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Stavropoulou I, Sakellari E, Barbouni A, Notara V. Community-Based Virtual Reality Interventions in Older Adults with Dementia and/or Cognitive Impairment: A Systematic Review. Exp Aging Res 2024:1-28. [PMID: 38972047 DOI: 10.1080/0361073x.2024.2377438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 06/05/2024] [Indexed: 07/09/2024]
Abstract
INTRODUCTION Virtual reality devices have been widely used for the rehabilitation among older people with cognitive impairments. They enable the user to navigate in three-dimensional environments, which are constructed by a computer. Recent studies have been focused on the cognitive benefits of virtual reality for people with cognitive deficits. The current study aimed to investigate the overall impact of community-based virtual reality interventions in older adults with dementia and/or cognitive impairment. METHODS A systematic review of the literature was conducted according to the PRISMA guidelines. Google Scholar, PubMed, Science Direct and Scopus databases were searched for the years 2010-2022. RESULTS Of the 245 articles 20 met the inclusion criteria. The results of the current systematic review indicated that virtual reality improved older adults' cognitive and motor skills and increased their positive emotions while minimizing less positive ones. However, there is insufficient data of its impact on their overall quality of life. CONCLUSION There is a need to implement and evaluate interventions that examine its impact not only on cognitive functioning, but also on other aspects of older people with cognitive deficits.
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Affiliation(s)
- Iliana Stavropoulou
- Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
| | - Evanthia Sakellari
- Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
| | - Anastasia Barbouni
- Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
| | - Venetia Notara
- Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
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Bom JAM, Voormolen DC, Brouwer WBF, de Bekker-Grob EW, van Exel J. Construct Validity, Reliability, and Responsiveness of the 10-Item Well-Being Instrument for Use in Economic Evaluation Studies. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:871-878. [PMID: 38447742 DOI: 10.1016/j.jval.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/18/2024] [Accepted: 02/25/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVES Economic evaluations of interventions in health and social care require outcome measures that capture their full benefits, including those beyond health. This study aimed to assess construct validity, test-retest reliability, and responsiveness of the newly developed 10-item Well-being instrument (WiX). METHODS Data were gathered via an online survey in a representative sample of the adult general population in The Netherlands (N = 1045). Construct validity was assessed by inspecting convergent, structural, and discriminant validity, following the COnsensus-based Standards for the selection of health status Measurement INstruments methodology. Regression analyses of the WiX and its items on other validated measures of well-being were performed to assess the convergent validity of the instrument and the relevance of its items. Dimensionality of the WiX was assessed using exploratory factor analysis. To assess discriminant validity, several hypotheses in terms of well-being differences were assessed. Finally, a second survey was sent out 2 weeks after the initial survey (n = 563; 53.9% response rate) to assess the test-retest reliability and responsiveness of the WiX. RESULTS The WiX showed to be correlated with alternative well-being measures as expected and able to sufficiently differentiate between relevant subgroups in the population. Moreover, the dimensionality analysis indicated that the WiX captures a broad array of elements relevant to well-being, including physical and mental health. The test-retest reliability was good, with an intraclass correlation coefficient of 0.82. CONCLUSIONS The results regarding the WiX are favorable and indicate that this new instrument may be a promising alternative for existing measures of well-being for evaluating interventions in health and social care.
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Affiliation(s)
- Judith A M Bom
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Daphne C Voormolen
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Werner B F Brouwer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Esther W de Bekker-Grob
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Job van Exel
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Ishida T, Samukawa M. The Difference in the Assessment of Knee Extension/Flexion Angles during Gait between Two Calibration Methods for Wearable Goniometer Sensors. SENSORS (BASEL, SWITZERLAND) 2024; 24:2092. [PMID: 38610306 PMCID: PMC11014198 DOI: 10.3390/s24072092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024]
Abstract
Frontal and axial knee motion can affect the accuracy of the knee extension/flexion motion measurement using a wearable goniometer. The purpose of this study was to test the hypothesis that calibrating the goniometer on an individual's body would reduce errors in knee flexion angle during gait, compared to bench calibration. Ten young adults (23.2 ± 1.3 years) were enrolled. Knee flexion angles during gait were simultaneously assessed using a wearable goniometer sensor and an optical three-dimensional motion analysis system, and the absolute error (AE) between the two methods was calculated. The mean AE across a gait cycle was 2.4° (0.5°) for the on-body calibration, and the AE was acceptable (<5°) throughout a gait cycle (range: 1.5-3.8°). The mean AE for the on-bench calibration was 4.9° (3.4°) (range: 1.9-13.6°). Statistical parametric mapping (SPM) analysis revealed that the AE of the on-body calibration was significantly smaller than that of the on-bench calibration during 67-82% of the gait cycle. The results indicated that the on-body calibration of a goniometer sensor had acceptable and better validity compared to the on-bench calibration, especially for the swing phase of gait.
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Affiliation(s)
| | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, North 12, West 5, Kita-ku, Sapporo 060-0812, Japan;
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Angevaare MJ, Pieters JA, Twisk JWR, van Hout HPJ. Social Activity and Cognitive Decline in Older Residents of Long-Term Care Facilities: A Cohort Study. J Alzheimers Dis 2024; 98:433-443. [PMID: 38427473 DOI: 10.3233/jad-221053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
Background Cognitive decline is a major reason for dependence and resource use in long-term care. Objective We explored whether social activities may prevent cognitive decline of older residents of long-term care facilities. Methods In a routine care cohort, 3,603 residents of long-term care facilities were assessed on average 4.4 times using the interRAI-Long-Term-Care-Facilities instrument which includes frequency of participation in social activities of long standing interest over the last 30 days and the Cognitive Performance Scale. Linear mixed models repeated measures analyses were performed corrected for age, sex, physical activity, Activities of Daily Living, mood, and health indicators. Results Social activity was associated with cognitive preservation over time. This association was stronger in those with no or mild cognitive impairment at baseline, relative to those with moderate to severe impairment. Participation in specific social activities such as conversing and helping others showed a similar positive association. The relation between social activity and cognitive impairment appeared to be bi-directional. Conclusions The protective effects of social activity offer a window of opportunity to preserve cognitive functioning in long-term care residents.
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Affiliation(s)
- Milou J Angevaare
- Departments of General Practice and Medicine for Older People, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Jack A Pieters
- Departments of General Practice and Medicine for Older People, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Hein P J van Hout
- Departments of General Practice and Medicine for Older People, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
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Keramat SA, Lee V, Patel R, Hashmi R, Comans T. Cognitive impairment and health-related quality of life amongst older Australians: evidence from a longitudinal investigation. Qual Life Res 2023; 32:2911-2924. [PMID: 37289356 PMCID: PMC10473991 DOI: 10.1007/s11136-023-03449-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Australia's population is steadily growing older, with older persons expected to make up over 20% of the population by 2066. Ageing is strongly associated with a significant drop in cognitive ability, ranging from mild cognitive impairment to severe cognitive impairment (dementia). This study examined the association between cognitive impairment and health-related quality of life (HRQoL) in older Australians. METHODS Two waves of longitudinal data from the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey were utilised, with the age cut-off for older Australians defined as above 50. The final analysis included 10,737 person-year observations from 6892 unique individuals between 2012 and 2016. This study utilised the Backwards Digit Span (BDS) test and Symbol Digit Modalities test (SDMT) to assess cognitive function. HRQoL was measured using the physical and mental component summary scores of the SF-36 Health Survey (PCS and MCS). Additionally, HRQoL was measured using health state utility values (SF-6D score). A longitudinal random-effects GLS regression model was used to analyse the association between cognitive impairment and HRQoL. RESULTS This study found that approximately 89% of Australian adults aged 50 or older had no cognitive impairment, 10.16% had moderate cognitive impairment, and 0.72% had severe cognitive impairment. This study also found that moderate and severe cognitive impairment were both negatively associated with HRQoL. Older Australians with moderate cognitive impairment scored worse on the PCS (β = - 1.765, SE = 0.317), MCS (β = - 1.612, SE = 0.326), and SF-6D (β = - 0.024, SE = 0.004) than peers without cognitive impairment given other covariates reference categories remain constant. Older adults experiencing severe cognitive had lower PCS (β = - 3.560, SE = 1.103), and SF-6D (β = - 0.034, SE = 0.012) scores compared to their counterparts with no cognitive impairment given other covariates reference categories remain constant. CONCLUSION We found evidence that HRQoL is negatively associated with cognitive impairment. Our findings will be beneficial for the future cost-effectiveness intervention targeted at reducing cognitive impairment since it provides information on the disutility associated with moderate and severe cognitive impairment.
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Affiliation(s)
- Syed Afroz Keramat
- Faculty of Medicine, Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia.
| | - Vanessa Lee
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Rajat Patel
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Rubayyat Hashmi
- The Australian Centre for Housing Research, The University of Adelaide, Adelaide, Australia
| | - Tracy Comans
- Faculty of Medicine, Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
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Ng WQ, Ng GR, Yang H. Sense of Control Mediates the Relation between Discrimination and Executive Functions in Middle-Aged and Older Adults: A Structural Equation Modeling Approach. Exp Aging Res 2023; 49:501-515. [PMID: 36214758 DOI: 10.1080/0361073x.2022.2132073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 09/27/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Despite previous findings of a negative association between everyday discrimination and executive functions (EF) - a set of domain-general cognitive control processes - in middle-aged and older adults, less is known about the underlying mechanism. Thus, we focused on sense on control and its two facets - perceived constraints and personal mastery - as potential psychosocial mediators of this relation. METHODS By analyzing a nationally representative adult cohort from the Midlife Development in the United States (MIDUS) 2 study, we examined two mediational models: a single mediation model with sense of control and a parallel mediation model with perceived constraints and personal mastery as mediators. RESULTS Structural equation modeling analyses showed that sense of control, as well as personal mastery and perceived constraints, mediated the relationship between discrimination and EF in middle-aged and older adults. This held true when we controlled for age, race, gender, education, and health status. CONCLUSION Our findings underscore the unique and distinctive roles of sense of control and its two facets in the relation between everyday discrimination and EF in middle-aged and older adults.
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Affiliation(s)
- Wee Qin Ng
- School of Social Sciences, Singapore Management University, Singapore, Singapore
| | - Gilaine Rui Ng
- School of Social Sciences, Singapore Management University, Singapore, Singapore
| | - Hwajin Yang
- School of Social Sciences, Singapore Management University, Singapore, Singapore
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Sadiq A, Arshad MS, Amjad RB, Munir H, Rohi M, Khalid W, Nadeem MT, Suleria HAR. Impact of gamma irradiation and guava leaf extract on the quality and storage stability of chicken patties. Food Sci Nutr 2023; 11:4485-4501. [PMID: 37576041 PMCID: PMC10420856 DOI: 10.1002/fsn3.3174] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 08/15/2023] Open
Abstract
The current investigation was carried out to evaluate the impact of gamma irradiation and guava leaf extract (GLE) on chicken meat patties. The effects of treatments on chicken meat patties were determined by physicochemical, stability (oxidative and microbial), and antioxidant status during different packaging (aerobic and vacuum) at storage intervals (0, 5, and 10 days). The changes in physicochemical parameters of chicken patties were observed on various treatments, storage intervals, and different packaging. The TBARS and POV were found to increase significantly (p < .05) on 2 kGy and with the passage of storage time. The results of microbial load in samples were found to decrease on gamma irradiation with and without GLE. The antioxidant profile in chicken patties was with respect to control. Slight changes were seen in sensory parameters on different treatments at storage intervals. It is concluded that gamma irradiation eliminated the microbes and different concentrations of GLE improve the stability and antioxidant profile of chicken patties.
