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Riera Arias G, Serra Corcoll J, Casadevall Arnaus M, Vidal-Alaball J, Ramírez-Morros A, Arnau Solé G. [Improving quality of life in older adults with the decline syndrome: The role of occupational therapy in primary care]. Aten Primaria 2024; 56:102879. [PMID: 38359516 PMCID: PMC10877117 DOI: 10.1016/j.aprim.2024.102879] [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] [Received: 11/16/2023] [Revised: 12/19/2023] [Accepted: 01/02/2024] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVE To evaluate the effect of an occupational therapy intervention in users recently diagnosed with the decline syndrome, who have experienced a decrease in the Barthel and/or Lawton index in the last month and susceptible to improvement based on medical opinion. DESIGN Non-controlled, quasi-experimental longitudinal study. A pre-post intervention. LOCATION Sant Hipòlit de Voltregà health centre. Osona, Barcelona. PARTICIPANTS Patients referred by the centre's primary care nursing, social work or medical staff with a recent diagnosis of decline syndrome who may benefit from the intervention of an occupational therapy professional. INTERVENTION Following the initial assessment visit, four training sessions were conducted to improve functional independence, mobility and adaptation of the home environment, providing training to primary caregivers. MAIN MEASUREMENTS Patient autonomy was assessed using the Barthel and Lawton scales, quality of life using the EuroQol questionnaire (EQ-5D) and home suitability using the home suitability assessment questionnaire. RESULTS Improvements were observed in autonomy in activities of daily living (p=0.003), mobility (p=0.001) and housing adaptation (p<0.001). The level of anxiety/depression was reduced (p=0.028), and the mean health status score increased markedly (p<0.001). CONCLUSIONS This study highlights the improvement in the quality of life and autonomy in the basic activities of daily living for individuals receiving occupational therapy, emphasizing the need for home adaptation and family support.
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Affiliation(s)
- Gemma Riera Arias
- Equipo de Atención Primaria Sant Hipòlit de Voltregà, Gerència d'Atenció Primària i a la Comunitat de Catalunya Central, Institut Català de la Salut, Cataluña, España
| | - Judith Serra Corcoll
- Equipo de Atención Primaria Sant Hipòlit de Voltregà, Gerència d'Atenció Primària i a la Comunitat de Catalunya Central, Institut Català de la Salut, Cataluña, España
| | - Marina Casadevall Arnaus
- Equipo de Atención Primaria Sant Hipòlit de Voltregà, Gerència d'Atenció Primària i a la Comunitat de Catalunya Central, Institut Català de la Salut, Cataluña, España
| | - Josep Vidal-Alaball
- Unidad de Soporte a la Investigación de la Catalunya Central, Instituto Universitario para la investigación en atención primaria Jordi Gol i Gurina, Barcelona, España; Facultad de medicina, Universidad de Vic - Universidad Central de Cataluña, Cataluña, España; Grupo de promoción de la salud en áreas rurales, Gerència d'Atenció Primària i a la Comunitat de Catalunya Central, Institut Català de la Salut, Cataluña, España.
| | - Anna Ramírez-Morros
- Unidad de Soporte a la Investigación de la Catalunya Central, Instituto Universitario para la investigación en atención primaria Jordi Gol i Gurina, Barcelona, España
| | - Glòria Arnau Solé
- Equipo de Atención Primaria Sant Hipòlit de Voltregà, Gerència d'Atenció Primària i a la Comunitat de Catalunya Central, Institut Català de la Salut, Cataluña, España
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White J, Maier AB, Iacobaccio L, Iseli R. Foot Problems in Older Adults Presenting to a Falls and Balance Clinic. Gerontology 2024; 70:732-740. [PMID: 38697042 DOI: 10.1159/000539160] [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] [Received: 10/20/2023] [Accepted: 04/23/2024] [Indexed: 05/04/2024] Open
Abstract
INTRODUCTION Foot problems, including musculoskeletal problems, peripheral neuropathy, peripheral arterial disease and dermatologic pathology are common in older adults and are associated with an increased risk of falling. Multicomponent podiatry interventions have been shown to reduce the incidence of falls. This paper aimed to identify older adults requiring podiatry input in a Falls and Balance clinic; to describe the model of foot health care they receive; to explore cross-sectional associations between foot problems and function and ultimately demonstrate the role of podiatry input in the multidisciplinary management of falls risk. METHODS Cohort study of patients attending a Falls and Balance Clinic for Comprehensive Geriatric Assessment. Demographic information was collected and functional independence, mobility, foot problems, and footwear were assessed in the clinic. RESULTS One-hundred and two patients were included; median age 79.3 (73-84.3) years, 68.6% female, 93.1% residing independently, 62.7% used a gait aid. Podiatry referrals were made in 80.4% of cases, with muscle weakness being the most common problem identified (90.2%); 74.8% were found to be wearing inappropriate footwear. Most patients received footwear education and half were prescribed foot and ankle strengthening exercises. Hallux and lesser toe weakness were associated with lower Short Physical Performance Battery scores (p < 0.001). CONCLUSION The majority of older adults in the Falls and Balance Clinic required podiatry input, with foot weakness and inappropriate footwear being common reasons for referral. Those with weakness of the hallux and lesser toes had poorer balance and mobility, which is known to be associated with greater falls risk. This highlights the need for podiatry assessment and interventions as part of the multidisciplinary approach to the management of falls risk in older adults.
