Sex Differences in Frail Older Adults with Foot Pain in a Spanish Population: An Observational Study

IGBO Version of the Older People's Quality Of Life Questionnaire (OPQOL-35) Is Valid and Reliable: Cross-Cultural Adaptation and Validation

To translate, cross-culturally adapt, and psychometrically evaluate the Older People's Quality of Life Questionnaire (OPQOL-35) among the Igbo older adult population in Enugu State. The original English OPQOL-35 (E-OPQOL-35) was translated into Igbo language, synthesized, back translated, and subsequently subjected to expert panel review, pre-testing and cognitive debriefing interview. The final Igbo version (I-OPQOL-35) was tested for internal consistency, concurrent, and structural validities in a cross-sectional study of 115 consenting apparently healthy older adults that were conveniently recruited from Enugu State, at 0.05 level of significance. The Spearman correlation coefficients between the participants' domain and total scores on the I-OPQOL-35 and E-OPQOL-35 (rho = .92-1.00) were excellent. The Mann-Whitney U test revealed no significant difference between corresponding scores in the E-OPQOL-35 and I-OPQOL-35 (P = .65-.94). The internal consistency coefficient of the I-OPQOL-35 was 0.78. The ceiling and floor effects were 0% respectively. The I-OPQOL-35 is therefore a valid and reliable instrument for the assessment of quality of life among Igbo older adults in Nigeria.

Frailty as a Predictor of Hospitalization and Low Quality of Life in Geriatric Patients at an Internal Medicine Outpatient Clinic: A Cross-Sectional Study

Frailty is an aging-associated state that increases patients’ vulnerability to disease, and can lead to various adverse outcomes. It is classified as either physical frailty alone or physical frailty in combination with cognitive impairment (cognitive frailty). There are currently limited data available regarding the prevalence and adverse outcomes of frailty in Thailand. This was a cross-sectional study aimed at determining the prevalence of physical and cognitive frailty and their effects on hospitalization and quality of life. Participants were older patients who attended an internal medicine outpatient clinic. Frailty was diagnosed using the Thai Frailty Index. The Thai version of the MoCA was used to evaluate cognitive status. Univariate and multivariate analyses were performed to compare adverse outcomes in terms of poor quality of life and history of admission to hospital between patients with frailty and non-frail patients, and among patients with physical frailty, cognitive frailty, cognitive impairment, and robust (non-frail and non-cognitively impaired) patients. We enrolled 198 participants. The prevalence of physical and cognitive frailty was 28.78% and 20.70%, respectively. When compared with non-frail patients, frailty was associated with hospitalization (adjusted OR 3.01, p = 0.002) but was not significantly related to quality of life (adjusted OR = 1.98, p = 0.09). However, physical and cognitive frailty were associated with fair quality of life when compared with normal patients (adjusted OR = 4.34, p = 0.04 and adjusted OR = 4.28, p = 0.03, respectively). The prevalence of frailty—particularly cognitive frailty—was high. Frailty was associated with adverse outcomes in terms of hospitalization and quality of life.

Walking Speed Assessed by 4-Meter Walk Test in the Community-Dwelling Oldest Old Population in Vietnam

This study aims to provide data on usual walking speed in individuals aged 80 years or older and determine the association between walking speed and related factors in community-dwelling older adults. A cross-sectional study design was conducted to measure walking speed on community-dwelling elders aged 80 years or older in Soc Son district, Vietnam. Walking speed was assessed by a 4-Meter Walk Test with a usual-pace walking mode. Health-related characteristics of participants including risk of falls (The Timed Up and Go test, activities of daily living (ADL), instrumental activities of daily living (IADLs), cognitive impairment (Mini-Cog test) and frailty syndrome (The Reported Edmonton Frail Scale (REFS)). Multiple logistic regression was used to analyze the association between a slow walking speed and selected factors. A total of 364 older people were recruited, and the majority were female (65.4%). The overall average walking speed was 0.83 ± 0.27 m/s. The proportion of participants with a slow walking speed (<0.8 m/s) was 40.4%. Multiple logistic regression analyses showed that age, female, high fall risk (assessed by TUG test), ADL/IADL dependence and frailty syndrome had a negative effect on slow walking speed in this population. The results could provide useful reference data for further investigations and measures in clinical practice.

Cross-Cultural Adaptation and Reliability of the Home Falls and Accidents Screening Tool (HOME FAST) in Assessing Fall-Risk Home Hazards for Stroke Using Technologies over a Conventional Home Visit

Objective

This study is aimed at translating the Home Falls and Accidents Screening Tool (HOME FAST) into the three main languages spoken in Malaysia and investigating its reliability through an alternative technology-based evaluation.