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Affiliation(s)
- Anam Sadiq
- Department of Food Science, Faculty of Life SciencesGovernment College UniversityFaisalabadPakistan
| | - Muhammad Sajid Arshad
- Department of Food Science, Faculty of Life SciencesGovernment College UniversityFaisalabadPakistan
| | | | - Haroon Munir
- Department of Food Science, Faculty of Life SciencesGovernment College UniversityFaisalabadPakistan
| | - Madiha Rohi
- Department of Food Science and TechnologyGovernment College Women University FaisalabadFaisalabadPakistan
| | - Waseem Khalid
- University Institute of Food Science and TechnologyThe University of LahoreLahorePakistan
| | - Muhammad Tahir Nadeem
- Department of Food Science, Faculty of Life SciencesGovernment College UniversityFaisalabadPakistan
- Grand Asian University SialkotSialkotPakistan
| | - Hafiz Ansar Rasul Suleria
- School of Agriculture and Food, Faculty of Veterinary and Agricultural SciencesThe University of MelbourneParkvilleVic.Australia
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Montalto A, Park HRP, Williams LM, Korgaonkar MS, Chilver MR, Jamshidi J, Schofield PR, Gatt JM. Negative association between anterior insula activation and resilience during sustained attention: an fMRI twin study. Psychol Med 2023; 53:3187-3199. [PMID: 37449488 DOI: 10.1017/s0033291721005262] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND While previous studies have suggested that higher levels of cognitive performance may be related to greater wellbeing and resilience, little is known about the associations between neural circuits engaged by cognitive tasks and wellbeing and resilience, and whether genetics or environment contribute to these associations. METHODS The current study consisted of 253 monozygotic and dizygotic adult twins, including a subsample of 187 early-life trauma-exposed twins, with functional Magnetic Resonance Imaging data from the TWIN-E study. Wellbeing was measured using the COMPAS-W Wellbeing Scale while resilience was defined as a higher level of positive adaptation (higher levels of wellbeing) in the presence of trauma exposure. We probed both sustained attention and working memory processes using a Continuous Performance Task in the scanner. RESULTS We found significant negative associations between resilience and activation in the bilateral anterior insula engaged during sustained attention. Multivariate twin modelling showed that the association between resilience and the left and right insula activation was mostly driven by common genetic factors, accounting for 71% and 87% of the total phenotypic correlation between these variables, respectively. There were no significant associations between wellbeing/resilience and neural activity engaged during working memory updating. CONCLUSIONS The findings suggest that greater resilience to trauma is associated with less activation of the anterior insula during a condition requiring sustained attention but not working memory updating. This possibly suggests a pattern of 'neural efficiency' (i.e. more efficient and/or attenuated activity) in people who may be more resilient to trauma.
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Affiliation(s)
- Arthur Montalto
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Haeme R P Park
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Leanne M Williams
- Stanford School of Medicine, Stanford University, Stanford, CA, USA
- Mental Illness Research Education and Clinical Centers VISN21, Veterans Administration Palo Alto Health Care System, Palo Alto, CA, 94304-151-Y, USA
| | - Mayuresh S Korgaonkar
- Brain Dynamics Centre, The Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Miranda R Chilver
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Javad Jamshidi
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Science, University of New South Wales, Sydney, NSW, Australia
| | - Justine M Gatt
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
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Trajectories of mobility difficulty and falls in community-dwelling adults aged 50 + in Taiwan from 2003 to 2015. BMC Geriatr 2022; 22:902. [PMID: 36434511 PMCID: PMC9700940 DOI: 10.1186/s12877-022-03613-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/11/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND A decline in mobility leads to fall occurrence and poorer performance in instrumental activities of daily living, which are widely proved to be associated with older adults' health-related quality of life. To inform potential predicaments faced by older adults at different age levels, predictors of this mobility change and falls along with the ageing process need to be further evaluated. Therefore, this study examined the risk factors associated with the longitudinal course of mobility difficulty and falls among community-dwelling middle-aged and older adults in the Taiwanese community. METHODS We evaluated data for the period between 2003 and 2015 from the Taiwan Longitudinal Study on Aging; the data cover 5267 community-based middle-aged and older adults with approximately 12 years of follow-up. In terms of mobility, the participants self-reported difficulties in mobility tasks (eg, ambulation) and whether they used a walking device. We employed linear mixed-effects regression models and cumulative logit models to examine whether personal characteristics are associated with mobility difficulty and falls. RESULTS Mobility difficulty significantly increased over time for the participants aged ≥ 60 years. Perceived difficulties in standing, walking, squatting, and running became apparent from a younger age than limitations with hand function. The probability of repeated falls increased significantly with older age at 70 (p = .002), higher level of mobility difficulty (p < .0001), lower cognitive status (p = .001), living alone (p = .001), higher number of comorbid illnesses (p < .001), walking device use (p = .003), longer time in physical activities (p < .011), and elevated depressive symptoms (p = .006). Although walking aid use increased the probability of falls, individuals with mobility difficulty had a reduced probability of repeated falls when using a walking device (p = .02). CONCLUSION Community-dwelling Taiwanese adults face an earlier mobility difficulty starting in 60 years old. Individuals with more leisure and physical activities in daily life were more likely to maintain mobility and walking safety. Long-term, regular, social, and physical activity could be a referral option for falls prevention program. The use of a walking device and safety precautions are warranted, particularly for individuals with walking difficulties.
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Jiang G, Wu X. Effects of resistance training combined with balance training on physical function among older adults: a protocol for a randomised controlled trial. BMJ Open 2022; 12:e062486. [PMID: 36198467 PMCID: PMC9535182 DOI: 10.1136/bmjopen-2022-062486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The world's population is ageing. Age-related declines in physical function negatively affect the quality of life but may be ameliorated by certain types of exercise. The purpose of this study is to investigate the effects of combining resistance training (RT) with balance training on physical function in older community-dwelling adults to provide a reference for this type of exercise compared with other exercises and to provide a theoretical basis for optimising exercise plans to improve physical function among older adults. METHODS This single-blind randomised controlled trial will recruit 66 community dwelling adults 60-89 years of age with normal cognition. Participants will be randomly assigned to one of three groups: RT, RT combined with balance training or a control group with usual daily activities. Exercise interventions will be conducted in three 45 min sessions per week for 24 weeks. Primary physical function outcomes will be assessed using the timed up and go test, usual walking speed, maximal walking speed, 30 s chair stand and 30 s arm curl. Secondary assessments will be conducted using the 2 min step test, back scratch test and chair sit-and-reach test. All physical function assessments will be performed at baseline and after 12 and 24 weeks of exercise interventions. Exercise intensity will be monitored to maintain moderate intensity by heart rate, ratings of perceived exertion and OMNI-Resistance Exercise Scale. Data that conform to a normal distribution will be expressed as means±SD, otherwise as medians and interquartile intervals. Pretest, mid-test and post-test outcomes will be analysed for within-group and between-group comparisons using two-way repeated measures analyses of variance. ETHICS AND DISSEMINATION This proposal was reviewed and approved by the Shanghai University of Sport Research Ethics Committee (102772021RT067). The results will be disseminated to the trial participants and as a peer-reviewed publication. TRIAL REGISTRATION NUMBER ChiCTR2200056090.
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Affiliation(s)
- Guiping Jiang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
- School of Physical Education, Harbin University, Harbin, China
| | - Xueping Wu
- School of Physical Education, Shanghai University of Sport, Shanghai, China
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Full-Body Mobility Data to Validate Inertial Measurement Unit Algorithms in Healthy and Neurological Cohorts. DATA 2022. [DOI: 10.3390/data7100136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Gait and balance dysfunctions are common in neurological disorders and have a negative effect on quality of life. Regularly quantifying these mobility limitations can be used to measure disease progression and the effect of treatment. This information can be used to provide a more individualized treatment. Inertial measurement units (IMUs) can be utilized to quantify mobility in different contexts. However, algorithms are required to extract valuable parameters out of the raw IMU data. These algorithms need to be validated to make sure that they extract the features they should extract. This validation should be performed per disease since different mobility limitations or symptoms can influence the performance of an algorithm in different ways. Therefore, this dataset contains data from both healthy subjects and patients with neurological diseases (Parkinson’s disease, stroke, multiple sclerosis, chronic low back pain). The full bodies of 167 subjects were measured with IMUs and an optical motion capture (reference) system. Subjects performed multiple standardized mobility assessments and non-standardized activities of daily living. The data of 21 healthy subjects are shared online, data of the other subjects and patients can only be obtained after contacting the corresponding author and signing a data sharing agreement.
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Aging and Psychological Well-Being: The Possible Role of Inhibition Skills. Healthcare (Basel) 2022; 10:healthcare10081477. [PMID: 36011134 PMCID: PMC9408411 DOI: 10.3390/healthcare10081477] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Psychological well-being (PWB) is a multidimensional construct which is a key protective factor against chronic diseases in older adults. Numerous psychological and cognitive factors can influence older people’s PWB. However, while most studies have explored the effect of general cognition, only a few investigated the role of specific cognitive functions such as the efficiency of executive functions. Thus, the present study aimed to directly explore the relationships between PWB, age, and the core executive functions (namely working memory, flexibility, and inhibition). (2) Methods: A sample of 51 healthy older adults (age range: 60–88) were enrolled and tested both for PWB (by Ryff’s psychological well-being scale) and the core executive functions (by the Digit span backward, the Trail Making Test, and the Stroop test). (3) Results: Age and inhibitory skills are negatively correlated to the personal growth subscale of the PWB scale. Moreover, a hierarchical regression analysis showed that inhibition, but not working memory and flexibility, predicted the sense of continued growth and development (personal growth) of older adults, even after controlling for age and educational levels. Limitations and implications for future research and prevention interventions are discussed.
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Janssen N, Handels RL, Wimo A, Antikainen R, Laatikainen T, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M, Evers SMAA, Verhey FRJ, Ngandu T. Association Between Cognition, Health Related Quality of Life, and Costs in a Population at Risk for Cognitive Decline. J Alzheimers Dis 2022; 89:623-632. [PMID: 35912737 PMCID: PMC9535559 DOI: 10.3233/jad-215304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The association between health-related quality of life (HRQoL) and care costs in people at risk for cognitive decline is not well understood. Studying this association could reveal the potential benefits of increasing HRQoL and reducing care costs by improving cognition. Objective: In this exploratory data analysis we investigated the association between cognition, HRQoL utilities and costs in a well-functioning population at risk for cognitive decline. Methods: An exploratory data analysis was conducted using longitudinal 2-year data from the FINGER study (n = 1,120). A change score analysis was applied using HRQoL utilities and total medical care costs as outcome. HRQoL utilities were derived from the Short Form Health Survey-36 (SF-36). Total care costs comprised visits to a general practitioner, medical specialist, nurse, and days at hospital. Analyses were adjusted for activities of daily living (ADL) and depressive symptoms. Results: Although univariable analysis showed an association between cognition and HRQoL utilities, multivariable analysis showed no association between cognition, HRQoL utilities and total care costs. A one-unit increase in ADL limitations was associated with a -0.006 (p < 0.001) decrease in HRQoL utilities and a one-unit increase in depressive symptoms was associated with a -0.004 (p < 0.001) decrease in HRQoL utilities. Conclusion: The level of cognition in people at-risk for cognitive decline does not seem to be associated with HRQoL utilities. Future research should examine the level at which cognitive decline starts to affect HRQoL and care costs. Ideally, this would be done by means of cross-validation in populations with various stages of cognitive functioning and decline.
