, are important and contributed indirectly to quality of life. Negative aspects, such as performance-related stress and injury, also have an effect.

CONCLUSIONS

People with mobility limitations playing adapted sports and people without limitations have a similar quality of life. Participation in adapted sports was identified as having positive effects on self-esteem, self-efficacy, sense of belonging, participation in meaningful activities, society's attitude towards people with mobility limitations, and physical well-being. However, participants stated that this involvement, especially at higher levels, had a negative impact on their social life.

Upper and lower limb functionality and body mass index in physically active older adults

Abstract Introduction: Aging leads to sarcopenia and functional capacity decline, compromising upper (UL) and lower limb (LL) performance of activities. Body mass index (BMI) is an important parameter for the assessment of health conditions in older adults, especially with regard to obesity, since it leads to functional limitations in terms of mobility and task performance. Objective: To investigate the potential association between UL and LL functionality and BMI in physically active older adults; and to characterize this population with regard to BMI and UL and LL functionality. Methods: The data were collected between August 2013 and April 2014. The sample comprised 371 physically active older adults. This study used secondary data from the program “PET Saúde IPA/SMS”. The program interviewed older adults living in areas comprised by the Third Family Health Unit of a neighborhood in Porto Alegre/RS. This paper used questions from the “Instrumento de Avaliação Multidimensional Rápida da Pessoa Idosa” (Instrument for Rapid Multidimensional Assessment of Elderly People, in English) that had to do with UL and LL functionality, weight, height and BMI. Results and Conclusion: There was no association between UL and LL functionality and BMI in physically active older adults. More than half of the sample was overweight. Most participants had functional UL and LL. While occupation, self-perception of health as “good” and “very good”, and physical activity were found to be associated with LL functionality; regular physical exercise was found to be associated with UL and LL functionality.

The impact of measures taken in the outdoor environment on an ageing population: a panel study over a ten-year period

For older people mobility and participation in activities can be restricted both by individual factors and by the environment. The aim of this paper was to examine the longitudinal impact of measures taken in the outdoor environment on an ageing population. The following factors were examined on three occasions over a nine-year period: frequency of walking; differences in report on environmental barriers; and reported valuation of the outdoor environment; and how these relate to different characteristics. At the second follow-up, the respondents experienced more functional limitations and more were using mobility devices than at baseline. At the first and second follow-up, the respondents did not experience as many environmental barriers in their outdoor environment compared to baseline. However, frequency of walking and evaluation of the outdoor environment decreased in general between baseline and first- and second follow-up. A quite promising result from the study is that compared to people not using mobility devices, mobility device users were more likely to be frequent walkers at first- and second follow-up than at baseline. Likewise, at second follow-up respondents having functional limitations were less likely to experience traffic barriers than at baseline. In terms of accessibility, usability and mobility for an ageing population, the results are promising, showing that measures in the outdoor environment can possibly facilitate walking for those who are more fragile, even in a longitudinal perspective.

Association between satisfaction and participation in everyday occupations after stroke

BACKGROUND

Within occupational therapy, it is assumed that individuals are satisfied when participating in everyday occupations that they want to do. However, there is little empirical evidence to show this.

AIMS

The aim of this study is to explore and describe the relation between satisfaction and participation in everyday occupations in a Swedish cohort, 5 years post stroke.

METHODS

Sixty-nine persons responded to the Occupational Gaps Questionnaire (OGQ). The questionnaire measures subjective restrictions in participation, i.e. the discrepancy between doing and wanting to do 30 different occupations in everyday life, and satisfaction per activity. Results were analysed with McNemar/chi-square.

RESULTS

Seventy percent of the persons perceived participation restrictions. Individuals that did not perceive restrictions in their participation had a significantly higher level of satisfaction (p = .002) compared to those that had restrictions. Participants that performed activities that they wanted to do report between 79 and 100% satisfaction per activity.

CONCLUSION

In this cohort, there was a significant association between satisfaction and participating in everyday occupations one wants to do, showing that satisfaction is an important aspect of participation and substantiates a basic assumption within occupational therapy. The complexity of measuring satisfaction and participation in everyday occupations is discussed.

