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Seaton L, Brown T. The Relationship between Body Function and Structure Factors and the Activity-Participation of Healthy Community-Dwelling Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2018. [DOI: 10.1080/02703181.2018.1443193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Linda Seaton
- Occupational Science and Therapy Program, School of Health and Social Development, Faculty of Health, Deakin University – Waterfront Campus, Geelong, Victoria, Australia
| | - Ted Brown
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University – Peninsula Campus, Frankston, Victoria, Australia
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Sakakibara BM, Routhier F, Miller WC. Wheeled-mobility correlates of life-space and social participation in adult manual wheelchair users aged 50 and older. Disabil Rehabil Assist Technol 2017; 12:592-598. [PMID: 27377171 PMCID: PMC5503677 DOI: 10.1080/17483107.2016.1198434] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To characterize the life-space mobility and social participation of manual wheelchair users using objective measures of wheeled mobility. METHOD Individuals (n = 49) were included in this cross-sectional study if they were aged 50 or older, community-dwelling and used their wheelchair on a daily basis for the past 6 months. Life-space mobility and social participation were measured using the life-space assessment and late-life disability instrument. The wheeled mobility variables (distance travelled, occupancy time, number of bouts) were captured using a custom-built data logger. RESULTS After controlling for age and sex, multivariate regression analyses revealed that the wheeled mobility variables accounted for 24% of the life-space variance. The number of bouts variable, however, did not account for any appreciable variance above and beyond the occupancy time and distance travelled. Occupancy time and number of bouts were significant predictors of social participation and accounted for 23% of the variance after controlling for age and sex. CONCLUSIONS Occupancy time and distance travelled are statistically significant predictors of life-space mobility. Lower occupancy time may be an indicative of travel to more distant life-spaces, whereas the distance travelled is likely a better reflection of mobility within each life-space. Occupancy time and number of bouts are significant predictors of participation frequency. Implications for rehabilitation Component measures of wheelchair mobility, such as distance travelled, occupancy time and number of bouts, are important predictors of life-space mobility and social participation in adult manual wheelchair users. Lower occupancy time is an indication of travel to more distant life-spaces, whereas distance travelled is likely a better reflection of mobility within each life-space. That lower occupancy time and greater number of bouts are associated with more frequent participation raises accessibility and safety issues for manual wheelchair users.
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Affiliation(s)
- Brodie M Sakakibara
- a Faculty of Health Sciences , Simon Fraser University , Burnaby , BC , Canada
- b Rehabilitation Research Program , GF Strong Rehabilitation Centre, Vancouver Coastal Health Research Institute , Vancouver , BC , Canada
| | - François Routhier
- c Department of Rehabilitation , Université Laval , Quebec City , QC , Canada
- d Center for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Institut de réadaptation en déficience physique de Québec , Quebec City , QC , Canada
| | - William C Miller
- b Rehabilitation Research Program , GF Strong Rehabilitation Centre, Vancouver Coastal Health Research Institute , Vancouver , BC , Canada
- e Department of Occupational Science and Occupational Therapy , University of British Columbia , Vancouver , BC , Canada
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Liu JYW. The severity and associated factors of participation restriction among community-dwelling frail older people: an application of the International Classification of Functioning, Disability and Health (WHO-ICF). BMC Geriatr 2017; 17:43. [PMID: 28143597 PMCID: PMC5286833 DOI: 10.1186/s12877-017-0422-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 01/13/2017] [Indexed: 11/21/2022] Open
Abstract
Background The International Classification of Functioning, Disability, and Health (WHO-ICF) describes participation restriction as one aspect of disability. Participation restriction refers to health problems that can hinder people’s involvement in different life events. It is rational to believe that the prevalence of participation restriction increases among a frail population. However, information about the level of participation restriction among older people, particularly the pre-frail or frail, remains scant. The aim of this study was to identify the prevalence and underlying risk factors associated with participation restriction among community-dwelling frail and pre-frail older people. Methods A cross-section of 299 community-dwelling frail older people with a mean age of 79.5 participated in this study. They had to have been identified as being either pre-frail or frail based on the five common characteristics of the frailty phenotype. Their level of participation restriction was assessed based on the Chinese Reintegration to Nursing Living Index (C-RNLI). All other independent variables were identified and systematically linked to different components in the WHO-ICF framework. Results Among all participants, 207 (69.2%) were identified as encountering participation restrictions in at least one aspect of their life, with a mean C-RNLI score of 68.3 (SD 19.43). A multivariate regression analysis showed that the participants’ status of frailty, self-perceived social status, level of exhibited depressive mood, sleep quality, mobility, level of fear of falling, and physical activity levels had a significant association with participation restriction. When all of the variables, regardless of significance, were included, the factors together explained 67.1% of the variance in the participants’ participation restriction. Conclusion Participation restriction was prevalent among community-dwelling frail older people and was associated with factors across different components in the WHO-ICF. This finding supports the view that participation restriction is multifactorial in nature.