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Affiliation(s)
- Niels Janssen
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Ron L Handels
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Neurobiology, Care Science and Society, Division of Neurogeriatrics, Karolinska Institute, Stockholm, Sweden
| | - Anders Wimo
- Department of Neurobiology, Care Science and Society, Division of Neurogeriatrics, Karolinska Institute, Stockholm, Sweden.,Centre for Research & Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden
| | - Riitta Antikainen
- Center for life course health research/Geriatrics, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Tiina Laatikainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland.,Joint municipal authority for North Karelia Social and Health Services (Siun sote), Finland
| | - Hilkka Soininen
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.,Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Timo Strandberg
- Institute of Health Sciences/Geriatrics, University of Oulu and Oulu University Hospital, Oulu, Finland.,Department of Medicine, Geriatric Clinic, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Jaakko Tuomilehto
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland.,South Ostrobothnia Central Hospital, Seinajoki, Finland.,Saudi Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Miia Kivipelto
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden.,Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Silvia M A A Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, The Netherlands.,Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Centre for Economic Evaluation Utrecht, The Netherlands
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Tiia Ngandu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
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14
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Taani MH, Strath SJ, Cho CC, Ellis J, Oh H. Objective Physical Activity Levels, Sedentary Time, and Muscle Mass, Strength, and Function: Impact on Physical and Mental Health-Related Quality of Life in Older Adults. Res Gerontol Nurs 2022; 15:131-139. [PMID: 35417271 DOI: 10.3928/19404921-20220408-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Limited physical activity, sedentary behavior, and reduction in muscle mass, strength, and function are accompanied by negative outcomes. The relationship between these factors and physical and mental health-related quality of life (HRQoL) has yet to be elucidated in continuing care retirement community (CCRC) residents. The current study investigated the relationships among physical activity, sedentary behavior, and muscle mass, strength, and function to physical and mental HRQoL. A sample of 105 CCRC residents participated in this cross-sectional correlational study. Findings demonstrated that low physical activity and muscle function were significantly associated with low physical HRQoL and explained 38% of the variance in physical HRQoL. Handgrip strength was significantly associated with low mental HRQoL and explained 8% of the variance in mental HRQoL. Older adults living in CCRCs may benefit from interventions targeting physical activity and the distinct muscle components of sarcopenia that have the potential to improve physical and mental HRQoL. [Research in Gerontological Nursing, 15(3), 131-139.].
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15
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Gong J, Xu Z, Wang SX, Gu M, Ong P, Li Y. Established and Nascent Entrepreneurs: Comparing the Mental Health, Self-Care Behaviours and Wellbeing in Singapore. FRONTIERS IN SOCIOLOGY 2022; 7:843101. [PMID: 35399193 PMCID: PMC8990876 DOI: 10.3389/fsoc.2022.843101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Abstract
Mental health problems currently affect a quarter of the world's population. Recent research in western societies has started to examine the relationship between entrepreneurship and mental health problems such as Attention Deficit Hyperactivity Disorder (ADHD) and dyslexia. However, little has been done to categorize entrepreneurs into different types and investigate how their levels of mental health and well-being correspond to these types. This study divided entrepreneurs into established and nascent categories and examined this topic in Singapore. By distributing two sets of surveys, a total of 834 responses were collected, with 346 responses from established entrepreneurs and 488 responses from nascent ones. The results showed that the nascent entrepreneurs' levels of well-being were found to be much lower than those of the established entrepreneurs. Furthermore, entrepreneurs with ADHD or dyslexia symptoms generally had a much lower level of life satisfaction, compared with those without. However, the self-care behaviours observed in this sample differed somewhat from observations made in western societies, which might be explained by the different cultures and habits in Singaporean society. The findings not only highlight the need for relevant organizations to support nascent entrepreneurs but serve to remind veteran entrepreneurs to practice more healthy self-care behaviours.
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Affiliation(s)
- Jiankun Gong
- Faculty of Art and Social Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Zezheng Xu
- Department of Diplomacy, China Foreign Affairs University, Beijing, China
| | - Sherry Xueli Wang
- Institute of Central China Development, Wuhan University, Wuhan, China
- Department of Geography, National University of Singapore, Queenstown, Singapore
| | - Mingyan Gu
- School of Business and Management, University of South Wales, Cardiff, United Kingdom
| | - PuayChin Ong
- Stirling Management School, Singapore Institute of Management, Singapore, Singapore
| | - Yuanzhe Li
- School of Materials Science and Engineering, Nanyang Technological University, Singapore, Singapore
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16
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Association between Chronic Disease Self-Management, Health Status, and Quality of Life in Older Taiwanese Adults with Chronic Illnesses. Healthcare (Basel) 2022; 10:healthcare10040609. [PMID: 35455788 PMCID: PMC9027156 DOI: 10.3390/healthcare10040609] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/09/2022] [Accepted: 03/21/2022] [Indexed: 12/24/2022] Open
Abstract
Aging is accompanied by many chronic comorbidities and disabilities, and entails medical expenses, which affects the quality of life among older adults. The purpose of this study was to investigate whether the health status of older adults with chronic diseases mediates chronic disease self-management to predict quality of life. Methods: This research adopted a cross-sectional correlation study design. Convenient sampling was performed in outpatient departments commonly visited by older adults in a medical center in Southern Taiwan. The following measures were collected: (1) Physiological measurement: left handgrip, right handgrip, and lower extremities’ muscle strength. (2) Questionnaires: cognitive function was measured by the Alzheimer’s disease (AD)-8 scale, possible frailty with the Kihon Checklist (KCL), functional status with the Barthel Index (BI) and the Lawton and Brody Instrumental Activities of Daily Living (IADL) scales, and self-management for chronic disease and quality of life with the (WHOQOL)-BREF, Taiwan version. Results: Chronic disease self-management is correlated with health status and is directly related to quality of life. Chronic disease self-management also indirectly affects quality of life through health status (cognitive status and risk of frailty), showing that health status partly mediates the correlation between chronic disease self-management and quality of life. Conclusions: A health status feedback system should be introduced in related chronic disease self-management measures for older adults so that they can be aware of their own health status and so that their quality of life is improved. Custom-made nursing interventions are necessary for the reduction in or delay of disability or risk of frailty in older adults, thereby enhancing their quality of life.
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17
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Werner C, Wolf-Belala N, Nerz C, Abel B, Braun T, Grüneberg C, Thiel C, Büchele G, Muche R, Hendlmeier I, Schäufele M, Dams J, König HH, Bauer JM, Denkinger M, Rapp K. A multifactorial interdisciplinary intervention to prevent functional and mobility decline for more participation in (pre-)frail community-dwelling older adults (PromeTheus): study protocol for a multicenter randomized controlled trial. BMC Geriatr 2022; 22:124. [PMID: 35164686 PMCID: PMC8842871 DOI: 10.1186/s12877-022-02783-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/24/2022] [Indexed: 01/19/2023] Open
Abstract
Background Age-related decline in physical capacity can lead to frailty, associated with an increased vulnerability to adverse health outcomes and greater healthcare utilization. In an aging population, effective strategies to prevent physical decline and frailty, and preserve independence are needed. Prevention programs for vulnerable community-dwelling older adults are, however, often not yet established and implemented in routine practice. Research on the feasibility, implementation, and (cost-)effectiveness of multifactorial, interdisciplinary intervention programs that take advantage of available services of healthcare providers is also limited. The main aim of this study is to evaluate the effectiveness of such an intervention program (PromeTheus) to prevent functional and mobility decline for more participation in community-dwelling (pre-)frail older adults. Methods The study is designed as a three-center, randomized controlled trial with a 12-month intervention period. Four hundred community-dwelling (pre-)frail (Clinical Frailty Scale score 4–6) older adults (≥70 years) will be randomized in a 1:1 ratio to the intervention group (IG) or the control group (CG). The IG will receive the PromeTheus program consisting of obligatory home-based physical exercises (Weight-bearing Exercise for Better Balance) accompanied by physiotherapists and facultative counseling services (person-environment-fit, coping with everyday life, nutrition, group-based activities) delivered via existing healthcare structures (e.g., social workers, nutritionists). The CG will receive usual care and a one-time counseling session on recommendations for physical activity and nutrition. Primary outcomes assessed at months 6 and 12 are the function component of the Late-Life Function and Disability Instrument and the University of Alabama at Birmingham Life-Space Assessment. Secondary outcomes are disability, physical capacity and activity, frailty, nutritional status, falls, fear of falling, health status, and psychosocial components. Process and economic evaluations are also conducted. Primary statistical analyses will be based on the intention-to-treat principle. Discussion Compared to usual care, the PromeTheus program is expected to result in higher function and mobility, greater independence and lower need for care, and more participation. As the PromeTheus program draws on existing German healthcare structures, its large-scale translation and delivery will be feasible, if evidence of (cost-)effectiveness and successful implementation can be demonstrated. Trial registration German Clinical Trials Register, . Registered on March 11, 2021.
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Affiliation(s)
- Christian Werner
- Center for Geriatric Medicine, Agaplesion Bethanien Hospital Heidelberg, Heidelberg University, Heidelberg, Germany.
| | | | - Corinna Nerz
- Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Bastian Abel
- Center for Geriatric Medicine, Agaplesion Bethanien Hospital Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Tobias Braun
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany
| | - Christian Grüneberg
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany
| | - Christian Thiel
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany
| | - Gisela Büchele
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Reiner Muche
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Ingrid Hendlmeier
- Department of Social Work, University of Applied Sciences, Mannheim, Germany
| | - Martina Schäufele
- Department of Social Work, University of Applied Sciences, Mannheim, Germany
| | - Judith Dams
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jürgen M Bauer
- Center for Geriatric Medicine, Agaplesion Bethanien Hospital Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Michael Denkinger
- Institute for Geriatric Research, Ulm University, Ulm, Germany.,Agaplesion Bethesda Clinic, Ulm, Germany
| | - Kilian Rapp
- Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany
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18
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Hewston P, Kennedy C, Ioannidis G, Merom D, Hladysh G, Marr S, Lee J, Sztramko R, Trainor L, Grenier A, Woolhouse MH, Patterson C, Papaioannou A. Development of GERAS DANcing for Cognition and Exercise (DANCE): a feasibility study. Pilot Feasibility Stud 2022; 8:9. [PMID: 35045863 PMCID: PMC8767754 DOI: 10.1186/s40814-021-00956-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 12/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dance is a mind-body activity of purposeful rhythmic movement to music. There is growing interest in using dance as a form of cognitive and physical rehabilitation. This manuscript describes the development of GERAS DANcing for Cognition and Exercise (DANCE) and evaluates its feasibility in older adults with cognitive and mobility impairments. METHODS The progressive dance curricula were delivered for 15 weeks (1-h class; twice weekly). Participants were eligible if they were community-dwelling older adults aged 60+ with early cognitive or mobility impairment able to follow three-step commands and move independently. Feasibility outcomes included recruitment/retention, adherence, participant satisfaction, safety, and adverse events. RESULTS Twenty-five older adults (mean (standard deviation [SD]) age = 77.55 (6.10) years, range 68-90 years) with early cognitive (Montreal Cognitive Assessment score (SD) = 21.77 (4.05)) and mobility (92% were pre-frail/frail as indicated on the Fried Frailty Phenotype) impairments were recruited from a geriatric out-patient clinic or within the community. A total of 20/25 (80%) participants completed the study. Average class attendance was 72%, and self-reported homework adherence "most-days / every day" was 89%. A stepwise progression in the dance curricula was observed with increases in motor complexity and balance demands, and 95% of participants rated the program as a "just-right" challenge. Ninety percent of participants rated GERAS DANCE as excellent, and 100% would recommend the program to a friend or family member. Over 50% of participants connected outside of class time for a self-initiated coffee club. Adverse events of falls and fractures were reported for 2 participants, which occurred at home unrelated to the dance intervention during the study period. Pre-determined thresholds for feasibility were met for all outcomes. DISCUSSION GERAS DANCE is a feasible and enjoyable program for older adults with early cognitive or mobility impairments. GERAS DANCE curriculum grading (duration; sequence; instructions) and motor complexity increases in agility, balance, and coordination appear appropriately tailored for this population. Future work will explore the feasibility of GERAS DANCE in new settings (i.e., virtually online, community centers, or retirement homes) and the mind-body-social benefits of dance.