Quality of life and related factors of nursing home residents in Singapore

Background

Litter is known about the well-being of nursing home (NH) residents in Singapore. This study aimed to identify predictors of self-reported quality of life (QOL) of NH residents in Singapore.

Methods

In face-to-face interviews, trained medical students assessed each consenting resident recruited from 6 local NHs using a modified Minnesota QOL questionnaire, and rating scales and questions assessing independence, cognitive function, depression, and communication. Predictors of residents’ QOL in five aspects (comfort, dignity, food enjoyment, autonomy, and security) were identified using the censored least absolute deviations (CLAD) models.

Results

A total of 375 residents completed the interviews. A higher score on comfort was negatively associated with major depression while a higher score on dignity was positively associated with no difficulty in communication with staff. Higher scores in food enjoyment were negatively associated with major depression and poorer cognitive function. Higher scores in autonomy were negatively associated with major depression, greater dependence, and difficulty in communication with staff. A higher score on security were negatively associated with major depression.

Conclusion

It appears that depression and difficulty in communication with staff are the two main modifiable risk factors of poor quality of life of local NH residents.

How to Find Lessons from the Public Health Literature: Example of a Scoping Study Protocol on the Neighborhood Environment

Background:

As key determinants of many favorable health and quality of life outcomes, it is important to identify factors associated with mobility and social participation. Although several investigations have been carried out on mobility, social participation and neighborhood environment, there is no clear integration of these results. This paper presents a scoping study protocol that aims to provide a comprehensive understanding of how the physical and social neighborhood environment is associated with or influences mobility and social participation in older adults.

Methods:

The rigorous methodological framework for scoping studies is used to synthesize and disseminate current knowledge on the associations or influence of the neighborhood environment on mobility and social participation in aging. Nine databases from public health and other fields are searched with 51 predetermined keywords. Using content analysis, all data are exhaustively analyzed, organized, and synthesized independently by two research assistants.

Discussion:

A comprehensive synthesis of empirical studies provides decision-makers, clinicians and researchers with current knowledge and best practices regarding neighborhood environments with a view to enhancing mobility and social participation. Such a synthesis represents an original contribution and can ultimately support decisions and development of innovative interventions and clear guidelines for the creation of age-supportive environments. Improvements in public health and clinical interventions might be the new innovation needed to foster health and quality of life for aging population. Finally, the aspects of the associations or influence of the neighborhood environment on mobility and social participation not covered by previous research are identified.

Conclusions:

Among factors that impact mobility and social participation, the neighborhood environment is important since interventions targeting it may have a greater impact on an individual's mobility and social participation than those targeting individual factors. Although investigations from various domains have been carried out on this topic, no clear integration of these results is available yet.

Community and social participation among adults with mobility impairments: A mixed methods study

BACKGROUND

Community and social participation is a complex phenomenon that is influenced by personal and environmental factors and is linked to a good quality of life and well-being. Individuals with mobility impairments are at risk of experiencing limitations in participating in community activities due to a wide range of factors.

OBJECTIVE

To understand community participation as defined by adults with mobility impairments and to examine relationships among factors that influence community participation.

METHODS

A mixed-methods study design was used. In-depth interviews of 13 adults with mobility impairments were conducted and themes related to community participation were identified. Data from the Americans' Changing Lives Survey were used to construct variables that mimic the themes from the qualitative phase and structural equation modeling was used to examine the relationships among those variables including community participation.

RESULTS

Individuals with mobility impairments identified health and function, neighborhood factors and self-efficacy as possible factors influencing participation in community activities. Findings from the SEM suggest a strong causal pathway between health and function and community and social participation. Neighborhood factors and health and function had a significant impact on self-efficacy, and a possible indirect effect through self-efficacy on community and social participation.

CONCLUSIONS

Our study provides new empirical evidence that health and function have a significant impact on community and social participation. Our quantitative findings did not support the direct influence of neighborhood factors in community and social participation, yet these factors may have an indirect role by influencing the self-efficacy of individuals with mobility impairments.