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Affiliation(s)
- Justina Yat Wa Liu
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
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Willie-Tyndale D, Holder-Nevins D, Mitchell-Fearon K, James K, Laws H, Waldron NK, Eldemire-Shearer D. Participation in Social Activities and the Association with Socio-Demographic and Health-Related Factors among Community-Dwelling Older Adults in Jamaica. J Cross Cult Gerontol 2016; 31:427-447. [DOI: 10.1007/s10823-016-9297-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Auger C, Miller WC, Jutai JW, Tamblyn R. Development and feasibility of an automated call monitoring intervention for older wheelchair users: the MOvIT project. BMC Health Serv Res 2015; 15:386. [PMID: 26376853 PMCID: PMC4572692 DOI: 10.1186/s12913-015-1048-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 09/07/2015] [Indexed: 11/15/2022] Open
Abstract
Background Recent advances in wheeled mobility technology are multiplying opportunities for community integration and improved quality of life. The mobility needs of older wheelchair users are particularly complex due to a constellation of chronic conditions and comorbidities that may compromise optimal use of the device. The purpose of the Mobility Outcomes via Information Technologies (MOvIT) project is to examine the feasibility of automated calls for the systematic monitoring for adverse outcomes associated with wheelchair use. Methods A two-phase mixed methods approach was used. Phase I involved user-centered development and face validation of a monitoring questionnaire with end-users (seven wheelchair users and five healthcare providers). Phase II tested the feasibility of monitoring outcomes using automated calls to administer the MOvIT questionnaire 1 and 3 months after wheelchair delivery with a prospective cohort of older adults (50–84 years of age). When problems were identified, the computer monitoring system notified a clinical coordinator who followed up with respondents requiring interventions. Feasibility data were extracted from the web database and from individual interviews covering perceived ease of use, usefulness and intention to use the MOvIT questionnaire in the future. Results The MOvIT monitoring questionnaire developed in phase I tracks nine potential wheelchair-related adverse outcomes considered important for end-users: 1) non-use of wheelchair, 2) pain, 3) skin condition, 4) positioning, 5) wheelchair incidents, 6) psychosocial issues, 7) restricted wheelchair participation, 8) limited wheelchair skills and knowledge, and 9) technical problems. In phase II, 92 individuals who received a wheelchair were eligible, 71 out of 92 accepted (77 %) and 65 out of 71 (92 %) completed the 3-month follow-up. In the sample of 65 participants, a wheelchair-related adverse outcome was confirmed by a rehabilitation professional for 58.5 %, and at least one recommendation was given to 66.2 % during the 3-month monitoring period. A majority of participants found the intervention useful (82.8 %) and said they intended to use the MOvIT monitoring questionnaire in the future (81.5 %). Participants made suggestions to make the calls more adaptive to various ability profiles. Conclusions Automated calls tailored for individuals with mobility limitations and associated comorbidities are a promising approach to reach clients who need post-rehabilitation support.
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Affiliation(s)
- Claudine Auger
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal and School of Rehabilitation, Université de Montréal, C.P. 6128, succursale Centre-ville, Montreal, QC, H3C 3J7, Canada.
| | - William C Miller
- GF Strong Rehabilitation Center and Graduate Program in Rehabilitation Sciences, Department of Occupational Science & Occupational Therapy, University of British Columbia, T325-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.
| | - Jeffrey W Jutai
- Bruyère Research Institute and Interdisciplinary School of Health Sciences, University of Ottawa, 25 University Private, Ottawa, ON, K1N 6N5, Canada.
| | - Robyn Tamblyn
- Clinical and Health Informatics Research Group, Department of Medicine, and Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, 1140 Pine Avenue West, Montreal, QC, H3A 1A3, Canada.