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Affiliation(s)
- Patricia Hewston
- GERAS Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada. .,Department of Medicine, McMaster University, Hamilton, ON, Canada.
| | - Courtney Kennedy
- GERAS Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - George Ioannidis
- GERAS Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Dafna Merom
- School of Science and Health , University of Western Sydney, Penrith, Australia
| | | | - Sharon Marr
- GERAS Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Justin Lee
- GERAS Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Richard Sztramko
- GERAS Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Laurel Trainor
- Department of Psychology, Neuroscience, & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Amanda Grenier
- Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | | | - Christopher Patterson
- GERAS Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Alexandra Papaioannou
- GERAS Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada.,Department of Health Research and Methods, McMaster University, Hamilton, ON, Canada
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19
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Péntek M, Poór G, Gulácsi L, Zrubka Z, Brodszky V, Rencz F, Dobos Á, Farkas M, Kovács L, Baji P. Musculoskeletal health and capability wellbeing: Associations between the HAQ-DI, ICECAP-A and ICECAP-O measures in a population survey. Musculoskelet Sci Pract 2021; 55:102420. [PMID: 34271413 DOI: 10.1016/j.msksp.2021.102420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/26/2021] [Accepted: 06/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The capability approach has received increasing attention in wellbeing measurement in the past years, but it has still remained an underexplored area in musculoskeletal (MSK) health. OBJECTIVE We aimed to explore the capability wellbeing in relation to MSK health, by measuring the associations between the Health Assessment Questionnaire Disability Index (HAQ-DI) physical functioning and the ICECAP-A and ICECAP-O capability wellbeing measures. DESIGN A cross-sectional survey was performed in 2019 on a representative sample of the Hungarian general adult population. METHOD Capability wellbeing was measured by the ICECAP-A (age-group 18-64) and ICECAP-O (age group 65+) questionnaires. MSK health was defined by the HAQ-DI, the mobility domain of the EQ-5D-3L/-5L health status measures, self-reported walking problems and MSK diagnosis (neck/back/low back defects, hip/knee arthrosis, osteoporosis). RESULTS Altogether 2021 individuals (female: 50.1%) participated in the survey with mean (SD) age of 48.7 (17.9) years and HAQ-DI of 0.138 (0.390). ICECAP-A (N = 1568, 77.6%) and ICECAP-O (N = 453, 22.4%) scores were on average (SD) 0.894 (0.126) and 0.828 (0.150), respectively. Spearman correlations between the HAQ-DI and ICECAP-A/-O index scores were moderate (r = -0.303 and -0.496; p < 0.05). Both the ICECAP-A/-O index scores differed significantly (ANOVA test, p < 0.05) across all MSK subgroups. In the ordinary least square regressions, marginal effects of ICECAP-A/-O scores on HAQ-DI were significant (-0.149 and -0.123) when controlling for socio-demographic characteristics. CONCLUSIONS MSK health problems are associated with lower capability wellbeing. ICECAP-A/-O might capture effects of MSK conditions not measured by the HAQ-DI or the EQ-5D-5L. Further studies should test these associations in disease-specific samples.
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Affiliation(s)
- Márta Péntek
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Bécsi út 96/B, H-1034, Budapest, Hungary; Department of Health Economics, Corvinus University of Budapest, Fővám Tér 8, H-1093, Budapest, Hungary.
| | - Gyula Poór
- I. Department of Rheumatology, National Institute of Rheumatology and Physiotherapy; Frankel Leó út 62., H-1023, Budapest, Hungary
| | - László Gulácsi
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Bécsi út 96/B, H-1034, Budapest, Hungary; Department of Health Economics, Corvinus University of Budapest, Fővám Tér 8, H-1093, Budapest, Hungary
| | - Zsombor Zrubka
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Bécsi út 96/B, H-1034, Budapest, Hungary; Department of Health Economics, Corvinus University of Budapest, Fővám Tér 8, H-1093, Budapest, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám Tér 8, H-1093, Budapest, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám Tér 8, H-1093, Budapest, Hungary; Hungarian Academy of Sciences, Premium Postdoctoral Research Programme, Nádor U. 7, H-1051, Budapest, Hungary
| | - Ágota Dobos
- Corvinus Center for Teaching Foreign Language Education and Research, Corvinus University of Budapest, Fővám Tér 8, H-1093, Budapest, Hungary
| | - Miklós Farkas
- Department of Accounting and Finance, University of Bristol, Priory Road Complex, Bristol BS8 1TU, UK
| | - Levente Kovács
- Physiological Controls Research Center, University Research and Innovation Center, Óbuda University, Bécsi út 96/B, H-1034, Budapest, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám Tér 8, H-1093, Budapest, Hungary
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20
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O'Shea DM, Davis JD, Tremont G. Verbal memory is associated with adherence to COVID-19 protective behaviors in community dwelling older adults. Aging Clin Exp Res 2021; 33:2043-2051. [PMID: 34131881 PMCID: PMC8204921 DOI: 10.1007/s40520-021-01905-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/01/2021] [Indexed: 11/27/2022]
Abstract
Background Adherence to protective behaviors is central to limiting the spread of COVID-19 and associated risk of serious illness and mortality in older populations. Whether cognition predicts adherence to protective behaviors has not been examined in older adults. Aims To examine whether specific cognitive abilities predict adherence to COVID-19 protective behaviors in older adults, independent of other relevant factors. Methods Data from 431 older adults (i.e., ≥ 65 years) who took part in the COVID-19 module of the Health and Retirement Study were included in the present study. Separate binary logistic regression models were used to examine whether performance on measures of immediate and delayed recall and working memory predicted adherence to COVID-19 protective behaviors, controlling for demographics, level of COVID-19 concern, depressive symptoms, and medical conditions. Results For every unit increase in immediate and delayed recall, the probability of adhering to COVID-19 protective behaviors increased by 47% and 69%, respectively. There was no association between the measure of working memory and adherence. Discussion It is of public interest to understand the factors that reduce adherence to protective behaviors so that we can better protect those most vulnerable and limit community spread. Our findings demonstrate that reduced memory predicts non-adherence to COVID-19 protective behaviors, independent of virus concern, and other relevant demographic and health factors. Conclusions Public health strategies aimed at increasing adherence to COVID-19 protective behaviors in community dwelling older adults, should account for the role of reduced cognitive function in limiting adherence.
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Affiliation(s)
- Deirdre M O'Shea
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA.
| | - Jennifer D Davis
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA
| | - Geoffrey Tremont
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA
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21
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Synergistic Effects of Aldehyde Dehydrogenase 2 Polymorphisms and Alcohol Consumption on Cognitive Impairment after Ischemic Stroke in Han Chinese. Behav Neurol 2021; 2021:6696806. [PMID: 34257742 PMCID: PMC8253650 DOI: 10.1155/2021/6696806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/16/2021] [Accepted: 06/07/2021] [Indexed: 11/17/2022] Open
Abstract
Aldehyde dehydrogenase 2 (ALDH2) polymorphisms are related to both stroke risk and alcohol consumption. However, the influence of ALDH2 polymorphisms and alcohol consumption on cognitive impairment after ischemic stroke remains unknown, as do the possible mechanisms. We enrolled 180 Han Chinese ischemic stroke patients from four community health centers in Bengbu, China. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), and two different MoCA cutoff scores were used to define cognitive impairment in ischemic stroke patients. The ALDH2 genotypes were determined using polymerase chain reaction and direct sequencing. To assess the associations of ALDH2 polymorphisms and alcohol consumption with cognitive impairment after ischemic stroke, we performed binary logistic regression analysis with odds ratios. We revealed that individuals with the ALDH2 wild-type genotype were more likely to have high MoCA scores than those with the mutant and heterozygous types (p = 0.034). In addition, using two MoCA cutoff scores, the percentage of moderate to excessive alcohol consumption in the cognitive impairment group was higher than that in the nonimpairment group (p = 0.001). The levels of 4-hydroxy-2-nonenal (p = 0.001) and swallowing function (p = 0.001) were also higher in the cognitive impairment group than in the nonimpairment group. Moreover, after adjusting for other potential risk factors, ALDH2 polymorphisms and alcohol consumption had a significant synergistic effect on cognitive impairment (p = 0.022). Specifically, the ALDH2∗2 mutant allele and higher alcohol consumption were associated with cognitive impairment and swallowing ability after ischemic stroke. Targeting ALDH2 may be a useful biomarker for cognitive rehabilitation following ischemic stroke.
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22
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Associations between health-related quality of life and physical function in older adults with or at risk of mobility disability after discharge from the hospital. Eur Geriatr Med 2021; 12:1247-1256. [PMID: 34106446 PMCID: PMC8626396 DOI: 10.1007/s41999-021-00525-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/31/2021] [Indexed: 01/02/2023]
Abstract
Aim To investigate if health-related quality of life (HRQOL) is associated with physical function in older adults with or at risk of mobility disability after hospital discharge. Findings Better physical function (SPPB) was significantly associated with a higher level of physical HRQOL (SF-36 subscales physical functioning, role physical, bodily pain and general health). Message The positive associations between physical function and physical HRQOL might indicate that the exercise interventions aiming to improve physical function might also improve physical HRQOL in this group of older adults. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00525-0. Purpose To optimise the treatment for older adults after hospitalisation, thorough health status information is needed. Therefore, we aimed to investigate the associations between health-related quality of life (HRQOL) and physical function in older adults with or at risk of mobility disability after hospital discharge. Methods This cross-sectional study recruited 89 home-dwelling older people while inpatients within medical wards at a general hospital in Oslo, Norway. HRQOL [the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36)] and physical function [the Short Physical Performance Battery (SPPB)] were measured a median of 49 [interquartile range (IQR) 26–116] days after discharge. Simple linear regression analyses were conducted, and multivariable regression models were fitted. Results The mean age of the patients was 78.3 years; 43 (48.9 %) were females. Multivariable regressions showed positive associations between SPPB and the physical subscales {physical functioning [B (95% CI) 4.51 (2.35–6.68)], role physical [B (95% CI) 5.21 (2.75–7.67)], bodily pain [B (95% CI) 3.40 (0.73–6.10)] and general health [B (95% CI) 3.12 (1.13–5.12)]}. Univariable regressions showed no significant associations between SPPB and the mental subscales {vitality [B (95% CI) 1.54 (− 0.10–3.18)], social functioning [B (95% CI) 2.34 (− 0.28–4.96)], role emotional [B (95% CI) 1.28 (− 0.96–3.52)] and mental health [B (95% CI) 1.00 (− 0.37–2.36)]}. Conclusion The results reinforce that physical function and physical HRQOL are strongly linked, and interventions improving physical function might improve physical HRQOL. However, this hypothesis would have to be tested in a randomised controlled trial. Trial registration ClinicalTrials.gov. Registered 19 September 2016 (NCT02905383). Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00525-0.
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Sandgren A, Arnoldsson L, Lagerholm A, Bökberg C. Quality of life among frail older persons (65+ years) in nursing homes: A cross-sectional study. Nurs Open 2021; 8:1232-1242. [PMID: 34482652 PMCID: PMC8046081 DOI: 10.1002/nop2.739] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/28/2020] [Accepted: 11/11/2020] [Indexed: 11/09/2022] Open
Abstract
AIM To assess the quality of life in frail older persons (65+ years) living in nursing homes and to examine differences between quality of life perceptions among different gender and age groups. DESIGN Cross-sectional. METHODS Data were collected during 2015-2017 based on two questionnaires (WHOQOL-OLD and WHOQOL-BREF). Seventy-eight older persons living in nursing homes in southern Sweden answered the questionnaires in structured interviews. Descriptive and comparative statistics were used to analyse the data. The study was guided by Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) guidelines. RESULTS The frail older persons reported low autonomy related to few opportunities to engage in everyday activities and were unable to do the things they liked to do and not feeling in control of their future. Another important result was that frail older persons seemed to have no or little fear of death and dying. No significant differences between gender or age on quality of life were revealed.