Promoting community readiness for physical activity among older adults in Germany--protocol of the ready to change intervention trial

Background

Healthy ageing is an important concern for many societies facing the challenge of an ageing population. Physical activity (PA) is a major contributor to healthy ageing; however insufficient PA levels are prevalent in old age in Germany. Community capacity building and community involvement are often recommended as key strategies to improve equitable access to prevention and health promotion. However, evidence for the effectiveness of these strategies is scarce. This study aims to assess the community readiness for PA promotion in local environments and to analyse the utility of strategies to increase community readiness for reaching vulnerable groups.

Methods/Design

We designed a mixed method intervention trial comprising three study modules. The first module includes an assessment of community readiness for PA interventions in older adults. The assessment is carried out in a sample of 24 municipalities in the Northwest of Germany using structured key informant interviews. In the second module, eight municipalities with the low community readiness are selected from the sample and randomly assigned to one of two study groups: active enhancement of community readiness (intervention) versus no enhancement (control). After enhancing community readiness in the active enhancement group, older adults in both study groups will be recruited for participation in a PA intervention. Participation rates are compared between the study groups to evaluate the effects of the intervention. In addition, a cost-effectiveness analysis is carried out calculating recruitment costs per person reached in the two study groups. In the third module, qualitative interviews are conducted with participants and non-participants of the PA intervention exploring reasons for participation or non-participation.

Discussion

This study offers the potential to contribute to the evidence base of reaching vulnerable older adults for PA interventions and provide ideas on how to reduce participation barriers. Its findings will inform governmental authorities, professionals, academics, and NGOs with an estimate of resources necessary to achieve equitable access to physical activity programs for vulnerable older adults.

Trial registration

German Clinical Trials Register DRKS00009564 (Date of registration 03-11-2015)

A systematic review of instruments for measuring outcomes in economic evaluation within aged care

BACKGROUND

This paper describes the methods and results of a systematic review to identify instruments used to measure quality of life outcomes in older people. The primary focus of the review was to identify instruments suitable for application with older people within economic evaluations conducted in the aged care sector.

METHODS

Online databases searched were PubMed, Medline, Scopus, and Web of Science, PsycInfo, CINAHL, Embase and Informit. Studies that met the following criteria were included: 1) study population exclusively above 65 years of age 2) measured health status, health related quality of life or quality of life outcomes more broadly through use of an instrument developed for this purpose, 3) used a generic preference based instrument or an older person specific preference based or non-preference based instrument or both, and 4) published in journals in the English language after 2000.

RESULTS

The most commonly applied generic preference based instrument in both the community and residential aged care context was the EuroQol - 5 Dimensions (EQ-5D), followed by the Adult Social Care Outcomes Toolkit (ASCOT) and the Health Utilities Index (HUI2/3). The most widely applied older person specific instrument was the ICEpop CAPability measure for Older people (ICECAP-O) in both community and residential aged care.

CONCLUSION

In the absence of an ideal instrument for incorporating into economic evaluations in the aged care sector, this review recommends the use of a generic preference based measure of health related quality of life such as the EQ-5D to obtain quality adjusted life years, in combination with an instrument that has a broader quality of life focus like the ASCOT, which was designed specifically for evaluating interventions in social care or the ICECAP-O, a capability measure for older people.

Very low neighbourhood income limits participation post stroke: preliminary evidence from a cohort study

BACKGROUND

Neighbourhood income level is associated with the incidence of stroke and stroke-related mortality. It has also been linked to receipt of appropriate services, post discharge motor recovery and functional status following a stroke. We examined the impact of neighbourhood income on participation among community-dwelling stroke survivors during the two years following the stroke.

METHODS

Secondary analysis of data from a prospective cohort study. Participants were 67 individuals who were treated in acute care or rehabilitation following a first ever stroke, and were discharged to the community with FIM™ scores of at least 3 for comprehension, memory and problem solving. On this functional independence measure, these scores indicate that assistance is needed with related tasks up to 50 % of the time. Participation at 6, 9, 12, 18 and 24-months post stroke was measured using the Reintegration to Normal Living Index (RNLI). Income was measured by median neighbourhood annual family income according to postal code. The impact of very low neighbourhood income (median family income $20,000 Cdn or less) on participation at each follow-up period was determined controlling for potential confounders.