Methods

Translation into three languages and cross-cultural adaptation of the HOME FAST was conducted via the five steps adopted from the Mapi Institute. For interrater reliability, occupational therapists who attended a face-to-face home hazard workshop were recruited. Each therapist rated the HOME FAST by using the provided combination of videos and photographs of stroke survivors manoeuvring in their home. For test-retest reliability, the same occupational therapists were invited to rate the same combination of photographs and videos again. Reliability was analysed using Gwet's AC₁ and Bland and Altman's plot to describe agreement.

Results

The translation challenges were minimal and rectifiable. A Bahasa Melayu, Mandarin, and Tamil versions of the HOME FAST were developed. Overall interrater reliability for both video (AC₁ = 0.91) and photograph (AC₁ = 0.91) were good. The test-retest reliability yielded similar outcome (video: overall AC₁ = 0.92 and photograph: overall AC₁ = 0.93).

Conclusion

Using alternative technology (video and photograph) to do a home hazard assessment was feasible. However, the asynchronous nature of these methods has limitations in clarifying certain aspects in the home. Moving forward, potential investigation on other technologies such as telehealth for synchronous and real-time interaction is warranted.

Reliability of Frail and Barthel Tests for Detecting Frailty in Palliative Oncological Patients in a Home Hospitalization Unit: A Comparative Study

Cancer is a condition that can increase the risk of frailty. In addition, palliative oncological patients in home hospitalization can find their activities of daily living affected. The main objective was to measure the degree of frailty in the oncological population in home hospitalization comparing Barthel and Frail-VIG Indexes. This is a descriptive cross-sectional study. A sample of oncological patients in home hospitalization (n = 50) that included 27 men and 23 women were recruited, and disability due to frailty was measured using the VIG frailty index and the Barthel scale for Activities of Daily Living (ADLs). Spearman's correlation coefficients were categorized as weak (rs ≤ 0.40), moderate (0.41 ≤ rs ≥ 0.69) or robust (0.70 ≤ rs ≥ 1.00), with a strong indirect correlation between the domains using the toilet, transferring and wandering on the Frail-VIG scale with an r (s) value -0.810 (p < 0.001), -0.831 (p < 0.001) and -0.805 (p < 0.001), respectively, and a moderate indirect correlation for the domains of eating -0.718 (p < 0.001), dressing -0.770 (p < 0.001) and urination -0.704 (<0.001). The Frail-VIG index above 0.35 points, that is, from moderate to severe, does not affect ADLs except in the nutritional dimension in a palliative oncological population in home hospitalization. The preliminary outcomes obtained should be considered to determine the impact of nutritional status with regard to ADLs in palliative oncological patients in a home hospitalization unit.

Repeatability and Reliability of the Rheumatoid Arthritis Foot Disease Activity Index in Spanish Patients: A Transcultural Adaptation

Simple Summary

The Rheumatoid Arthritis Foot Disease Activity Index (RADAI-F5) is the first questionnaire designed to check the level of involvement in the feet of patients with rheumatoid arthritis. It is a validated and reliable five-question questionnaire in English. It is also considered suitable for clinical use. We aim was to translate and validate the Spanish version. The findings of this research suggest that is a valid, strong and trustworthy clinimetric tool that appropriately applies to the Spanish community and can be managed as a whole or in terms of its respective dimensions, such as arthritis activity in the foot, joint tenderness and swelling, and foot arthritis pain sub-scales.

Abstract

Background: The Rheumatoid Arthritis Foot Disease Activity Index (RADAI-F5) questionnaire, based on five questions, is used to assess the severity of rheumatoid arthritis disease in the foot. Nowadays, RADAI-F5 has been validated in different languages; however a Spanish version was lacking. Therefore, the purpose of this research was to translate and validate the Spanish version (RADAI-F5-es). Methods: A cross-cultural translation of the RADAI-F5 questionnaire was performed from English to Spanish. To validate its use, 50 subjects with rheumatoid arthritis who responded to the translated questionnaire two times in an interval of less than 3 months were selected in order to verify the psychometric properties. Results: Excellent agreement between the two versions according to the Cronbach’s α was shown. Five domains with regards to arthritis activity in foot joint tenderness and swelling, foot arthritis pain, general foot health and joint stiffness were added together to obtain the total score. Excellent retest reliability was shown for the total score. Test/retest reliability was excellent for joint stiffness on awakening and foot arthritis pain domains. There were no significant differences among any domains (p > 0.05). There were no statistically significant differences (p = 0.000) for the mean ± standard deviations (SD) between pre- and post-tests (98.09 ± 15.42) [93.75–102.43] and 97.96 ± 13.88 [94.5–101.86] points, respectively). Bland–Altman plots or clinically pertinent variations were not statistically significantly different. Conclusions: The RADAI-F5-es is considered a valid and strong tool with adequate repeatability in the Spanish community.