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Affiliation(s)
- Anna Sandgren
- Department of Health and Caring SciencesFaculty of Health and Life SciencesCenter for Collaborative Palliative CareLinnaeus UniversityVäxjöSweden
| | - Lisa Arnoldsson
- Department of Health SciencesFaculty of MedicineLund UniversityLundSweden
| | - Annika Lagerholm
- Department of Health SciencesFaculty of MedicineLund UniversityLundSweden
| | - Christina Bökberg
- Department of Health SciencesFaculty of MedicineLund UniversityLundSweden
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A Study of Physical Activity, Frailty, and Health-Related Quality of Life Among Community-Dwelling Older Adults in Taiwan. J Nurs Res 2020; 28:e124. [PMID: 32941303 PMCID: PMC7664969 DOI: 10.1097/jnr.0000000000000402] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) in community-dwelling older adults increases as physical activity improves, and age-related frailty has a negative effect on HRQoL. Research on these associations is lacking. PURPOSE The aims of this study were to (a) analyze the effect of demographic characteristics on HRQoL, (b) explore the correlation between physical activity and HRQoL, (c) analyze the effect of frailty on HRQoL, and (d) investigate the potential predictors of HRQoL in community-dwelling older adults. METHODS In this cross-sectional study, a convenience sample of 150 older adults was recruited from community care sites in Shilin and Beitou Districts in Taipei City, Taiwan. Data were collected at baseline using a demographic characteristics datasheet, the Center for Epidemiologic Studies Depression Scale, the Physical Activity Scale for the Elderly, and the 12-Item Short Form Health Survey. The Senior Fitness Test and hand-grip strength test were also performed. Student t test, chi-square test, analysis of variance, Pearson correlation coefficient, and hierarchical regression were applied to analyze the statistical results using IBM SPSS Statistics Version 22.0. RESULTS Being of older age, experiencing a higher number of falls, having more chronic diseases, and having a higher body mass index were identified as factors that significantly affect HRQoL. Moreover, HRQoL was found to be significantly affected by the performance of physical activity or status of frailty. Furthermore, the prefrail period was shown to be an important predictor of HRQoL after adjusting for demographic variables, history of chronic illness, history of falls, and physical activity. CONCLUSIONS/IMPLICATIONS FOR PRACTICE In this study, HRQoL was found to be significantly affected by upper limb dysfunction and the prefrail period. Community health promotion activities should focus greater attention on the physical functioning of older adults. Furthermore, providing information on age-related frailty and promoting active participation in community activities may increase the attention given by community-dwelling older adults to physical fitness and quality of life.
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Xu F, Cohen SA, Greaney ML, Earp JE, Delmonico MJ. Longitudinal
Sex‐Specific
Physical Function Trends by Age, Race/Ethnicity, and Weight Status. J Am Geriatr Soc 2020; 68:2270-2278. [DOI: 10.1111/jgs.16638] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 01/06/2023]
Affiliation(s)
- Furong Xu
- Department of Kinesiology University of Rhode Island Kingston Rhode Island USA
| | - Steven A. Cohen
- Department of Health Studies University of Rhode Island Kingston Rhode Island USA
| | - Mary L. Greaney
- Department of Health Studies University of Rhode Island Kingston Rhode Island USA
| | - Jacob E. Earp
- Department of Kinesiology University of Rhode Island Kingston Rhode Island USA
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Knaak C, Brockhaus WR, Spies C, Borchers F, Piper SK, Radtke FM, Lachmann G. Presurgical cognitive impairment is associated with postoperative delirium and postoperative cognitive dysfunction. Minerva Anestesiol 2020; 86:394-403. [DOI: 10.23736/s0375-9393.20.13903-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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27
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Long-term unsupervised mobility assessment in movement disorders. Lancet Neurol 2020; 19:462-470. [PMID: 32059811 DOI: 10.1016/s1474-4422(19)30397-7] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 09/26/2019] [Accepted: 10/07/2019] [Indexed: 12/25/2022]
Abstract
Mobile health technologies (wearable, portable, body-fixed sensors, or domestic-integrated devices) that quantify mobility in unsupervised, daily living environments are emerging as complementary clinical assessments. Data collected in these ecologically valid, patient-relevant settings can overcome limitations of conventional clinical assessments, as they capture fluctuating and rare events. These data could support clinical decision making and could also serve as outcomes in clinical trials. However, studies that directly compared assessments made in unsupervised and supervised (eg, in the laboratory or hospital) settings point to large disparities, even in the same parameters of mobility. These differences appear to be affected by psychological, physiological, cognitive, environmental, and technical factors, and by the types of mobilities and diagnoses assessed. To facilitate the successful adaptation of the unsupervised assessment of mobility into clinical practice and clinical trials, clinicians and researchers should consider these disparities and the multiple factors that contribute to them.
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Cleland J, Hutchinson C, Khadka J, Milte R, Ratcliffe J. A Review of the Development and Application of Generic Preference-Based Instruments with the Older Population. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2019; 17:781-801. [PMID: 31512086 DOI: 10.1007/s40258-019-00512-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Older people (aged 65 years and over) are the fastest growing age cohort in the majority of developed countries, and the proportion of individuals defined as the oldest old (aged 80 years and over) living with physical frailty and cognitive impairment is rising. These population changes put increasing pressure on health and aged care services, thus it is important to assess the cost effectiveness of interventions targeted for older people across health and aged care sectors to identify interventions with the strongest capacity to enhance older peoples' quality of life and provide value for money. Cost-utility analysis (CUA) is a form of economic evaluation that typically uses preference-based instruments to measure and value health-related quality of life for the calculation of quality-adjusted life-years (QALYS) to enable comparisons of the cost effectiveness of different interventions. A variety of generic preference-based instruments have been used to measure older people's quality of life, including the Adult Social Care Outcomes Toolkit (ASCOT); Health Utility Index Mark 2 (HUI2); Health Utility Index Mark 3 (HUI3); Short-Form-6 Dimensions (SF-6D); Assessment of Quality of Life-6 dimensions (AQoL-6D); Assessment of Quality of Life-8 dimensions (AQoL-8D); Quality of Wellbeing Scale-Self-Administered (QWB-SA); 15 Dimensions (15D); EuroQol-5 dimensions (EQ-5D); and an older person specific preference-based instrument-the Investigating Choice Experiments Capability Measure for older people (ICECAP-O). This article reviews the development and application of these instruments within the older population and discusses the issues surrounding their use with this population. Areas for further research relating to the development and application of generic preference-based instruments with populations of older people are also highlighted.
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Affiliation(s)
- Jenny Cleland
- Health and Social Care Economics Group, College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide, SA, 5042, Australia
| | - Claire Hutchinson
- Health and Social Care Economics Group, College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide, SA, 5042, Australia
| | - Jyoti Khadka
- Health and Social Care Economics Group, College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide, SA, 5042, Australia
- Healthy Ageing Research Consortium, Registry of Older South Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Rachel Milte
- Health and Social Care Economics Group, College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide, SA, 5042, Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide, SA, 5042, Australia.
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29
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REM sleep behavior disorder predicts functional dependency in early Parkinson's disease. Parkinsonism Relat Disord 2019; 66:138-142. [DOI: 10.1016/j.parkreldis.2019.07.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 07/13/2019] [Accepted: 07/20/2019] [Indexed: 02/08/2023]
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Fiorini L, De Mul M, Fabbricotti I, Limosani R, Vitanza A, D'Onofrio G, Tsui M, Sancarlo D, Giuliani F, Greco A, Guiot D, Senges E, Cavallo F. Assistive robots to improve the independent living of older persons: results from a needs study. Disabil Rehabil Assist Technol 2019; 16:92-102. [PMID: 31329000 DOI: 10.1080/17483107.2019.1642392] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND More than 70% of elderly people age 80 and older are experiencing problems in personal mobility. Assistive robotics can represent a concrete support providing also a support for caregivers, clinicians and nurses by reducing their burden. METHODS A total of 20 older people and 34 caregivers (formal and informal) were interviewed in Italy and the Netherlands to investigate and prioritize their needs concerning the personal mobility domains and their attitudes towards assistive robots. The data were analysed from a user point of view by means of thematic content analysis by underlying recurrent topics. RESULTS The results revealed four categories of needs from the perspective of the older individuals: instrumental needs, rehabilitation needs, personal safety and indoor activities of daily life. Additionally, the results underline how personal mobility issues influence different aspects of daily life. Complementarily, three categories of caregiver needs were also distinguished: instrumental needs, rehabilitation monitoring needs and checkup needs. The highest percentage of participants showed a positive expectation towards assistive robotics. CONCLUSIONS The results were clustered according to the robot abilities (i.e., motion, interaction, manipulation, decision support and perception abilities) as a list of functional and technical requirements that should be developed to address all the needs related to the personal mobility. Robotic developer teams that work in this context could take advantage of this research. Additionally, this work can be used as a basis for clinicians and nurses working in geriatric units to understand how the robots can support and enhance their work. Implications for rehabilitation The incidence of personal mobility limitations affects 35% of adults age 70 and older and 72% of people over 80 years of age. Assistive robots can support elderly people during daily tasks: they could promote their personal mobility acting as a supporting tool. The results of the needs analysis revealed four categories of needs from the perspective of the older individuals: instrumental needs, rehabilitation needs, personal safety, and indoor activities of daily life. Three categories of caregiver needs were also distinguished: instrumental needs, rehabilitation monitoring needs, and check-up needs.
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Affiliation(s)
- Laura Fiorini
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Marleen De Mul
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands
| | - Isabelle Fabbricotti
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands
| | - Raffaele Limosani
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Alessandra Vitanza
- ICT, Innovation and Research Unit, Fondazione "Casa Sollievo della Sofferenza" - IRCCS, San Giovanni Rotondo, Italy
| | - Grazia D'Onofrio
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy.,Department of Medical Sciences, Complex Unit of Geriatrics, Fondazione "Casa Sollievo della Sofferenza" - IRCCS, San Giovanni Rotondo, Italy
| | - Michael Tsui
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands
| | - Daniele Sancarlo
- Department of Medical Sciences, Complex Unit of Geriatrics, Fondazione "Casa Sollievo della Sofferenza" - IRCCS, San Giovanni Rotondo, Italy
| | - Francesco Giuliani
- ICT, Innovation and Research Unit, Fondazione "Casa Sollievo della Sofferenza" - IRCCS, San Giovanni Rotondo, Italy
| | - Antonio Greco
- Department of Medical Sciences, Complex Unit of Geriatrics, Fondazione "Casa Sollievo della Sofferenza" - IRCCS, San Giovanni Rotondo, Italy
| | - Denis Guiot
- Centre de recherche DRM-Ermes, PSL, Université Paris-Dauphine, Paris, France
| | - Eloïse Senges
- Centre de recherche DRM-Ermes, PSL, Université Paris-Dauphine, Paris, France
| | - Filippo Cavallo
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
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Older women take shorter steps during backwards walking and obstacle crossing. Exp Gerontol 2019; 122:60-66. [PMID: 31034865 DOI: 10.1016/j.exger.2019.04.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 04/19/2019] [Accepted: 04/20/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Community ambulation requires the ability to adapt walking patterns to task demands. For example, complex walking tasks, such as obstacle crossing (OBS) and backwards walking (BW), require modification of gait kinematics to complete the task, maintain stability and prevent falling. More women than men fall each year, but few studies have investigated gender differences in performance of adaptive walking tasks. OBJECTIVE The purpose of this study was to determine gender differences in two common adaptive tasks. METHODS Walking performance was assessed from 54 age and gender matched participants (72 ± 5 yrs.) while they completed forward walking (FW), OBS and BW. Gait outcomes and the distance of the lead foot and the trail foot from the obstacle were normalized by leg length and assessed using multivariate analysis of variance. Additionally, performance in a battery of clinical physical and cognitive measures as well as self-reported activity levels were associated with adaptive gait behavior. RESULTS Gait speed and step width were not different between genders in any walking task. Compared to FW and OBS, women only decreased step length in BW, resulting in significantly shorter step lengths than men in OBS (p = 0.02) and BW (p = 0.04), a conservative walking strategy. Women crossed the obstacle in a manner that may limit recovery steps in case of a trip: stepping closer to the obstacle during approach without increasing trail toe-clearance. The Timed Up and Go mobility test, Short Physical Performance Battery, and Trail Making Test of processing speed and executive function were associated with gender differences in adaptive gait patterns. CONCLUSION The findings revealed that older adult women adapt walking in a way that might predispose them to tripping or falling (i.e. shorter steps and closer obstacle approach). Gender differences in adaptive walking are related to functional test performance and processing speed. Clinicians should consider targeting step length during adaptive walking tasks in women that may be at risk of mobility impairments.