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Affiliation(s)
- Josephine White
- Department of Medicine, Dentistry and Health Science, University of Melbourne, Parkville, Victoria, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Healthy Longevity, National University Health System, Singapore, Singapore
| | - Laura Iacobaccio
- Department of Podiatry, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Rebecca Iseli
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
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Sorbie GG, Williams AK, Carter SE, Campbell AK, Glen J, Lavallee D, Sculthorpe N, Murray A, Beaumont AJ. Improved Physical Health in Middle-Older Aged Golf Caddies Following 24 Weeks of High-Volume Physical Activity. J Phys Act Health 2024; 21:134-145. [PMID: 37939701 DOI: 10.1123/jpah.2023-0288] [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] [Received: 06/14/2023] [Revised: 08/28/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND The physical demands of golf caddying, including walking while carrying a golf bag, may potentially affect body composition, and markers of metabolic, cardiovascular, and musculoskeletal health. Therefore, this study examined the impact of 24 weeks of caddying on physical health in middle-older aged males. METHODS Eleven full-time experienced male caddies (age: 59 [8] y; caddying experience: 14 [12] y) were recruited from a local golf course. The following were assessed at preseason and after 24 weeks of caddying (March-September 2022): body composition, heart rate, blood pressure, blood lipids, and performance tests (static and dynamic balance, strength, and submaximal fitness). Physical activity (PA) levels were assessed at preseason and at the mid-point of the caddying season. Across the caddying season, participants completed a monthly average of 24.0 (3.8) rounds. RESULTS Following the caddying season, improvements in static balance (Δ = 13.5 s), dynamic balance (Δ = -1.8 s), and lower back absolute strength (Δ = 112.8 N), and muscle quality (Δ = 2.0 N·kg-1) were observed (all P < .05). Additionally, blood lipids, including total cholesterol (Δ = -0.6 mmol·L-1), high-density lipoprotein cholesterol (Δ = 0.1 mmol·L-1), low-density lipoprotein cholesterol (Δ = -0.6 mmol·L-1) (all P < .05), and body composition, including body mass (Δ = -2.7 kg), fat mass (Δ = -1.9 kg), fat percentage (Δ = -1.4%), fat-to-muscle ratio (Δ = -0.03), and body mass index (Δ = -0.9 kg·m-2) (all P < .05) improved. Caddying did not offer beneficial changes to cardiovascular variables or cardiorespiratory fitness (P > .05), while coronary heart disease risk score decreased (Δ = -3.3%) (P < .05). In relation to PA, light- (Δ = 145 min) and moderate-intensity (Δ = 71 min) PA, moderate to vigorous PA (Δ = 73 min), and total PA (Δ = 218 min) between preseason and the mid-point of the caddying season increased, while sedentary time (Δ = -172 min) decreased (all P < .05). CONCLUSION Golf caddying can provide several physical health benefits such as improvements in various markers of cardiometabolic health, lower back absolute strength, and static and dynamic balance. The physical health improvements that caddying offers is likely contributed to by increased PA volume and intensity through walking on the golf course. Therefore, caddying may represent a feasible model for increasing PA volume and intensity and achieve physical health-related benefits.