Influence of foot pain on frailty symptoms in an elderly population: a case-control study

BACKGROUND

Frailty is a condition that can increase the risk of falls. In addition, foot disorders can negatively influence elderly people, thus affecting their condition of frailty.

OBJECTIVE

To determine whether foot pain can influence a greater degree of frailty.

DESIGN AND SETTING

Cross-sectional descriptive study conducted at the University of Valencia, Valencia, Spain.

METHODS

A sample older than 60 years (n = 52), including 26 healthy subjects and 26 foot pain patients, was recruited. Frailty disability was measured using the 5-Frailty scale and the Edmonton Frailty scale (EFS).

RESULTS

There were statistically significant differences in the total EFS score and in most of its subscales, according to the Mann-Whitney U test (P < 0.05). In addition, foot pain patients presented worse scores (higher 5-Frailty scores) than did healthy patients, regarding matched-paired subjects (lower EFS scores). With regard to the rest of the measurements, there were no statistically significant differences (P > 0.05). The highest scores (P < 0.001) were for fatigue on the 5-Frailty scale and the EFS, and for the subscale of independence function in EFS.

CONCLUSIONS

These elderly patients presented impairment relating to ambulation and total 5-Frailty score, which seemed to be linked to the presence of frailty syndrome and foot disorders.

Age-based inter-subject variability in platelet and white blood cell concentrations of platelet-rich plasma prepared using a new application to blood separation system

The benefit of autologous platelet‐rich plasma (PRP) treatment is still under discussion. Variations in PRP products, consequence of the lack of a standardised protocol for the multitude of commercially available blood separation systems and the lack of knowledge of the optimal composition of PRP or its suitability for the proposed indication are some of the reasons behind clinical inconsistencies. The impact of inter‐subject variability in PRP has received less attention in comparison. The purpose of this study was to determine the inter‐subject variability, based on age, in the concentrates prepared by a new blood concentration system. Twenty‐six healthy volunteers of both genders (29‐93 years) were enrolled. Whole blood (WB) was collected from each participant to prepare PRP using the Easy PRP kit. Platelets and white blood cells (WBC) from WB and PRP were analysed after split population by age; patients younger than 65 years (n = 13) and patients ≥65 years old (n = 13). Among the demographic characteristics tested, only age was significantly different between the groups. Cell capture efficiency of the system was specific for each type of blood cell and identical for both age groups. Platelets and WBC in PRP were higher than in WB (P < .001). In WB, platelets and WBC concentrations were significantly lower in older group (P ≤ .035). These differences persisted in the prepared PRP (P ≤ .004). The ageing of population has a strong influence on the haematocrit and therefore on the composition of PRP. Because the efficiency of blood separator system seems to be constant across individuals, the inter‐subject haematocrit variability based on age could be used as a predictor of resulting PRP. The clinical application of PRP should be restricted to the specific cell capture capacity of the different commercial devices.

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

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

Effects of HIIT and MIIT Suspension Training Programs on Sleep Quality and Fatigue in Older Adults: Randomized Controlled Clinical Trial

Poor sleep quality lessens general health quality and is related to physical and mental problems. Moreover, fatigue is one of the foremost common complaints in medical care and plays a role in the decreasing quality of life of the older population. For these reasons, the objective of this study was to examine the effect of high- and moderate-intensity interval training programs (HIIT vs. MIIT)-both consisting of twelve weeks of TRX training-on the sleep quality and fatigue levels of the elderly. A randomized controlled clinical trial (NCT03404830) was conducted. A total of 82 subjects were randomized to either a HIIT group (n = 28) that performed a main squat activity with a suspension system, comprising four four-minute intervals between 90-95% of the maximum heart rate (HR), an MIIT group (n = 27) with an intensity of 70% of the maximum HR, and a control group (CG) (n = 27) that continued their daily lifestyle. The two exercise groups trained twice a week for 12 weeks, with each session lasting 45 min. Sleep quality was measured using the Pittsburgh sleep quality index (PSQI), and fatigue was assessed using the fatigue severity scale (FSS). Outcomes were measured before the intervention and after the intervention period. Post-intervention sleep quality measurements revealed a statistically significant interaction regarding group × time (p < 0.005) and fatigue (p = 0.002). Specifically, fatigue decreased in the HIIT group between both measurement moments (p = 0.003). In addition, differences were obtained in the post-intervention measure between the HIIT and MIIT groups (p = 0.013) and HIIT and control (p = 0.029). Our analysis indicates that a population of the elderly showed improvements in sleep quality and fatigue after performing a high-intensity intervention using suspension training (TRX), with markedly better results in the HIIT group.