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Yang YC, Lin MH, Wang CS, Lu FH, Wu JS, Cheng HP, Lin SI. Geriatric syndromes and quality of life in older adults with diabetes. Geriatr Gerontol Int 2019; 19:518-524. [PMID: 30957935 DOI: 10.1111/ggi.13654] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/28/2019] [Accepted: 02/15/2019] [Indexed: 12/18/2022]
Abstract
AIM To describe geriatric syndromes and their relationships with quality of life in older adults with diabetes. METHODS Community-dwelling older adults (aged >60 years) with diabetes (n = 316) participated in the present study. Eight geriatric syndromes, including polypharmacy (number of medications), pain (Brief Pain Inventory), urinary incontinence (International Consultation on Incontinence Questionnaire), sleep disturbance (hours of sleep), lower cognitive level (Mini-Mental State Examination), falls, depressive symptoms (Geriatric Depression Scale short form) and functional limitation (Barthel Index and Instrumental Activity of Daily Living), were assessed. The WHOQOL-BREF Taiwan version was used to measure physical, psychological, social and environmental domains of quality of life. RESULTS Polypharmacy was the most common geriatric syndrome (46.6%), followed by pain (41.5%). Participants with any of the geriatric syndromes, except for polypharmacy and sleep disturbance, had significantly poorer quality of life than those without. The Geriatric Depression Scale score was the only common and significant contributor to all four domains of quality of life, explaining 16~29% of the variance. Number of medications, pain level and cognitive level were also significant contributors, although they explained a small amount (<5%) of the variance. The number of geriatric syndromes (mode = 2) was significantly correlated with all four domains of quality of life (partial correlation r = -0.278~0.460, all P < 0.001). CONCLUSIONS Geriatric syndromes, especially polypharmacy and pain, were common among older adults with diabetes. A greater number of geriatric syndromes or a higher Geriatric Depression Scale score were associated with poorer quality of life. Further studies focusing on combinations of different geriatric syndromes or comorbidities are required. Geriatr Gerontol Int 2019; 19: 518-524.
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Affiliation(s)
- Yi-Ching Yang
- Department of Family Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan.,Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ming-Hsing Lin
- Department of Family Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Chong-Shan Wang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Alian Health Clinic, Kaohsiung County, Taiwan
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hui-Ping Cheng
- Institute of Allied Health Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sang-I Lin
- Institute of Allied Health Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Fairbairn P, Tsofliou F, Johnson A, Dyall SC. Combining a high DHA multi-nutrient supplement with aerobic exercise: Protocol for a randomised controlled study assessing mobility and cognitive function in older women. Prostaglandins Leukot Essent Fatty Acids 2019; 143:21-30. [PMID: 30975379 DOI: 10.1016/j.plefa.2019.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 03/20/2019] [Accepted: 04/01/2019] [Indexed: 01/14/2023]
Abstract
There is a complex interplay between cognition and gait in older people, with declines in gait speed coexisting with, or preceding cognitive decline. Omega-3 fatty acids, B vitamins, vitamin E, phosphatidylserine, and Ginkgo Biloba show promise in preserving mobility and cognitive function in older adults. Exercise benefits mobility and there is evidence suggesting positive interactions between exercise and omega-3 fatty acids on physical and cognitive function in older adults. Non-frail or pre-frail females aged ≥60 years are included in a randomized placebo controlled study. Intervention groups are: high DHA multi-nutrient supplement and exercise, placebo supplement and exercise, high DHA multi-nutrient supplement, and placebo supplement. Dietary supplementation is 24 weeks. The exercise intervention, two cycle ergometer classes per week, is for the final 12 weeks. The primary outcome is habitual walking speed, secondary outcomes include gait variables under single and dual task, five times sit to stand, verbal and spatial memory, executive function, interference control and health related quality of life. Blood fatty acids, serum homocysteine, dietary intake, physical activity, and verbal intelligence are measured to assess compliance and control for confounding factors. The study is registered at www.clinicaltrials.gov (NCT03228550).
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Affiliation(s)
- Paul Fairbairn
- Faculty of Health and Social Sciences, Bournemouth University, Dorset, U.K
| | - Fotini Tsofliou
- Faculty of Health and Social Sciences, Bournemouth University, Dorset, U.K
| | - Andrew Johnson
- Department of Psychology, Faculty of Science and Technology, Cognition and Cognitive Neuroscience Research Centre, Bournemouth University, Dorset, U.K
| | - Simon C Dyall
- Department of Life Sciences, University of Roehampton, London, U.K.
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Bjerk M, Brovold T, Skelton DA, Liu-Ambrose T, Bergland A. Effects of a falls prevention exercise programme on health-related quality of life in older home care recipients: a randomised controlled trial. Age Ageing 2019; 48:213-219. [PMID: 30615055 DOI: 10.1093/ageing/afy192] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 12/09/2018] [Accepted: 11/23/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND falls have serious consequences for quality of life (QOL) and contribute substantially to the global burden of disease. Home care is an important arena to address falls prevention and QOL, but this vulnerable group of older adults is underrepresented in health research. This study explores the effects of a falls prevention exercise programme on health-related quality of life (HRQOL), physical function and falls self-efficacy in older fallers receiving home care. METHODS the study design is a parallel-group randomised controlled trial. The intervention group performed a falls prevention programme based on the Otago Exercise Programme (OEP). The control group received usual care. 155 participants were recruited from primary health care in six Norwegian municipalities. Local physiotherapists supervised the programme. The primary outcome, HRQOL, was measured by the Short-Form 36 Health Survey (SF-36). Secondary outcomes were Berg Balance Scale (BBS), 30-s sit to stand (STS), 4-m walk test, instrumental activities of daily living and Falls Efficacy Scale International. RESULTS intention-to-treat analysis showed that, compared to the control group, the intervention group improved on SF-36's physical component summary as well as BBS. However, the intervention group also demonstrated a decline in the mental health subscale of SF-36. Per-protocol analyses showed significant improvements in all physical subscales of SF-36, STS and BBS scores in the intervention group compared with the control group. CONCLUSION a falls prevention exercise programme based on OEP significantly improved physical HRQOL and balance in older adults receiving home care. TRIAL REGISTRATION ClinicalTrials.gov. NCT02374307. First registration, 16 February 2015.
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Affiliation(s)
- Maria Bjerk
- Department of Physiotherapy, OsloMet—Oslo Metropolitan University, PO Box 4 St. Olavs Plass, Oslo, Norway
| | - Therese Brovold
- Department of Physiotherapy, OsloMet—Oslo Metropolitan University, PO Box 4 St. Olavs Plass, Oslo, Norway
| | - Dawn A Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, Canada
| | - Astrid Bergland
- Department of Physiotherapy, OsloMet—Oslo Metropolitan University, PO Box 4 St. Olavs Plass, Oslo, Norway
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Baptista FM, Rodrigues AM, Gregório MJ, de Sousa R, Cruz E, Canhão H. Functional Status and Quality of Life Determinants of a Group of Elderly People With Food Insecurity. Front Nutr 2018; 5:99. [PMID: 30410883 PMCID: PMC6209666 DOI: 10.3389/fnut.2018.00099] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/04/2018] [Indexed: 01/02/2023] Open
Abstract
Background: A good functionality is appointed by the elderly as one of the most important factors for a good quality of life, since it is associated with independency and autonomy. Studies show that elderly with food insecurity have greater limitations in daily living activities (DLA) when compared to food security elderly. Moreover, food insecure elderly are 60% more likely to be diagnosed with depression. We aimed to investigate the potential determinants of functional status (HAQ) and quality of life (EQ-5D-3L) in a sample of elderly with food insecurity. Methods: Forty-one participants with food insecurity were evaluated by a multidisciplinary team, in April and May of 2016 (a baseline cross-sectional study prior to the intervention program). Results: This study demonstrates correlations of functional status and quality of life to such aspects of elderly assessment as age, BMI, manual strength, among others. It was found that manual strength, gender, family income, anxiety, and depression were correlated to quality of life; and that mobility, manual strength, anxiety and gender were correlated to the functional status. After multivariable adjustment, only mobility (β = −0.220; p ≤ 0.01) and quality of life (β = −1.457; p ≤ 0.01) remained significantly associated with higher levels of functional disability. With regard to quality of life, only the functional status (β = −0.242; p ≤ 0.01), the presence of depression (β = −0.169; p ≤ 0.05), and family income (β = 0.185; p ≤ 0.05) remained significantly associated with health-related quality of life. Conclusions: The study aims to verify the potential determinants of functional status (HAQ) and quality of life (EQ-5D-3L) in a sample of elderly with food insecurity. Even in a small cohort, the study demonstrated that in an elderly population with food insecurity, functional status is associated with mobility and quality of life, and that health-related quality of life is also associated with symptoms of depression and family income. Larger studies in other populations may be useful to confirm these observations.
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Affiliation(s)
| | - Ana Maria Rodrigues
- CEDOC, EpiDoc Unit - Unidade de Epidemiologia em Doenças Crónicas, Nova Medical School, Lisbon, Portugal.,Associação EpiSaúde, Évora, Portugal.,Sociedade Portuguesa de Reumatologia, Lisbon, Portugal.,Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Maria João Gregório
- CEDOC, EpiDoc Unit - Unidade de Epidemiologia em Doenças Crónicas, Nova Medical School, Lisbon, Portugal.,Associação EpiSaúde, Évora, Portugal.,Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - Rute de Sousa
- CEDOC, EpiDoc Unit - Unidade de Epidemiologia em Doenças Crónicas, Nova Medical School, Lisbon, Portugal.,Associação EpiSaúde, Évora, Portugal
| | - Eduardo Cruz
- Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - Helena Canhão
- CEDOC, EpiDoc Unit - Unidade de Epidemiologia em Doenças Crónicas, Nova Medical School, Lisbon, Portugal.,Associação EpiSaúde, Évora, Portugal.,Sociedade Portuguesa de Reumatologia, Lisbon, Portugal.,Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
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Bjerk M, Brovold T, Skelton DA, Bergland A. Associations between health-related quality of life, physical function and fear of falling in older fallers receiving home care. BMC Geriatr 2018; 18:253. [PMID: 30348098 PMCID: PMC6198355 DOI: 10.1186/s12877-018-0945-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 10/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Falls and injuries in older adults have significant consequences and costs, both personal and to society. Although having a high incidence of falls, high prevalence of fear of falling and a lower quality of life, older adults receiving home care are underrepresented in research on older fallers. The objective of this study is to determine the associations between health-related quality of life (HRQOL), fear of falling and physical function in older fallers receiving home care. METHODS This study employed cross-sectional data from baseline measurements of a randomised controlled trial. 155 participants, aged 67+, with at least one fall in the previous year, from six Norwegian municipalities were included. Data on HRQOL (SF-36), physical function and fear of falling (FES-I) were collected in addition to demographical and other relevant background information. A multivariate regression model was applied. RESULTS A higher score on FES-I, denoting increased fear of falling, was significantly associated with a lower score on almost all subscales of SF-36, denoting reduced HRQOL. Higher age was significantly associated with higher scores on physical function, general health, mental health and the mental component summary. This analysis adjusted for sex, education, living alone, being at risk of or malnourished, physical function like balance and walking speed, cognition and number of falls. CONCLUSION Fear of falling is important for HRQOL in older fallers receiving home care. This association is independent of physical measures. Better physical function is significantly associated with higher physical HRQOL. Future research should address interventions that reduce fear of falling and increase HRQOL in this vulnerable population. TRIAL REGISTRATION ClinicalTrials.gov. NCT02374307 . First registration, 16 February 2015. First enrolment of participants, February 2016.