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Elderly benzodiazepine users at increased risk of activity limitations: influence of chronicity, indications, and duration of action--the three-city cohort. Am J Geriatr Psychiatry 2015; 23:840-51. [PMID: 25500117 DOI: 10.1016/j.jagp.2014.10.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 10/15/2014] [Accepted: 10/28/2014] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To examine the cross-sectional and longitudinal associations between benzodiazepine use and daily activity limitations, according to drug indications and duration of action. DESIGN Prospective cohort study. SETTING Population-based three-city study. PARTICIPANTS 6,600 participants aged 65 years and over included between 1999 and 2001 and followed after 2, 4, and 7 years. MEASUREMENTS Benzodiazepine users were separated into hypnotic, short-acting anxiolytic, and long-acting anxiolytic users and compared with non users. Three outcomes were examined assessing restrictions in mobility, instrumental activities of daily living (IADLs) and social participation. RESULTS In multivariate simple or mixed logistic models adjusted for sociodemographic variables, impairments and comorbidity, and for anxiety, insomnia, and depression, hypnotic benzodiazepines were moderately associated with mobility limitation prevalence and IADL limitation incidence. Short-acting and long-acting anxiolytics were associated with IADL limitation prevalence and with mobility limitation prevalence and incidence and long-acting anxiolytics were also associated with IADL limitation incidence. Chronic benzodiazepines users were at a marked risk of developing restrictions for the three outcomes; odds ratio: 1.71 (95% CI: 1.23-2.39) for mobility, 1.54 (95% CI: 1.14-2.10) for IADL, and 1.74 (95% CI: 1.23-2.47) for participation limitations. CONCLUSIONS Benzodiazepine users are at increased risk of activity limitations regardless of the duration of action or indication. Chronic use of benzodiazepines should be avoided in order to extend disability-free survival.
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Fairhall N, Sherrington C, Cameron ID, Blyth F, Naganathan V, Clemson L, Le Couteur D, Handelsman DJ, Waite L, Cumming RG. Predicting participation restriction in community-dwelling older men: the Concord Health and Ageing in Men Project. Age Ageing 2014; 43:31-7. [PMID: 23927887 DOI: 10.1093/ageing/aft111] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND participation restriction, defined as 'problems an individual may experience in involvement in life situations' (e.g. work and leisure), reflects difficulty functioning at a societal level and is a key component of disability. Our objective was to describe changes in participation in older men over a 2-year period and to identify baseline variables associated with participation and change in participation over the 2-year period. METHODS one thousand and three hundred and twenty-seven community-dwelling men aged 70 years or over who completed the baseline and 2-year follow-up phases of the Concord Health and Ageing in Men Project, a population-based cohort study in Sydney, Australia, were studied. Participation restriction and a range of other variables were measured using self-report and performance measures. Regression analyses were conducted to examine factors associated with participation and change in participation. RESULTS over the 2-year period, participation in life roles deteriorated in 47.3% (627/1,327) of men, stayed the same in 20.7% (275/1,327) and improved in the remainder (32.0%). Overall, there was a significant deterioration in participation (P < 0.001). Reduced participation at 2-year follow-up was significantly associated with the following baseline factors: age, more comorbidities, mild cognitive impairment or dementia, lower mood, weakness, slower gait, worse activities of daily living performance, driving and baseline participation score. These variables explained 56% of the variance in participation at 2 years. CONCLUSION participation in life roles worsened over a 2-year period in some community-dwelling older men. A number of associated factors were identified, which may provide targets for intervention to improve participation among older men.