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Affiliation(s)
- Graeme G Sorbie
- Division of Sport and Exercise Sciences, School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Ashley K Williams
- Division of Sport and Exercise Sciences, School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Sophie E Carter
- School of Science, Technology and Health, York St John University, York, United Kingdom
| | - Amy K Campbell
- School of Science, Technology and Health, York St John University, York, United Kingdom
| | - Jonathan Glen
- Division of Sport and Exercise Sciences, School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - David Lavallee
- Division of Sport and Exercise Sciences, School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Nicholas Sculthorpe
- Institute of Clinical Exercise and Health Sciences, School of Science and Sport, University of the West of Scotland, Lanarkshire, United Kingdom
| | - Andrew Murray
- Medical and Scientific Department, The R&A, St Andrews, United Kingdom
- Sport and Exercise, University of Edinburgh, Edinburgh, United Kingdom
| | - Alexander J Beaumont
- School of Science, Technology and Health, York St John University, York, United Kingdom
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Tobis S, Piasek-Skupna J, Neumann-Podczaska A, Religioni U, Suwalska A. Determinants of Attitude to a Humanoid Social Robot in Care for Older Adults: A Post-Interaction Study. Med Sci Monit 2023; 29:e941205. [PMID: 37679949 PMCID: PMC10496516 DOI: 10.12659/msm.941205] [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] [Received: 05/24/2023] [Accepted: 07/10/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND While there is a growing body of research examining opinions on social robots in elderly care, there is a lack of comprehensive studies investigating the underlying factors influencing these opinions. The Godspeed Questionnaire Series (GQS) measures perceptions related to human-robot interactions (HRIs). The Comprehensive Geriatric Assessment (CGA) is widely used to evaluate physical, cognitive, and social functions of older patients. The EASYCare 2010 Standard (EC) is a tool for assessing unmet needs in older individuals. TIAGo, a social humanoid robot, integrates perception, navigation, and HRI capabilities. This study aimed to identify the determinants of perception following interactions between older individuals and TIAGo, utilizing the GQS, selected CGA items, and EC. MATERIAL AND METHODS We analyzed a database of opinions from older individuals who interacted with TIAGo, based on the Users' Needs, Requirements, and Abilities Questionnaire. We examined the relationships between the robot's roles (companion/assistant/useful device), its assistive/social functions, and various characteristics of the older participants. RESULTS The study included 161 participants (mean age: 75.2±9.8 years), comprising 89 women and 113 institutionalized individuals. Positive correlations were observed between the robot's role, its functions, and the participants'; perceptions across most evaluated parameters (Anthropomorphism, Animacy, Likeability, Perceived intelligence, Perceived safety). Only a few individual correlations were found for other parameters. CONCLUSIONS The primary determinant of older individuals' opinions was their perception of the robot. Therefore, involving older adults in the co-design process of such robots is crucial. Additionally, a paradigm shift is needed in the study of humanoid social robots, focusing on successful aging rather than deficits associated with aging.