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Affiliation(s)
- Maria Bjerk
- Department of Physiotherapy, OsloMet – Oslo Metropolitan University, PO Box 4 St. Olavs plass, 0130 Oslo, Norway
| | - Therese Brovold
- Department of Physiotherapy, OsloMet – Oslo Metropolitan University, PO Box 4 St. Olavs plass, 0130 Oslo, Norway
| | - Dawn A. Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Astrid Bergland
- Department of Physiotherapy, OsloMet – Oslo Metropolitan University, PO Box 4 St. Olavs plass, 0130 Oslo, Norway
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Yan W, Shah P, Hiebert B, Pozeg Z, Ghorpade N, Singal RK, Manji RA, Arora RC. Long-term non-institutionalized survival and rehospitalization after surgical aortic and mitral valve replacements in a large provincial cardiac surgery centre. Interact Cardiovasc Thorac Surg 2018; 27:131-138. [PMID: 29462406 DOI: 10.1093/icvts/ivy018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 01/14/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Long-term quality of life following open surgical valve replacement is an increasingly important outcome to patients and their caregivers. This study examines non-institutionalized survival and rehospitalization within our surgical aortic valve replacement (AVR) and mitral valve replacement (MVR) populations. METHODS A retrospective single-centre study of all consecutive open surgical valve replacements between 1995 and 2014 was undertaken. Clinical data were linked to provincial administrative data for 3219 patients who underwent AVR, MVR or double (aortic and mitral) valve replacement with or without concomitant coronary artery bypass grafting (CABG). Non-institutionalized survival and cumulative incidence of rehospitalization was examined up to 15 years. RESULTS Follow-up was complete for 96.9% of the 2146 patients who underwent AVR ± CABG (66.7% of the overall cohort), 878 who underwent MVR ± CABG (27.3%) and 195 who underwent double (aortic and mitral) valve replacement ± CABG (6.0%) with a median follow-up time of 5.6 years. Overall non-institutionalized survival was 35.4% at 15 years, and the cumulative incidence of rehospitalization was 34.4%, 63.2% and 87.0% at 1, 5 and 15 years, respectively, without significant differences between valve procedure cohorts. Both non-institutionalized survival and cumulative incidence of rehospitalization improved in more recent eras, despite increasing age and comorbidities. CONCLUSIONS Non-institutionalized survival and rehospitalization data for up to 15 years suggest good functional outcomes long after surgical AVR and/or MVR. Continued improvements are seen in these metrics over the past 2 decades. This provides a unique insight into the quality of life after surgical valve replacement in the ageing demographics with valvular heart disease.
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Affiliation(s)
- Weiang Yan
- Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.,Cardiac Sciences Program, Winnipeg Regional Health Authority, Winnipeg, MB, Canada
| | - Pallav Shah
- Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.,Cardiac Sciences Program, Winnipeg Regional Health Authority, Winnipeg, MB, Canada
| | - Brett Hiebert
- Cardiac Sciences Program, Winnipeg Regional Health Authority, Winnipeg, MB, Canada
| | - Zlatko Pozeg
- Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.,Cardiac Sciences Program, Winnipeg Regional Health Authority, Winnipeg, MB, Canada
| | - Nitin Ghorpade
- Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.,Cardiac Sciences Program, Winnipeg Regional Health Authority, Winnipeg, MB, Canada
| | - Rohit K Singal
- Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.,Cardiac Sciences Program, Winnipeg Regional Health Authority, Winnipeg, MB, Canada
| | - Rizwan A Manji
- Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.,Cardiac Sciences Program, Winnipeg Regional Health Authority, Winnipeg, MB, Canada
| | - Rakesh C Arora
- Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.,Cardiac Sciences Program, Winnipeg Regional Health Authority, Winnipeg, MB, Canada
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Madva EN, Gomez-Bernal F, Millstein RA, Celano CM, Park ER, Mastromauro CA, Albanese AM, Beale EE, Huffman JC. Magnitude and sources of distress in mid-life adults with chronic medical illness: an exploratory mixed-methods analysis. PSYCHOL HEALTH MED 2018; 23:555-566. [PMID: 28984158 PMCID: PMC6186490 DOI: 10.1080/13548506.2017.1384554] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Most mid-life adults have at least one chronic medical condition (CMC) and are at risk for developing additional CMCs. Stressors specific to this life stage may contribute to CMC development by hindering healthy behaviors. The goal of this study was to compare sources and intensity of distress, as they relate to health behaviors, between mid-life and non-mid-life adults with CMCs. We utilized a mixed-methods approach by analyzing quantitative self-report measures of psychiatric symptoms and psychological well-being, with in-depth, semi-structured qualitative interviews to identify sources of stress in three cohorts of patients with CMCs (heart failure, type 2 diabetes, and coronary artery disease). Between-group differences on self-report measures were compared via independent samples t-tests and relevant themes from interview transcripts were compared via chi-square analysis. We found that mid-life participants (n = 30) reported greater psychological distress (depression/anxiety) than non-mid-life (n = 62) participants (Hospital Anxiety and Depression Scale scores 13.8 [SD 7.3] vs. 10.6 [SD 6.6]; t(90)=2.13; p = .035), and qualitative analysis revealed several specific sources of stress significantly more common (p < .001) in mid-life adults. Interventions targeting the needs of this population could reduce distress, improve health behaviors, and have a major impact on public health.
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Affiliation(s)
- Elizabeth N. Madva
- Harvard Medical School, Boston, MA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | | | - Rachel A. Millstein
- Harvard Medical School, Boston, MA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Christopher M. Celano
- Harvard Medical School, Boston, MA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Elyse R. Park
- Harvard Medical School, Boston, MA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | | | | | - Eleanor E. Beale
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Jeff C. Huffman
- Harvard Medical School, Boston, MA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
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Kazazi L, Foroughan M, Nejati V, Shati M. Association between age associated cognitive decline and health related quality of life among Iranian older individuals. Electron Physician 2018; 10:6663-6671. [PMID: 29881529 PMCID: PMC5984021 DOI: 10.19082/6663] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/10/2017] [Indexed: 01/09/2023] Open
Abstract
Background Age associated cognitive decline or normal cognitive aging is related with lower levels of functioning in real life, and may interfere with maintaining independence and health related quality of life (HRQL). Objective In this study, health related quality of life and cognitive function in community-dwelling older adults were evaluated with the aim of exploring the association between them by adjusting for potential confounders. Methods This cross-sectional study, was implemented on 425 community-dwelling older adults aged 60 and over, between August 2016 and October 2016 in health centers of the municipality of Tehran, Iran, using Mini Mental State Examination (MMSE) to assess cognitive function and Short Form-36 scales (SF-36) to assess HRQL. The relation between HRQL and cognitive function was evaluated by Pearson’s correlation coefficient, and the impact of cognitive function on HRQL adjusted for potential confounders was estimated by linear regression model. All analyses were done using SPSS, version 22.0. Results A positive significant correlation between cognitive function and quality of life (r=0.434; p<0.001) and its dimensions was observed. Two variables of educational level (B=2.704; 95% CI: 2.09 to 3.30; p<0.001) and depression (B=2.554; 95% CI: 2.00 to 3.10; p<0.001) were assumed as potential confounder by changing effect measure after entering the model. After adjusting for potential confounders in regression model, the association between MMSE scores and quality of life persisted (B=2.417; 95% CI: 1.86 to 2.96; p<0.001). Conclusion The results indicate that cognitive function was associated with HRQL in older adults with age associated cognitive function. Two variables of educational level and depression can affect the relation between cognitive decline and HRQL.
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Affiliation(s)
- Leila Kazazi
- Ph.D. Student of Gerontology, Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mahshid Foroughan
- M.D., Iranian Research Center on Aging, Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Vahid Nejati
- Ph.D., Associate Professor of Cognitive Neuroscience, Psychology Department, Shahid Beheshti University, Tehran, Iran
| | - Mohsen Shati
- MD, MPH, Ph.D. of Epidemiology, Department of Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Abstract
PURPOSE OF REVIEW Numerous population-based studies suggest that glaucoma is an independent risk factor for falling and motor vehicle collisions, particularly for older adults. These adverse events lead to increased healthcare expenditures and decreased quality of life. Current research priorities, therefore, include identifying factors that predispose glaucoma patients to falling and unsafe driving, and developing screening strategies and targeted rehabilitation. The purpose of this article is to review recent studies that address these priorities. RECENT FINDINGS Studies continue to support that glaucoma patients, particularly those with advanced disease, have an increased risk of falling or unsafe driving. Risk factors, however, remain variable and include severity and location of visual field defects, contrast sensitivity, and performance on divided attention tasks. Such variability is likely because of the multifactorial nature of ambulating and driving and compensatory strategies used by patients. SUMMARY Falls and unsafe driving remain a serious public health issue for older adults with glaucoma. Ambulation and driving are complex tasks and there is no consensus yet, regarding the best methods for risk stratification and targeted interventions to increase safety. Therefore, comprehensive and individualized assessments are recommended to most effectively evaluate a patient's risk for falling or unsafe driving.
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Multimorbidity: constellations of conditions across subgroups of midlife and older individuals, and related Medicare expenditures. JOURNAL OF COMORBIDITY 2017; 7:33-43. [PMID: 29090187 PMCID: PMC5556436 DOI: 10.15256/joc.2017.7.91] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 02/20/2017] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The Department of Health and Human Services' 2010 Strategic Framework on Multiple Chronic Conditions called for the identification of common constellations of conditions in older adults. OBJECTIVES To analyze patterns of conditions constituting multimorbidity (CCMM) and expenditures in a US representative sample of midlife and older adults (50-64 and ≥65 years of age, respectively). DESIGN A cross-sectional study of the 2010 Health and Retirement Study (HRS; n=17,912). The following measures were used: (1) count and combinations of CCMM, including (i) chronic conditions (hypertension, arthritis, heart disease, lung disease, stroke, diabetes, cancer, and psychiatric conditions), (ii) functional limitations (upper body limitations, lower body limitations, strength limitations, limitations in activities of daily living, and limitations in instrumental activities of daily living), and (iii) geriatric syndromes (cognitive impairment, depressive symptoms, incontinence, visual impairment, hearing impairment, severe pain, and dizziness); and (2) annualized 2011 Medicare expenditures for HRS participants who were Medicare fee-for-service beneficiaries (n=5,677). Medicaid beneficiaries were also identified based on their self-reported insurance status. RESULTS No large representations of participants within specific CCMM categories were observed; however, functional limitations and geriatric syndromes were prominently present with higher CCMM counts. Among fee-for-service Medicare beneficiaries aged 50-64 years, 26.7% of the participants presented with ≥10 CCMM, but incurred 48% of the expenditure. In those aged ≥65 years, these percentages were 16.9% and 34.4%, respectively. CONCLUSION Functional limitations and geriatric syndromes considerably add to the MM burden in midlife and older adults. This burden is much higher than previously reported.