RESULTS

Six (9.0 %) of the participants lived in very low-income neighbourhoods. These participants had average RNLI scores approximately 25 % lower at each follow-up period. While there was a trend for increasing participation with time among those in higher income neighbourhoods, this was not seen among very low-income neighbourhood participants. Very low me neighbourhood income had an independent effect on participation after controlling for discharge FIM™, 2-min walk test, gender, self-rated health, age, and emotional well-being at all follow-up periods.

CONCLUSIONS

Our results indicate that very low neighbourhood income is linked with decreased participation during the first two years following stroke. Our findings indicate the need for further investigation of this relationship, and the importance of close follow-up of stroke survivors living in very low-income contexts.

Importance of proximity to resources, social support, transportation and neighborhood security for mobility and social participation in older adults: results from a scoping study

BACKGROUND

Since mobility and social participation are key determinants of health and quality of life, it is important to identify factors associated with them. Although several investigations have been conducted on the neighborhood environment, mobility and social participation, there is no clear integration of the results. This study aimed to provide a comprehensive understanding regarding how the neighborhood environment is associated with mobility and social participation in older adults.

METHODS

A rigorous methodological scoping study framework was used to search nine databases from different fields with fifty-one keywords. Data were exhaustively analyzed, organized and synthesized according to the International Classification of Functioning, Disability and Health (ICF) by two research assistants following PRISMA guidelines, and results were validated with knowledge users.

RESULTS

The majority of the 50 selected articles report results of cross-sectional studies (29; 58%), mainly conducted in the US (24; 48%) or Canada (15; 30%). Studies mostly focused on neighborhood environment associations with mobility (39; 78%), social participation (19; 38%), and occasionally both (11; 22%). Neighborhood attributes considered were mainly 'Pro ducts and technology' (43; 86) and 'Services, systems and policies' (37; 74%), but also 'Natural and human-made changes' (27; 54%) and 'Support and relationships' (21; 42%). Mobility and social participation were both positively associated with Proximity to resources and recreational facilities, Social support, Having a car or driver's license, Public transportation and Neighborhood security, and negatively associated with Poor user-friendliness of the walking environment and Neighborhood insecurity. Attributes of the neighborhood environment not covered by previous research on mobility and social participation mainly concerned 'Attitudes', and 'Services, systems and policies'.

CONCLUSION

Results from this comprehensive synthesis of empirical studies on associations of the neighborhood environment with mobility and social participation will ultimately support best practices, decisions and the development of innovative inclusive public health interventions including clear guidelines for the creation of age-supportive environments. To foster mobility and social participation, these interventions must consider Proximity to resources and to recreational facilities, Social support, Transportation, Neighborhood security and User-friendliness of the walking environment. Future studies should include both mobility and social participation, and investigate how they are associated with 'Attitudes', and 'Services, systems and policies' in older adults, including disadvantaged older adults.

Translation, cultural adaptation and validation of the kidney disease quality of life-short form 1.3 in an African country

BACKGROUND

The impact of dialysis on patient quality of life has been recognized as an important outcome measure. The Dialysis Outcomes and Practice Patterns Study compared quality of life in 4 continents [1], but very scarce information is available about dialysis patients' quality of life in Africa. The objective of this study was to translate the Kidney Disease Quality of Life-Short Form (KDQOL-SF) into Moroccan and measure its psychometric properties.

METHODS

The questionnaire was first translated into Moroccan by 2 independent translators, and then 2 backward translations into English were performed after pretesting in 10 dialysis patients. The final questionnaire was then administered to 80 dialysis patients. Reliability was estimated by internal consistency and test-retest reliability. Validity was assessed using known group comparisons and correlations between overall health rating and scales scores.