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Affiliation(s)
- Sławomir Tobis
- Department of Occupational Therapy, Poznań University of Medical Sciences, Poznań, Poland
| | - Joanna Piasek-Skupna
- Institute of Robotics and Machine Intelligence, Poznań University of Technology, Poznań, Poland
| | | | - Urszula Religioni
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Warsaw, Poland
| | - Aleksandra Suwalska
- Department of Mental Health, Chair of Psychiatry, Poznań University of Medical Sciences, Poznań, Poland
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Bogucki S, Siddiqui G, Carter R, McGovern J, Dziura J, Gan G, Li F, Stover G, Cone DC, Brokowski C, Joseph D. Effect of a Home Health and Safety Intervention on Emergency Department Use in the Frail Elderly: A Prospective Observational Study. West J Emerg Med 2023; 24:522-531. [PMID: 37278776 PMCID: PMC10284516 DOI: 10.5811/westjem.58378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 01/24/2023] [Accepted: 02/09/2023] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Geriatric patients are often frail and may lose independence through a variety of mechanisms including cognitive decline, reduced mobility, and falls. Our goal was to measure the effect of a multidisciplinary home health program that assessed frailty and safety and then coordinated ongoing delivery of community resources on short-term, all-cause emergency department (ED) utilization across three study arms that attempted to stratify frailty by fall risk. METHODS Subjects became eligible for this prospective observational study via one of three pathways: 1) by visiting the ED after a fall (2,757 patients); 2) by self-identifying as at risk for falling (2,787); or 3) by calling 9-1-1 for a "lift assist" after falling and being unable to get up (121). The intervention consisted of sequential home visits by a research paramedic who used standardized assessments of frailty and risk of falling (including providing home safety guidance), and a home health nurse who aligned resources to address the conditions found. Outcomes of interest were all-cause ED utilization at 30, 60, and 90 days post-intervention compared with subjects who enrolled via the same study pathway but declined the study intervention (controls). RESULTS Subjects in the fall-related ED visit arm were significantly less likely to have one or more subsequent ED encounters post-intervention than controls at 30 days (18.2% vs 29.2%, P<0.001); 60 days (27.5% vs 39.8%, P<0.001); and 90 days (34.6% vs 46.2%, P<0.001). In contrast, participants in the self-referral arm had no difference in ED encounters post-intervention compared to controls at 30, 60, or 90 days (P=0.30, 0.84, and 0.23, respectively). The size of the 9-1-1 call arm limited statistical power for analysis. CONCLUSION A history of a fall requiring ED evaluation appeared to be a useful marker of frailty. Subjects recruited through this pathway experienced less all-cause ED utilization over subsequent months after a coordinated community intervention than without it. The participants who only self-identified as at risk for falling had lower rates of subsequent ED utilization than those recruited in the ED after a fall and did not significantly benefit from the intervention.
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Affiliation(s)
- Sandy Bogucki
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
| | - Gina Siddiqui
- New York City Health and Hospitals, Elmhurst Hospital Center, Department of Emergency Medicine, Queens, New York
| | - Ryan Carter
- Our Lady of Fatima Hospital, Department of Emergency Medicine, North Providence, Rhode Island
| | - Joanne McGovern
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
| | - James Dziura
- Yale School of Medicine, Yale Center for Analytical Science, Department of Emergency Medicine and of Endocrinology, New Haven, Connecticut
| | - Geliang Gan
- Yale School of Public Health, Yale Center for Analytical Sciences, New Haven, Connecticut
| | - Fangyong Li
- Yale School of Public Health, Yale Center for Analytical Sciences, New Haven, Connecticut
| | - Gina Stover
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
| | | | - Carolyn Brokowski
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
| | - Daniel Joseph
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
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Liu M, Peng W, Miyawaki CE, Mo C, Luo Y, Gong N. The bidirectional relationship between homebound status and falls among older adults: a longitudinal study. BMC Geriatr 2022; 22:923. [PMID: 36457078 PMCID: PMC9714142 DOI: 10.1186/s12877-022-03588-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 11/04/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Previous research has shown an association between homebound status and falls among older adults. However, this association was primarily drawn from cross-sectional studies. This study aimed to determine the bidirectional relationship between homebound status and falls among older adults in the community. METHODS We used data of the community-dwelling older adults from 2011 to 2015 of the National Health and Aging Trends Study, a nationally representative survey of Medicare Beneficiaries in the United States (Sample 1 [No falls at baseline]: N = 2,512; Sample 2 [Non-homebound at baseline]: N = 2,916). Homebound status was determined by the frequency, difficulty, and needing help for outdoor mobility. Falls were ascertained by asking participants whether they had a fall in the last year. Generalized estimation equation models were used to examine the bidirectional association between homebound status and falls longitudinally. RESULTS Participants with no falls at baseline (n = 2,512) were on average, 76.8 years old, non-Hispanic whites (70.1%), and female (57.1%). After adjusting for demographics and health-related variables, prior year homebound status significantly contributed to falls in the following year (Odds ratio [OR], 1.28, 95% CI: 1.09-1.51). Participants who were non-homebound at baseline (n = 2,916) were on average, 75.7 years old, non-Hispanic white (74.8%), and female (55.8%). Previous falls significantly predicted later homebound status (OR, 1.26, 95% CI: 1.10-1.45) in the full adjusted model. CONCLUSION This is the first longitudinal study to determine the bidirectional association between homebound status and falls. Homebound status and falls form a vicious circle and mutually reinforce each other over time. Our findings suggest the importance of developing programs and community activities that reduce falls and improve homebound status among older adults.