A Narrative Review on Sarcopenia in Type 2 Diabetes Mellitus: Prevalence and Associated Factors

Type 2 diabetes mellitus (T2DM) represents a major health burden for the elderly population, affecting approximately 25% of people over the age of 65 years. This percentage is expected to increase dramatically in the next decades in relation to the increased longevity of the population observed in recent years. Beyond microvascular and macrovascular complications, sarcopenia has been described as a new diabetes complication in the elderly population. Increasing attention has been paid by researchers and clinicians to this age-related condition—characterized by loss of skeletal muscle mass together with the loss of muscle power and function—in individuals with T2DM; this is due to the heavy impact that sarcopenia may have on physical and psychosocial health of diabetic patients, thus affecting their quality of life. The aim of this narrative review is to provide an update on: (1) the risk of sarcopenia in individuals with T2DM, and (2) its association with relevant features of patients with T2DM such as age, gender, body mass index, disease duration, glycemic control, presence of microvascular or macrovascular complications, nutritional status, and glucose-lowering drugs. From a clinical point of view, it is necessary to improve the ability of physicians and dietitians to recognize early sarcopenia and its risk factors in patients with T2DM in order to make appropriate therapeutic approaches able to prevent and treat this condition.

Impact of Footwear and Foot Deformities in patients with Parkinson's disease: A Case-Series Study

Background: Parkinson's disease (PD) is a common and complex neurological problem. Gait abnormalities are frequent in PD patients, and this increases the risk of falls. However, little is known about foot deformities and footwear in this vulnerable population. Here we investigate whether patients with PD use an appropriate shoe size and know if they have foot deformities or alterations. Methodology: A study of a series of observational descriptive cases in a convenience sample (n = 53 patients) diagnosed with Parkinson's disease. One trained investigator evaluated foot and ankle health. The footwear and foot measurements were obtained using a Brannock device. Results: The podiatric examination and footwear examination detected a high presence of podiatric pathologies and inappropriate footwear. This has a negative impact on the quality of life of these patients. Conclusions: This research detected an elevated number of people with foot deformities or alterations. Moreover, a high proportion of participants with PD wear inadequate footwear (in length, width, or both).

Gait and Balance Disorder in Patients with Transient Ischemic Attack or Minor Stroke

PURPOSE

Transient ischemic attack (TIA) and minor stroke had a high recurrence rate, resulting in potential neurological impairment. Only a few previous studies focused on gait and balance disorder in TIA and minor stroke. This study aimed to explore the relationship between gait and balance disorder and TIA/minor stroke.

PATIENTS AND METHODS

Eighty-two patients with TIA/minor stroke and fifty-two healthy control participants were recruited. The gait and balance function of the two groups was tested with six measurements (Four Square Step, Tandem, Functional Reach, Gait and Pivot Turn, Timed "Up and Go", and Single Leg Balance tests). The associations between these measures and TIA/minor stroke were determined through linear and logistic regression analyses.

RESULTS

There were no significant group differences in age, gender, body mass index, vision, and cognitive function. People with TIA/minor stroke had poorer performance in all six gait and balance measures (all p<0.05). Logistic regression analysis showed TIA/minor stroke was strongly associated with gait and balance disorder (Four Square Step Test [OR, 24.07; 95% CI 5.90-98.13; p<0.001], Tandem Test [OR, 5.50; 95% CI 1.64-18.40; p=0.006], Functional Reach Test [OR, 4.25; 95% CI 1.04-17.33; p=0.044], Gait and Pivot Turn Test [OR, 3.78; 95% CI 1.22-11.31; p=0.021], Timed"Up and Go"Test [OR, 15.79; 95% CI 2.32-107.48; p=0.005], and Single Leg Balance Test [OR, 8.96; 95% CI 2.34-34.01; p=0.001]). TIA/minor stroke patients with older age, cognitive dysfunction, high K-CRP level, and severe atherosclerosis in lower limbs were more likely to have gait and balance disorder.

CONCLUSION

Our findings highlight the significant relationship between gait and balance disorder and TIA/minor stroke. It seems that people with TIA/minor stroke had a higher possibility to get gait and balance disorder. Gait and balance disorder following a minor stroke or TIA may be attributed to cognitive function in these patients.