RESULTS

Some activities were substituted since they were not common in Morocco. All subscales had a Cronbach α above the recommended value except for 3 scales. All of the items showed good test-retest reliability. Correlation of items within subscales was higher than that of items outside subscales in 87% of cases. Regarding construct validity, all KDQOL-SF scales had significant correlation with overall health rating except for sexual function and dialysis staff encouragement. Furthermore, the questionnaire could be used to discriminate between subgroups of the patients.

CONCLUSIONS

The psychometric properties of the KDQOL-SF resulting from this first-time administration of the instrument support the validity and reliability of the KDQOL-SF as a measure of quality of life of patients having hemodialysis in Morocco.

Associations between environmental characteristics and life-space mobility in community-dwelling older people

OBJECTIVE

To examine the association between perceived environmental barriers to and facilitators for outdoor mobility with life-space among older people.

METHODS

Community-dwelling, 75- to 90-year-old people (n = 848) were interviewed face-to-face using standard questionnaires. The Life-Space Assessment (LSA), indicating distance and frequency of moving and assistance needed in moving (range 0-120), was used. Environmental barriers and facilitators outdoors were self-reported.

RESULTS

Altogether, 41% (n = 348) of the participants had restricted life-space (LSA score < 60). Those reporting one or more environmental barriers had more than double the odds for restricted life-space compared with those reporting no barriers after adjustments for ill health, functioning, and socioeconomic status (SES) differences. Similarly, those reporting four to seven facilitators had lower odds for restricted life-space compared with those reporting three or fewer facilitators.

DISCUSSION

Perceptions of one's environment may either constrain or extend older people's life-space. Longitudinal studies are needed to study the causality of the findings.

Influence of the environment on participation in social roles for young adults with down syndrome

Background

The concept of disability is now understood as a result of the interaction between the individual, features related to impairment, and the physical and social environment. It is important to understand these environmental influences and how they affect social participation. The purpose of this study is to describe the social participation of young adults with Down syndrome and examine its relationship with the physical and social environment.

Methods

Families ascertained from the Down syndrome ‘Needs Opinion Wishes’ database completed questionnaires during 2011. The questionnaires contained two parts, young person characteristics and family characteristics. Young adults’ social participation was measured using the Assessment of Life Habits (LIFE-H) and the influences of environmental factors were measured by the Measure of the Quality of the Environment (MQE). The analysis involved descriptive statistics and linear and logistic regression.

Results

Overall, participation in daily activities was higher (mean 6.45) than in social roles (mean 5.17) (range 0 to 9). When the physical and/or social environment was reported as a facilitator, compared to being no influence or a barrier, participation in social roles was greater (coef 0.89, 95%CI 0.28, 1.52, coef 0.83, 95%CI 0.17, 1.49, respectively). The relationships between participation and both the physical (coef 0.60, 95% CI −0.40, 1.24) and social (coef 0.20, 95%CI −0.47, 0.87) environments were reduced when age, gender, behavior and functioning in ADL were taken into account.

Conclusion

We found that young adults’ participation in social roles was influenced more by the physical environment than by the social environment, providing a potentially modifiable avenue for intervention.

Perceived environmental barriers to outdoor mobility and feelings of loneliness among community-dwelling older people

BACKGROUND

We examined the association between perceived environmental barriers to outdoor mobility and loneliness among community-dwelling older people. In addition, we studied whether walking difficulties and autonomy in participation outdoors affected this association.

METHODS

Cross-sectional analyses of face-to-face home interview data with 848 people aged 75-90 years (mean age: 80.1 years; 62% women) gathered within the "Life-Space Mobility in Old Age" (LISPE) project. Self-reports of loneliness, environmental barriers to outdoor mobility, and difficulties in walking 2 km were obtained with structured questionnaires. Autonomy in participation outdoors was assessed with the "Impact on Participation and Autonomy" questionnaire.