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Affiliation(s)
- Minhui Liu
- grid.216417.70000 0001 0379 7164Xiangya School of Nursing, Central South University, Changsha, China
| | - Wenting Peng
- grid.216417.70000 0001 0379 7164Xiangya School of Nursing, Central South University, Changsha, China
| | - Christina E. Miyawaki
- grid.266436.30000 0004 1569 9707Graduate College of Social Work, University of Houston, Houston, TX USA
| | - Cen Mo
- grid.216417.70000 0001 0379 7164Xiangya School of Nursing, Central South University, Changsha, China
| | - Yuqian Luo
- grid.216417.70000 0001 0379 7164Xiangya School of Nursing, Central South University, Changsha, China
| | - Ni Gong
- grid.431010.7The Third Xiangya Hospital of Central South University, 138 Tongzipo Road of Yuelu District, Changsha, 410013 China
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Kim N, Park J, Shin H, Bae Y. Gastrocnemius Medial Head Stiffness Is Associated with Potential Fall Risk in Community-Dwelling Older Adults. Healthcare (Basel) 2022; 10:healthcare10050785. [PMID: 35627922 PMCID: PMC9141566 DOI: 10.3390/healthcare10050785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/21/2022] [Accepted: 04/21/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study is to compare the muscle strength, balance ability, thickness, and stiffness of the tibialis anterior and gastrocnemius muscle in the elderly, with (fallers) and without (non-fallers) fall experience, and confirmed the correlation between the variables mentioned above and muscle stiffness in the faller. We selected 122 elderly participants, comprising 40 fallers and 82 non-fallers, and measured the muscle strength of the tibialis anterior (TA) and the gastrocnemius (GA). Balance ability was measured by the functional reach test (FRT), timed up and go test (TUG), short physical performance battery (SPPB), and gait speed (GS). We used shear wave elastography (SWE) to determine the thickness of the TA and the medial (GAmed) and lateral head (GAlat) of the gastrocnemius and the stiffness during relaxation and contraction. Balance ability, except muscle strength, was significantly lower in fallers compared with non-fallers. The GAmed and GAlat thickness were significantly lower in fallers than that in non-fallers. In fallers, the thickness, rest, and contractive stiffness of GAmed were correlated with the FRT, GS, SPPB. Low rest and GAmed contractive stiffness were related to lower balance ability in fallers. The muscle stiffness measurement using SWE was a novel method to assess potential fall risk.
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Guerreiro C, Botelho M, Fernández-Martínez E, Marreiros A, Pais S. Determining the Profile of People with Fall Risk in Community-Living Older People in Algarve Region: A Cross-Sectional, Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042249. [PMID: 35206432 PMCID: PMC8871874 DOI: 10.3390/ijerph19042249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/16/2022]
Abstract
One in three people aged 65 years or older falls every year. Injuries associated with this event among the older population are a major cause of pain, disability, loss of functional autonomy and institutionalization. This study aimed to assess mobility and fall risk (FR) in community-living older people and to determine reliable and independent measures (health, social, environmental and risk factors) that can predict the mobility loss and FR. In total, 192 participants were included, with a mean age of 77.93 ± 8.38. FR was assessed by EASY-Care (EC) Standard 2010, the Tinetti Test and the Modified Falls Efficacy Scale (MFES). An exploratory analysis was conducted using the divisive non-hierarchical cluster method, aiming to identify a differentiator and homogeneous group of subjects (optimal group of variables) and to verify if that group shows differences in fall risk. Individually, the health, social, environmental and risk factor categories were not found to be an optimal group; they do not predict FR. The most significant predictor variables were a mix of the different categories, namely, the presence of pain, osteoarthritis (OA), and female gender. The finding of a profile that allows health professionals to be able to quickly identify people at FR will enable a reduction in injuries and fractures resulting from falls and, consequently, the associated costs.