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Davis JC, Best JR, Khan KM, Dian L, Lord S, Delbaere K, Hsu CL, Cheung W, Chan W, Liu-Ambrose T. Slow Processing Speed Predicts Falls in Older Adults With a Falls History: 1-Year Prospective Cohort Study. J Am Geriatr Soc 2017; 65:916-923. [DOI: 10.1111/jgs.14830] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Jennifer C. Davis
- Aging, Mobility, and Cognitive Neuroscience Lab; Department of Physical Therapy; University of British Columbia; Vancouver British Columbia Canada
- Center for Hip Health and Mobility; Vancouver Coastal Health Research Institute; Vancouver British Columbia Canada
- Djavad Mowafaghian Centre for Brain Health; Vancouver British Columbia Canada
| | - John R. Best
- Aging, Mobility, and Cognitive Neuroscience Lab; Department of Physical Therapy; University of British Columbia; Vancouver British Columbia Canada
- Center for Hip Health and Mobility; Vancouver Coastal Health Research Institute; Vancouver British Columbia Canada
- Djavad Mowafaghian Centre for Brain Health; Vancouver British Columbia Canada
| | - Karim M. Khan
- Center for Hip Health and Mobility; Vancouver Coastal Health Research Institute; Vancouver British Columbia Canada
- Department of Family Practice; University of British Columbia; Vancouver British Columbia Canada
| | - Larry Dian
- Division of Geriatrics; Faculty of Medicine; University of British Columbia; Vancouver British Columbia Canada
| | - Stephen Lord
- Falls, Balance and Injury Research Centre; Neuroscience Research Australia; Sydney New South Wales Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre; Neuroscience Research Australia; Sydney New South Wales Australia
| | - Chun Liang Hsu
- Aging, Mobility, and Cognitive Neuroscience Lab; Department of Physical Therapy; University of British Columbia; Vancouver British Columbia Canada
- Center for Hip Health and Mobility; Vancouver Coastal Health Research Institute; Vancouver British Columbia Canada
- Djavad Mowafaghian Centre for Brain Health; Vancouver British Columbia Canada
| | - Winnie Cheung
- Aging, Mobility, and Cognitive Neuroscience Lab; Department of Physical Therapy; University of British Columbia; Vancouver British Columbia Canada
- Center for Hip Health and Mobility; Vancouver Coastal Health Research Institute; Vancouver British Columbia Canada
- Djavad Mowafaghian Centre for Brain Health; Vancouver British Columbia Canada
| | - Wency Chan
- Aging, Mobility, and Cognitive Neuroscience Lab; Department of Physical Therapy; University of British Columbia; Vancouver British Columbia Canada
- Center for Hip Health and Mobility; Vancouver Coastal Health Research Institute; Vancouver British Columbia Canada
- Djavad Mowafaghian Centre for Brain Health; Vancouver British Columbia Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Lab; Department of Physical Therapy; University of British Columbia; Vancouver British Columbia Canada
- Center for Hip Health and Mobility; Vancouver Coastal Health Research Institute; Vancouver British Columbia Canada
- Djavad Mowafaghian Centre for Brain Health; Vancouver British Columbia Canada
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Addressing future demands: Nursing students, elders, and pet birds: A student-initiated quality improvement project. Geriatr Nurs 2017. [DOI: 10.1016/j.gerinurse.2017.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Werner C, Ullrich P, Geravand M, Peer A, Bauer JM, Hauer K. A systematic review of study results reported for the evaluation of robotic rollators from the perspective of users. Disabil Rehabil Assist Technol 2017; 13:31-39. [PMID: 28125298 DOI: 10.1080/17483107.2016.1278470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the effectiveness and perception of robotic rollators (RRs) from the perspective of users. METHODS Studies identified in a previous systematic review published on 2016 on the methodology of studies evaluating RRs by the user perspective were re-screened for eligibility based on the following inclusion criteria: evaluation of the human-robot interaction from the user perspective, use of standardized outcome measurements, and quantitative presentation of study results. RESULTS Seventeen studies were eligible for inclusion. Due to the clinical and methodological heterogeneity across studies, a narrative synthesis of study results was conducted. We found conflicting results concerning the effectiveness of the robotic functionalities of the RRs. Only a few studies reported superior user performance or reduced physical demands with the RRs compared to unassisted conditions or conventional assistive mobility devices; however, without providing statistical evidence. The user perception of the RRs was found to be generally positive. CONCLUSIONS There is still no sufficient evidence on the effectiveness of RRs from the user perspective. More well-designed, high-quality studies with adequate study populations, larger sample sizes, appropriate assessment strategies with outcomes specifically tailored to the robotic functionalities, and statistical analyses of results are required to evaluate RRs at a higher level of evidence. Implications for Rehabilitation RRs cover intelligent functionalities that focus on gait assistance, obstacle avoidance, navigation assistance, sit-to-stand transfer, body weight support or fall prevention. The evaluation from the user perspective is essential to ensure that RRs effectively address users' needs, requirements and preferences. The evidence on the effectiveness of RRs is severely hampered by the low methodological quality of most of the available studies. RRs seem generally to be perceived as positive by the users. There is very limited evidence on the effectiveness and benefits of RRs compared to conventional assistive mobility devices. Further research with high methodological quality needs to be conducted to reach more robust conclusions about the effectiveness of RRs.
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Affiliation(s)
- Christian Werner
- a Department of Geriatric Research , AGAPLESION Bethanien-Hospital, Geriatric Centre at the University of Heidelberg , Heidelberg , Germany
| | - Phoebe Ullrich
- a Department of Geriatric Research , AGAPLESION Bethanien-Hospital, Geriatric Centre at the University of Heidelberg , Heidelberg , Germany
| | - Milad Geravand
- b Department of Robot and Assistant Systems , Fraunhofer Institute for Manufacturing Engineering and Automation IPA , Stuttgart , Germany
| | - Angelika Peer
- c Bristol Robotics Laboratory, University of the West of England , Bristol , UK
| | - Jürgen M Bauer
- a Department of Geriatric Research , AGAPLESION Bethanien-Hospital, Geriatric Centre at the University of Heidelberg , Heidelberg , Germany.,d Geriatric Medicine , Heidelberg University , Heidelberg , Germany
| | - Klaus Hauer
- a Department of Geriatric Research , AGAPLESION Bethanien-Hospital, Geriatric Centre at the University of Heidelberg , Heidelberg , Germany
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Davis JC, Best JR, Dian L, Khan KM, Hsu CL, Chan W, Cheung W, Liu-Ambrose T. Are the EQ-5D-3L and the ICECAP-O responsive among older adults with impaired mobility? Evidence from the Vancouver Falls Prevention Cohort Study. Qual Life Res 2016; 26:737-747. [DOI: 10.1007/s11136-016-1487-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2016] [Indexed: 01/23/2023]
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Salehi R, Shakhi K, Khiavi FF. ASSOCIATION BETWEEN DISABILITY AND QUALITY OF LIFE IN MULTIPLE SCLEROSIS PATIENTS IN AHVAZ, IRAN. Mater Sociomed 2016; 28:215-9. [PMID: 27482165 PMCID: PMC4949033 DOI: 10.5455/msm.2016.28.215-219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/19/2016] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Multiple Sclerosis (MS) is a neurodegenerative and chronic disease of central nervous system which affected the middle aged people. The disabling nature of this disease can limit the daily activities, restrict the society roles, unemployment and finally lead to decline the quality of life (QoL) in MS patients. So, the main purpose of this study was to determine association between disability and quality of life among MS patients in Ahvaz, Iran. MATERIALS AND METHODS One hundred and one MS patients who living in Khouzestan participated in the cross-sectional study. Two questionnaires include the MSQoL-54 and World Health Organization disability assessment schedule 2.0 (WHODAS2.0) were used in order to measure the QoL and disability severity. Descriptive statistics as well as Pearson correlation coefficient and simple linear regression were used to analysis the data. RESULTS The respondent rate was 100 percent. The disability showed a large and negative association with QoL (p<0.001) but QoL was not significantly associated with EDSS score. Social participation and cognition subscales recognized as QoL predictors according to simple regression results. CONCLUSION The cognition and participation, disability subscales, were the most important predicators for QoL. Therefore, increasing employment opportunities, changing society's attitude and using the psychotherapy programs might improve the MS patient's QoL.
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Affiliation(s)
- Reza Salehi
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khozestan, Iran
| | - Kamal Shakhi
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khozestan, Iran
| | - Farzad Faraji Khiavi
- Department of Healthcare Administration, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khozestan, Iran
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Self-reported Balance Confidence Relates to Perceived Mobility Limitations in Older Cancer Survivors. REHABILITATION ONCOLOGY 2016. [DOI: 10.1097/01.reo.0000000000000017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Paxton RJ, Murray AM, Stevens-Lapsley JE, Sherk KA, Christiansen CL. Physical activity, ambulation, and comorbidities in people with diabetes and lower-limb amputation. JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT 2016; 53:1069-1078. [PMID: 28355032 PMCID: PMC5474964 DOI: 10.1682/jrrd.2015.08.0161] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 12/01/2015] [Indexed: 11/05/2022]
Abstract
We characterized physical activity (PA) and its relation to physical function and number of comorbidities in people with diabetes and transtibial amputation (AMP), people with diabetes without AMP, and nondisabled adults without diabetes or AMP. Twenty-two individuals with type 2 diabetes mellitus (DM) and transtibial amputation (DM+AMP), 11 people with DM, and 13 nondisabled participants were recruited for this cross-sectional cohort study. Measures included PA volume and intensity, a Timed Up and Go test, a 2-min walk test, and number of comorbidities. The nondisabled group performed greater amounts of PA than the DM group, who performed greater amounts of PA than the DM+AMP group. PA was related to physical function in the DM group and in the DM+AMP group, whereas no such relationship existed in the nondisabled group. PA was not related to number of comorbidities in any group. These findings suggest the ability to walk may affect overall performance of PA. Alternately, PA may alleviate walking problems. This possibility is of interest because issues with walking may be modifiable by improved levels and intensity of PA. PA's lack of relation to number of comorbidities suggests that factors beyond multiple morbidities account for group differences in PA.
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Affiliation(s)
- Roger J. Paxton
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO
| | - Amanda M. Murray
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO
- Geriatric Research Education and Clinical Center, Department of Veterans Affairs Eastern Colorado Healthcare System, Denver, CO
| | - Jennifer E. Stevens-Lapsley
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO
- Geriatric Research Education and Clinical Center, Department of Veterans Affairs Eastern Colorado Healthcare System, Denver, CO
| | | | - Cory L. Christiansen
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO
- Geriatric Research Education and Clinical Center, Department of Veterans Affairs Eastern Colorado Healthcare System, Denver, CO
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Pan CW, Wang X, Ma Q, Sun HP, Xu Y, Wang P. Cognitive dysfunction and health-related quality of life among older Chinese. Sci Rep 2015; 5:17301. [PMID: 26601612 PMCID: PMC4658548 DOI: 10.1038/srep17301] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 10/28/2015] [Indexed: 11/09/2022] Open
Abstract
We aimed to assess the association of cognitive dysfunction with health-related quality of life (HRQOL) among older adults in China. We analyzed community-based cross-sectional data of 5,557 Chinese individuals aged 60 years and above in the Weitang Geriatric Diseases Study. Cognitive dysfunction and HRQOL were assessed using the Abbreviated Mental Test (AMT) and the European Quality of Life-5 dimensions (EQ-5D), respectively. We estimated the impacts of cognitive dysfunction on the EQ-5D index and visual analogue scale (VAS) scores using linear regression models, and the association between cognitive dysfunction and self-reported EQ-5D health problems using logistic regression models. The EQ-5D index and VAS scores were significantly lower for individuals with cognitive dysfunction than their counterparts. After controlling for covariates, the differences in EQ-5D index and VAS scores between individuals with and without cognitive dysfunction were −0.016 (95% confidence interval [CI]: −0.024, −0.008), and −3.4 (95% CI: −4.5, −2.4), respectively. Cognitive dysfunction was associated with reporting of problems in pain/discomfort (odds ration [OR]: 1.37; 95% CI: 1.12, 1.69), and anxiety/depression (OR: 2.13; 95% CI: 1.41, 3.23). The negative impact on HRQOL increased with the severity of cognitive dysfunction. The results indicate cognitive dysfunction was associated with worse HRQOL in older adults.
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Affiliation(s)
- Chen-Wei Pan
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xingzhi Wang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Qinghua Ma
- The 3rd People's Hospital of Xiangcheng District, Suzhou, China
| | - Hong-Peng Sun
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yong Xu
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Pei Wang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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