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Affiliation(s)
- Nicola Fairhall
- Musculoskeletal Division, The George Institute for Global Health, PO Box M201 Missenden Road, Sydney, NSW 2050, Australia
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Riddle DL, Perera RA, Stratford PW, Jiranek WA, Dumenci L. Progressing Toward, and Recovering From, Knee Replacement Surgery: A Five-Year Cohort Study. ACTA ACUST UNITED AC 2013; 65:3304-13. [DOI: 10.1002/art.38139] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 08/13/2013] [Indexed: 12/29/2022]
Affiliation(s)
| | | | - Paul W. Stratford
- McMaster University; Hamilton, Ontario Canada
- Sunnybrook Health Sciences Centre; Toronto, Ontario Canada
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Fiorilli G, Iuliano E, Aquino G, Battaglia C, Giombini A, Calcagno G, di Cagno A. Mental health and social participation skills of wheelchair basketball players: a controlled study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:3679-3685. [PMID: 24012595 DOI: 10.1016/j.ridd.2013.08.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 08/11/2013] [Accepted: 08/14/2013] [Indexed: 06/02/2023]
Abstract
The aim of this study was to assess differences in psychological well-being, symptomatic psychological disorders and social participation, between competitive wheelchair basketball participants and those non-participants. Forty-six wheelchair participants, 24 Basketball players (aged 35.60 ± 7.56) and 22 non-players (aged 36.20 ± 6.23), completed three validated self-report questionnaires: Participation Scale (PS), Psychological Well-Being Scale [PWBS] and Symptom Checklist 90 R [SCL-90-R]. ANOVA showed significant overall differences between the two groups. The social restriction score, evaluated by PS, was significantly higher in the non-basketball participants (p=0.00001) than the basketball participants. The PWB Scale showed significant differences in all 6 dimensions: positive relations with others, environmental mastery, personal growth, purpose in life and self-acceptance (p<0.01), and autonomy (p<0.05), with better scores in the basketball participants. The SCL-90-R scores were significantly lower for the basketball group in the following 6 symptomatic dimensions: depression, phobic anxiety, and sleep disorder (p<0.01), somatization, interpersonal sensitivity and psychoticism (with p<0.05). It was concluded that competitive wheelchair basketball participants showed better psychological well-being and social skills than those non-participants.
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Affiliation(s)
- Giovanni Fiorilli
- Department of Medicine and Health Science, University of Molise, 86100 Campobasso, Italy.
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Hermsen LAH, Terwee CB, Leone SS, van der Zwaard B, Smalbrugge M, Dekker J, van der Horst HE, Wilkie R. Social participation in older adults with joint pain and comorbidity; testing the measurement properties of the Dutch Keele Assessment of Participation. BMJ Open 2013; 3:e003181. [PMID: 23975101 PMCID: PMC3753519 DOI: 10.1136/bmjopen-2013-003181] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The Keele Assessment of Participation (KAP) questionnaire measures person-perceived participation in 11 aspects of life. Participation allows fulfilment of valued life activities and social roles, which are important to older adults. Since we aimed to use the KAP in a larger Dutch cohort, we examined the measurement properties of KAP in a Dutch sample of older adults with joint pain and comorbidity. DESIGN Cohort study. SETTING A community-based sample in Amsterdam, the Netherlands and North Staffordshire, UK. PARTICIPANTS Participants were aged 65 years and over, had at least two chronic diseases (identified through general practice consultation) and reported joint pain on most days (questionnaire). The Dutch cohort provided baseline data (n=407), follow-up data at 6 months (n=364) and test-retest data 2 weeks after 6 months (n=122). The UK cohort provided comparable data (n=404). OUTCOME MEASURES The primary outcome was person-perceived participation, as measured with the KAP. The measurement properties examined were the following: structural validity (factor analysis), internal consistency (Cronbach's α), reliability (intraclass correlation coefficients; ICC), construct validity (hypothesis testing), responsiveness (hypothesis testing and area under the curve) and cross-cultural validity (differential item functioning; DIF). RESULTS Factor analysis revealed two domains: KAPd1: 'participation in basic activities' and KAPd2: 'participation in complex activities', with Cronbach's α of 0.74 and 0.57 and moderate test-retest reliability: ICC of 0.63 and 0.57, respectively. Further analyses of KAPd1 showed poor construct validity and responsiveness. Despite the uniform DIF in item 'interpersonal relations', the total KAPd1 score seemed comparable between the Dutch and UK sample. CONCLUSIONS Only KAP domain 'participation in basic activities' showed good internal consistency and sufficient reliability. KAPd2 lacks sufficient measurement properties for application in studies, although items may be used as single items. Further development of the concept 'participation' may help the development and validation of instruments to measure participation.