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Affiliation(s)
- Carla Guerreiro
- Algarve Biomedical Center Research Institute (ABCRI), University of Algarve, 8005-139 Faro, Portugal; (C.G.); (M.B.); (A.M.); (S.P.)
| | - Marta Botelho
- Algarve Biomedical Center Research Institute (ABCRI), University of Algarve, 8005-139 Faro, Portugal; (C.G.); (M.B.); (A.M.); (S.P.)
| | - Elia Fernández-Martínez
- Department of Nursing, University of Huelva, 21004 Huelva, Spain
- Department of Nursing, University of Sevilla, 41009 Sevilla, Spain
- Correspondence:
| | - Ana Marreiros
- Algarve Biomedical Center Research Institute (ABCRI), University of Algarve, 8005-139 Faro, Portugal; (C.G.); (M.B.); (A.M.); (S.P.)
- Faculty of Medicine and Biomedical Sciences, University of Algarve, 8005-139 Faro, Portugal
| | - Sandra Pais
- Algarve Biomedical Center Research Institute (ABCRI), University of Algarve, 8005-139 Faro, Portugal; (C.G.); (M.B.); (A.M.); (S.P.)
- Faculty of Medicine and Biomedical Sciences, University of Algarve, 8005-139 Faro, Portugal
- Comprehensive Health Research Center (CHRC), 1150-082 Lisboa, Portugal
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Idaiani S, Indrawati L. Functional status in relation to depression among elderly individuals in Indonesia: a cross-sectional analysis of the Indonesian National Health Survey 2018 among elderly individuals. BMC Public Health 2021; 21:2332. [PMID: 34969381 PMCID: PMC8719407 DOI: 10.1186/s12889-021-12260-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/15/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Depression among elderly individuals is related to physical illness, functional status, prolonged treatment and other factors. Depression is not effectively treated with medication but can be alleviated by treating the physical illness and improving functional status. Therefore, this study aims to determine the relationship between functional status and depression in elderly individuals in Indonesia. METHODS The data used were obtained from a national survey dataset, namely, the Basic Health Research and Socio-Economic Survey in 2018, which was carried out in 34 provinces and 514 districts or cities. The total number of respondents was 93,829, aged ≥60 years. Functional status and depression were assessed using the Barthel index and MINI (Mini International Neuropsychiatric Interview), respectively. Furthermore, data processing was carried out with the Statistical Package for Social Sciences (SPSS) version 26 program and analyzed using the chi-square test and multiple logistic regression with the complex sample method. RESULTS Elderly individuals with severe dependence were at the greatest risk of becoming depressed compared to those without functional impairment or with independence after considering sociodemographic factors and disease history have 5.730 (95% CI = 4.302-7.632) the adj odds. Furthermore, this figure was higher than that of individuals with total dependence have 4.147 (95% CI = 3.231-5.231) the adj odds. The physical illness experienced also played a role in the risk for depression, which was higher among elderly individuals with stroke and a history of injury. The sociodemographic factors involved include low education and economic levels. In contrast, the area of residence and marital status had no statistically significant effect on the relationship between functional disorders and depression. CONCLUSIONS Elderly individuals with decreased functional status are prone to depression. The highest probability for depression was observed among those with severe dependence compared to those with total dependence. Consequently, interventions that involve various sectors, including social and family support, are needed.
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Affiliation(s)
- Sri Idaiani
- National Institute of Health Research and Development, Ministry of Health of Republic of Indonesia, Jalan Percetakan Negara. 29, Jakarta, 10560 Indonesia
| | - Lely Indrawati
- National Institute of Health Research and Development, Ministry of Health of Republic of Indonesia, Jalan Percetakan Negara. 29, Jakarta, 10560 Indonesia
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Wong AKC, Wong FKY, So C. Cost-effectiveness of a preventive self-care health management program for community-dwelling older adults: a randomised controlled trial. Age Ageing 2021; 50:440-446. [PMID: 32638995 DOI: 10.1093/ageing/afaa127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine the cost-effectiveness of a preventive self-care health management program for community-dwelling older adults as compared to usual care. DESIGN/INTERVENTION A cost-effectiveness analysis was executed alongside a randomised controlled trial. Nurse case managers provided interventions, including holistic assessment, empowerment of self-care, preventive health behaviours and self-efficacy with co-produced care planning, supported by nursing students. The control group received social control calls. PARTICIPANTS/SETTING Community-dwelling older adults were randomly assigned to the intervention (n = 271) or control (n = 269) group. The intervention was conducted in collaboration with 11 community centres under four non-government organisations in various districts of Hong Kong. MEASUREMENTS Cost and quality-adjusted life years (QALYs) were collected pre (baseline, 0 months) and post intervention (3 months) and 3 months after completion of the program (6 months). Incremental cost-effectiveness ratios between the groups were calculated, dividing the difference in cost by the difference in QALYs. RESULTS Analysis showed that the net incremental QALY gain was 0.0014 (3 months) and 0.0033 (6 months) when the intervention group was compared to the control group. The probability of being cost-effective at 6 months was 53.2% and 53.4%, based on the cost-effectiveness thresholds recommended by both the National Institute for Health and Clinical Excellence ($200,000/QALYs) and the World Health Organization (Hong Kong gross domestic product/capita, HK$381,780). CONCLUSIONS The results provide some evidence to suggest that the addition of a home-based, preventive self-care health management program may have effects on cost outcomes for community-dwelling older adults in Hong Kong.