RESULTS

Altogether, 28% of participants reported experiencing loneliness sometimes or often. These participants also reported more difficulties in walking 2 km, restricted autonomy in participation outdoors, and more environmental barriers to outdoor mobility than people not experiencing loneliness. Snowy and icy winter conditions (odds ratio: 1.59 [95% confidence interval: 1.15-2.20]), long distances to services (odds ratio: 1.57 [1.00-2.46]), and hills in the nearby environment (odds ratio: 1.49 [1.05-2.12]) significantly increased the odds for loneliness, even after adjustments for walking difficulties, autonomy in participation outdoors, perceived financial situation, living alone, and health. Path modeling revealed that environmental barriers increased loneliness either through direct association or indirectly through restricted autonomy in participation outdoors.

CONCLUSIONS

Prospective studies should investigate whether removing environmental barriers to outdoor mobility improves autonomy in participation outdoors and alleviates loneliness among older people.

Activity engagement of aging retirees in South Korea

[Purpose] The purpose of this study was to analyze the activity engagement of the retiree population in South Korea. [Methods] The Korean-Activity Card Sort (K-ACS) was used to collect research data. A One-way ANOVA and post-hoc comparisons showed significant group effects among three age groups. The independent t-tests was used to analyze the differences in mean retained level of activity (MRA) between men and women. [Results] The one-way ANOVA showed statistically significant differences in MRA among different age groups. Scheffé’s test revealed a statistically significant decrease in MRA in Group A, aged more than 75 years, as compared to the other two age groups. When participants were divided by gender, MRA of instrumental activities showed a statistically significant difference between the 65–74 years group and the 55–65 years group, but no difference in females of the leisure activities among the age groups. The independent t-tests demonstrated significant gender differences in MRA of activity of the 55–64 years group. [Conclusion] These findings suggest that health professionals should monitor the changes in retained level of activity after age 75, to maintain their engagement, and the importance of age-, gender- and activity-specific analyses in order to identifying patterns of activity engagement.

Social Participation after Stroke: One-Year Follow-Up of Stroke Survivors in Nigeria

Background. Stroke may negatively affect social participation in survivors. Aims. This study assessed the pattern of social participation in a sample of Nigerian stroke survivors across the first 12 months after stroke. Methods. Stroke survivors were consecutively recruited while on admission at a tertiary health institution. The London handicap scale was used to assess social participation at 1, 3, 6, 9, and 12 months at the homes of the stroke survivors. Overall and domain-specific patterns of social participation were examined independently and also in relation to initial stroke severity. Results. Overall social participation significantly improved over 12 months (), while significant improvements were observed only in the mobility, physical independence, and work and leisure domains at P equals 0.04, 0.04, and 0.05, respectively. In spite of the improvement in the work and leisure domain, the domain recorded the lowest level of participation. Social participation also differed by initial stroke severity with severe stroke survivors having the lowest level of participation across 12 months after stroke. Conclusions. The poor outcome in the work and leisure domain of social participation and in individuals with initial severe stroke has implications for planning and provision of appropriate long-term stroke rehabilitation.

The influence of the practice of physical activity on the quality of life, muscle strength, balance, and physical ability in the elderly

INTRODUCTION: Ageing has become a huge public health challenge due to the need to find solutions for improving quality of life. OBJECTIVE: This study aimed to assess quality of life, muscle strength, balance and physical capacity among elderly practitioners and non-practitioners of physical activity. MATERIALS AND METHODS: An observational, cross-sectional study was carried out involving 74 elderly individuals in the city of Santos (state of São Paulo, Brazil), divided into two groups: practitioners and non-practitioners of physical activity. The International Physical Activity Questionnaire was used for the classification of the participants. The generic SF-36 questionnaire was used to assess quality of life. The Berg scale was used for the analysis of balance. Dynamometry was used for the muscle strength test. The six-minute walk test was used for the assessment of physical capacity. RESULTS: Significant differences were found between elderly practitioners and non-practitioners of physical activity regarding quality of life (p = 0.001), muscle strength (p = 0.001), balance (p = 0.001) and physical capacity (p = 0.001). The data also showed that aspects of quality of life were strongly correlated with physical capacity among the non-practitioners of physical activity (r = 0.741). CONCLUSION: Elderly individuals in the city of Santos (Brazil) who practice physical activity have better quality of life, muscle strength, physical capacity and balance in comparison to those who do not practice physical activity.