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Affiliation(s)
- Lotte A H Hermsen
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Stephanie S Leone
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Babette van der Zwaard
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Martin Smalbrugge
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Joost Dekker
- Department of Rehabilitation Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Henriëtte E van der Horst
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Ross Wilkie
- Arthritis Research UK Primary Care Centre, Keele University, Staffordshire, UK
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Abstract
BACKGROUND This paper identifies core elements in principal definitions of elder abuse or mistreatment of older adults (EA/MOA) and discusses the relevance of four crucial concepts: age, vulnerability, trust, and power balance in relationships. METHOD A critical analysis of selected literature in EA/MOA with a focus on works from the last 10 years. RESULTS Current definitions of EA/MOA share commonalities regarding an understanding of elder abuse as a status offence, the inclusion of both acts and omissions, and the consideration of multiple levels of behavior and its effects. Definitions differ with regard to aspects as crucial as the intentionality of an abusive action and its actual or potential harmful effects. EA/MOA can be considered as a complex subtype of victimization in later life limited to victim-perpetrator relationships, where the perpetrator has assumed responsibility for the victim, the victim puts trust in the offender, or the role assigned to the offending person creates the perception and expectation that the victim may trust the perpetrator. Vulnerability is identified as a key variable in EA/MOA theory and research. With regard to neglect, the mere possibility of being neglected presupposes a heightened level of vulnerability. Power imbalance often characterizes victim - perpetrator relationships but is not a necessary characteristic of abuse. CONCLUSION Research on EA/MOA needs conceptual development. Confining phenomena of EA/MOA to specific relationships and tying them to notions of vulnerability has implications for research design and sampling and points to the limits of population-based victimization surveys.
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Theis KA, Murphy L, Hootman JM, Wilkie R. Social participation restriction among US adults with arthritis: a population-based study using the International Classification of Functioning, Disability and Health. Arthritis Care Res (Hoboken) 2013; 65:1059-69. [PMID: 23401463 PMCID: PMC4466902 DOI: 10.1002/acr.21977] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 01/29/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine arthritis impact among US adults with self-reported doctor-diagnosed arthritis using the International Classification of Functioning, Disability and Health (ICF) framework (including the impairments, activity limitations, environmental, and personal factors domains and social participation restriction [SPR] as the outcome) overall and among those with and without SPR, and to identify the correlates of SPR. METHODS Cross-sectional 2009 National Health Interview Survey data were analyzed to examine the distribution of the ICF domain components. Unadjusted and multivariable-adjusted prevalence ratios (PRs) and 95% confidence intervals (95% CIs) were estimated to identify the correlates of SPR. Analyses using SAS, version 9.2 survey procedures accounted for the complex sample design. RESULTS SPR prevalence was 11% of adults with arthritis (5.7 million). After initial multivariable adjustment by ICF domain, serious psychological distress (impairments domain; PR 2.5 [95% CI 2.0-3.2]), ≥5 medical office visits (environmental domain; PR 3.4 [95% CI 2.5-4.4]), and physical inactivity (personal domain; PR 4.8 [95% CI 3.6-6.4]) were most strongly associated with SPR. A combined measure (key limitations [walking, standing, or carrying]; PR 31.2 [95% CI 22.3-43.5]) represented the activity limitations domain. After final multivariable adjustment incorporating all ICF domains simultaneously, the strongest associations with SPR were key limitations (PR 24.3 [95% CI 16.8-35.1]), ≥9 hours of sleep (PR 1.6 [95% CI 1.3-2.0]), and income-to-poverty ratio <2.00 and severe joint pain (PR 1.4 [95% CI 1.2-1.6] for both). CONCLUSION SPR affects 1 of 9 adults with arthritis. This study is the first to use the ICF framework in a population-based sample to identify specific functional activities, pain, sleep, and other areas as priorities for intervention to reduce negative arthritis impacts on disability, including SPR. Increased use of existing clinical and public health interventions is warranted.