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Affiliation(s)
| | - Frances Kam Yuet Wong
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Ching So
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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Li Y, Liu M, Sun X, Hou T, Tang S, Szanton SL. Independent and synergistic effects of pain, insomnia, and depression on falls among older adults: a longitudinal study. BMC Geriatr 2020; 20:491. [PMID: 33228605 PMCID: PMC7684923 DOI: 10.1186/s12877-020-01887-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 11/10/2020] [Indexed: 11/25/2022] Open
Abstract
Background Few studies have examined the relationship between falls and pain, insomnia and depressive symptoms which are common and risk factors in older adults. We aimed to examine the independent and synergistic effects of these risk factors on future falls among older adults. Methods We used data of 2558 community-dwelling older adults from 2011 (Y1) to 2015 (Y5) of the National Health and Aging Trends Study (NHATS). Pain was determined by whether participants reported bothersome pain in the last month. Insomnia was assessed by two questions about how often the participants had trouble falling asleep and maintaining sleep. Depressive symptoms were assessed by Patient Health Questionnaire-2. Generalized estimation equation (GEE) models were used to examine the independent effects of pain, insomnia and depressive symptoms at prior-wave (period y-1) on falls at current wave (period y) adjusting for covariates (age, sex, education, race/ethnicity, living arrangement, BMI, smoking, vigorous activities, number of chronic illnesses and hospitalization). The significance of the three-way interaction of these factors (pain*insomnia*depression) was tested using the aforementioned GEE models to determine their synergistic effects on falls. Results Overall, the participants were mainly 65–79 years old (68%), female (57%) and non-Hispanic White (70%). At Y1, 50.0% of the participants reported pain, 22.6% reported insomnia and 9.9% reported depressive symptoms. The incidence of falls from Y2 to Y5 was 22.4, 26.0, 28.3, and 28.9%, respectively. Participants with pain (Odds ratio [OR], 95% confidence interval [CI] = 1.36, 1.23–1.50) and depressive symptoms (OR, 95% CI = 1.43, 1.23–1.67) had high rates of falling adjusting for covariates. After further adjustment for insomnia and depressive symptoms, pain independently predicted falls (OR, 95% CI = 1.36, 1.22–1.51). Depressive symptoms also independently predicted falls after further adjusting for pain and insomnia (OR, 95% CI = 1.40, 1.20–1.63). After adjusting for pain and depression, the independent effects of insomnia were not significant. None of the interaction terms of the three risk factors were significant, suggesting an absence of their synergistic effects. Conclusions Pain and depressive symptoms independently predict falls, but synergistic effects seem absent. Further research is needed to develop effective strategies for reducing falls in older adults, particularly with pain and depressive symptoms.
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Affiliation(s)
- Yuxiao Li
- Central South University, Xiangya School of Nursing, Changsha, 172 Tongzipo Road of Yuelu District, Changsha, 410013, Hunan, China
| | - Minhui Liu
- Central South University, Xiangya School of Nursing, Changsha, 172 Tongzipo Road of Yuelu District, Changsha, 410013, Hunan, China. .,Johns Hopkins University School of Nursing, Baltimore, MD, USA.
| | - Xiaocao Sun
- Central South University, Xiangya School of Nursing, Changsha, 172 Tongzipo Road of Yuelu District, Changsha, 410013, Hunan, China
| | - Tianxue Hou
- Central South University, Xiangya School of Nursing, Changsha, 172 Tongzipo Road of Yuelu District, Changsha, 410013, Hunan, China
| | - Siyuan Tang
- Central South University, Xiangya School of Nursing, Changsha, 172 Tongzipo Road of Yuelu District, Changsha, 410013, Hunan, China
| | - Sarah L Szanton
- Johns Hopkins University School of Nursing, Baltimore, MD, USA.,Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Bekele GT, Allene MD, Getnet MG, Hunegnaw MT, Janakiraman B. Assessing falls risk and associated factors among urban community dwellers older adults in Gondar town, Northwest Ethiopia 2019: A cross sectional study. INTERNATIONAL JOURNAL OF SURGERY OPEN 2020. [DOI: 10.1016/j.ijso.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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13
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Wong AKC, Wong FKY, Chang K. Effectiveness of a community-based self-care promoting program for community-dwelling older adults: a randomized controlled trial. Age Ageing 2019; 48:852-858. [PMID: 31437272 DOI: 10.1093/ageing/afz095] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 06/02/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The existing health care system tends to be focused on acute diseases or patients with high levels of need and is not ideal for meeting the challenges of an ageing population. This study introduced a community-based self-care promoting program for community-dwelling older adults, and tested its effects on maintaining health. OBJECTIVES To determine whether the program can increase self-efficacy, quality of life (QoL), basic and instrumental activities of daily living, and medication adherence, while reducing health service utilization for community-dwelling older adults. METHODS Researchers randomly assigned 457 older adults to receive the intervention (n = 230) or be controls (n = 227). The intervention included assessment and education of self-care and health-promoting behaviors, co-produced care planning and self-efficacy enhancing components supported by a health-social partnership. The control group received placebo social calls. The outcomes were measured at pre-intervention (T1) and three months post-intervention (T2). RESULTS Analysis showed that the intervention group had a significantly higher score in self-efficacy (P = 0.049), activities of daily living (ADL) (P = 0.012), instrumental activities of daily living (IADL) (P = 0.021) and the physical components of QoL (P < 0.001) at T2 than at T1. The program also significantly improved the mental component of QoL (P < 0.001) and medication adherence (P < 0.001), as well as reducing the total number of health service attendances compared to the control group (P = 0.016). CONCLUSION The program can help enhance the self-efficacy of community-dwelling older adults towards self-care, which may in turn enable them to maintain optimal well-being while remaining in the community.
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Affiliation(s)
- Arkers Kwan Ching Wong
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Frances Kam Yuet Wong
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Katherine Chang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
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14
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Riesgo de caídas y consumo de fármacos en los pacientes mayores de 65 años. Estudio PYCAF. Semergen 2019; 45:528-534. [DOI: 10.1016/j.semerg.2019.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 04/24/2019] [Accepted: 05/19/2019] [Indexed: 01/16/2023]
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Use of a Single Wireless IMU for the Segmentation and Automatic Analysis of Activities Performed in the 3-m Timed Up & Go Test. SENSORS 2019; 19:s19071647. [PMID: 30959897 PMCID: PMC6480218 DOI: 10.3390/s19071647] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/12/2019] [Accepted: 03/19/2019] [Indexed: 12/15/2022]
Abstract
Falls represent a major public health problem in the elderly population. The Timed Up & Go test (TU & Go) is the most used tool to measure this risk of falling, which offers a unique parameter in seconds that represents the dynamic balance. However, it is not determined in which activity the subject presents greater difficulties. For this, a feature-based segmentation method using a single wireless Inertial Measurement Unit (IMU) is proposed in order to analyze data of the inertial sensors to provide a complete report on risks of falls. Twenty-five young subjects and 12 older adults were measured to validate the method proposed with an IMU in the back and with video recording. The measurement system showed similar data compared to the conventional test video recorded, with a Pearson correlation coefficient of 0.9884 and a mean error of 0.17 ± 0.13 s for young subjects, as well as a correlation coefficient of 0.9878 and a mean error of 0.2 ± 0.22 s for older adults. Our methodology allows for identifying all the TU & Go sub–tasks with a single IMU automatically providing information about variables such as: duration of sub–tasks, standing and sitting accelerations, rotation velocity of turning, number of steps during walking and turns, and the inclination degrees of the trunk during standing and sitting.
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