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Affiliation(s)
- K A Theis
- Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
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Wilkie R, Blagojevic-Bucknall M, Jordan KP, Pransky G. Onset of work restriction in employed adults with lower limb joint pain: individual factors and area-level socioeconomic conditions. JOURNAL OF OCCUPATIONAL REHABILITATION 2013; 23:180-8. [PMID: 23653176 PMCID: PMC3666192 DOI: 10.1007/s10926-013-9443-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
PURPOSE To examine individual and area-level socioeconomic factors that predict the onset of work restriction in employed persons with lower limb joint pain. METHODS Population-based prospective cohort study. Adults were aged 50-59, reported hip, knee, foot pain or a combination and maintained employment through 3 year follow-up (n = 716). Work restriction was measured as inability to participate in work as desired. Multi-level logistic regression was used to assess the associations of work restriction onset with baseline factors: health (severity of knee pain/functional limitation, comorbidity, anxiety, depression, cognitive impairment, abnormal weight), demographic socio-economic, environment and area-level employment deprivation. RESULTS 108 (15.1 %) reported the onset of work restriction over 3 years. Severe lower limb joint pain and functional limitation, number of affected body sites and area employment deprivation were independently associated with onset. Significant interactions indicated a greater effect of area employment deprivation on older and more depressed workers. CONCLUSIONS Results suggest that effectively preventing work disability in those with OA will require both condition-specific interventions to decrease pain and maintain function, and providing alternative employment opportunities for those with progressive functional limitations. Results in older workers are particularly concerning, as retirement ages are expected to increase in the general population.
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Affiliation(s)
- Ross Wilkie
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Milisa Blagojevic-Bucknall
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Kelvin P. Jordan
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Glenn Pransky
- Center for Disability Research, Liberty Mutual Research Institute for Safety, 71 Frankland Rd., Hopkinton, MA 01748 USA
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Lowry KA, Vallejo AN, Studenski SA. Successful aging as a continuum of functional independence: lessons from physical disability models of aging. Aging Dis 2012; 3:5-15. [PMID: 22500268 PMCID: PMC3320804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Revised: 08/05/2011] [Accepted: 08/05/2011] [Indexed: 05/31/2023] Open
Abstract
Successful aging is a multidimensional construct that could be viewed as a continuum of achievement. Based on the disability model proposed by the WHO International Classification of Functioning, Disability and Health, successful aging includes not only the presence or absence of disease, but also aspects of mobility and social participation. Here we review definitions of successful aging and discuss relevance of the disability model in the evaluation of successful aging and frailty. In particular, we summarize evidences that highlight the importance of measures of mobility (ability to walk and perform activities of daily living), and social participation in identifying and locating older adults across the range of the successful aging continuum. Lastly, we discuss the role of inflammation in age-related decline and in frailty. Future research directions are proposed, including identifying causal pathways among inflammatory markers, disability, and frailty. A better understanding of immunological functioning in late life may help unlock novel ways to promote successful aging.
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Affiliation(s)
- Kristin A. Lowry
- Division of Geriatric Medicine, University of Pittsburgh, 3471 Fifth Avenue, Kaufmann Medical Building, Suite 500, Pittsburgh PA 15213, USA
| | - Abbe N. Vallejo
- Children’s Hospital of Pittsburgh, Departments of Pediatrics and Immunology, University of Pittsburgh, 4401 Penn Avenue, Rangos 9118, Pittsburgh, PA 15224, USA
| | - Stephanie A. Studenski
- Division of Geriatric Medicine, University of Pittsburgh, 3471 Fifth Avenue, Kaufmann Medical Building, Suite 500, Pittsburgh PA 15213, USA
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Theis KA, Furner SE. Shut-In? Impact of Chronic Conditions on Community Participation Restriction among Older Adults. J Aging Res 2011; 2011:759158. [PMID: 21837277 PMCID: PMC3151523 DOI: 10.4061/2011/759158] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 04/28/2011] [Indexed: 11/20/2022] Open
Abstract
Community participation may be especially important for older adults, who are often at risk for unwanted declines in participation. We estimated the prevalence of community participation restriction (PR) due to perceived environmental barriers among older adults (≥50 years) and compared the impact among those with selected chronic conditions. Individuals with low-prevalence conditions reported high community PR (9.1–20.4%), while those with highly prevalent conditions (e.g., arthritis) had relatively low community PR (5.1–10.0%) but represented the greatest absolute numbers of condition-associated burden (>1 million). Across all conditions, more than half of those with community PR reported being restricted “always or often.” Community PR most often resulted from modifiable environmental barriers. Promising targets to reduce community PR among adults ≥50 years with chronic conditions, particularly arthritis, include building design, sidewalks/curbs, crowd control, and interventions that improve the built environment.
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Affiliation(s)
- Kristina A Theis
- Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
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