Instrumental Activities of Daily Living (iADL) Limitations in Europe: An Assessment of SHARE Data

Informal and formal long-term care utilization and unmet needs in Europe: examining socioeconomic disparities and the role of social policies for older adults

The rising number of older adults with limitations in their daily activities has major implications for the demands placed on long-term care (LTC) systems across Europe. Recognizing that demand can be both constrained and encouraged by individual and country-specific factors, this study explains the uptake of home-based long-term care in 18 European countries with LTC policies and pension generosity along with individual factors such as socioeconomic status. Using data from the Survey of Health, Ageing and Retirement in Europe conducted in 2019, we apply a two-part multilevel model to assess if disparities in use of LTC are driven by disparities in needs or disparities in use of care when in need. While individual characteristics largely affect the use of care through its association with disparities in need, country-level characteristics are important for the use of care when in need. In particular, the better health of wealthier and more educated individuals makes them less likely to use any type of home-based personal care. At the country level, results show that the absence of a means-tested benefit scheme and the availability of cash-for-care benefits (as opposed to in-kind) are strongly associated with the use of formal care, whether it is mixed (with informal care) or exclusive. LTC policies are, however, shown to be insufficient to significantly reduce unmet needs for personal care. Conversely, generous pensions are significantly associated with lower unmet needs, underscoring the importance of considering the likely adverse effects of future pension reforms.

Comparing Preoperative Screening Tools for Elective Urologic Cancer Surgery: Insights from a Cluster Analysis

INTRODUCTION

The aim of this study was to evaluate the features and benefits of different geriatric screening tools for enhancing the perioperative care of patients who undergo elective cancer surgery using cluster analysis.

METHODS

This study was a retrospective, observational analysis of 1,019 consecutive patients who had elective major cancer surgery in the urology department of our hospital from October 2019 to January 2023. Before the surgery, a trained nurse screened the patients using six tools: Eastern Clinical Oncology Group performance status (ECOG-PS), flemish version of the triage risk screening tool (fTRST), geriatric-8 (G8), instrumental activities of daily living, patient health questionnaire-2 (PHQ-2), and simple questionnaire to rapidly diagnose sarcopenia (SARC-F). The study grouped the patients into four clusters based on their scores on these tools and compared their outcomes after the surgery. The outcomes included overall survival, ambulation failure, delirium, and severe complications. The study also examined how each screening tool was associated with the outcomes.

RESULTS

Based on their clinical data and screening results, we classified the patients into four groups: Healthy (73%), Depressive (11%), Intermediate (11%), and Unhealthy (5%). The Unhealthy group had the worst outcomes in overall survival (OS), ambulation failure, and delirium, followed by the Intermediate group. In addition, fTRST and SARC-F emerged as significant predictors of OS; ECOG-PS, fTRST, G8, and SARC-F of ambulation failure; ECOG-PS, fTRST, and G8 of delirium; and G8 of severe complications.

CONCLUSION

Various geriatric screening tools were found to have the potential to forecast diverse postoperative outcomes.

Palliative Care in the Ageing European Population: A Cross-Country Comparison

With Europe's ageing population and rising demand for palliative care, it is crucial to examine the use of palliative care among older adults during their last years of life and understand the factors influencing their access and end-of-life circumstances. This study employed a cohort of SHARE participants aged 65 years or older who had passed away between Wave 6 (2015) and Wave 7 (2017). Information on death circumstances, palliative care utilization, and associated variables were analysed. The study revealed that nearly 13.0% of individuals across these countries died under palliative care, with Slovenia having the lowest rate (0.3%) and France the highest (30.4%). Palliative care utilization in the last 30 days before death was observed in over 24.0% of participants, with the Czech Republic having the lowest rate (5.0%) and Greece the highest (48.8%). A higher risk of using or dying in palliative care was significantly associated with cognitive impairment (low verbal fluency), physical inactivity, and good to excellent self-perceived health. This work highlights the urgent need for enhanced global access to palliative care and advocates for the cross-country comparison of effective practices within Europe, tailored to the unique healthcare needs of older adults.

Is prehospital physical performance a predictor of functional capacity decline at discharge in hospitalized Brazilian older adults?

BACKGROUND

Hospitalization contributes to functional decline in older adults.

OBJECTIVE

To assess the relationship between physical performance on admission and functional capacity and functional capacity decline at discharge, and to investigate tools capable of predicting this decline.

METHODS

Prospective longitudinal study with 75 older adults admitted to a public hospital between July 2021 and February 2022. The independent variable was physical performance evaluated on admission by handgrip strength (HGS) and the Short Physical Performance Battery (SPPB). The dependent variables were functional capacity for basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs) and their decline between admission and discharge. Statistical analyses were performed using linear and logistic regression and ROC curves.

RESULTS

The median time between admission and participant assessment was 1 day (IQR=1-2 days). Median hospitalization time was 18 days (IQR= 7.5-30 days). Functional capacity for BADLs and IADLs declined in 39% and 79% of the participants, respectively. Performance in HGS and the SPPB at baseline, in adjusted models, explained 29.3 to 35.3% of functional capacity at discharge. One additional point in the SPPB decreased the risk of functional capacity decline for BADLs by 20.9% (OR=0.79, 95% CI: 0.68, 0.91). The AUC values for the SPPB (AUC=0.67) and HGS (AUC=0.65) were significant in identifying functional decline for BADLs, but not IADLs.

CONCLUSION

In Brazilian older adults, physical performance on admission was related to functional capacity and its decline at discharge. Physical performance on admission is predictive of functional decline at discharge.

Longitudinal Relationship Between Handgrip Strength and Cognitive Function in a European Multicentric Population Older Than 50 Years

OBJECTIVE

The aim of this study was to analyze the bidirectional association between handgrip strength (HGS) and cognitive performance in different cognitive functions in a European population and to evaluate the predictive validity of HGS for the risk of future cognitive impairment in aging individuals.

METHODS

This was a prospective cohort study conducted using data on individuals over 50 years of age from the Survey of Health, Aging and Retirement in Europe (SHARE). HGS measures and scores in numeracy, recall, and verbal fluency were repeated and analyzed biannually for 4 years and were used in generalized estimating equations to test the bidirectional association, categorized by sex.

RESULTS

Of the 8236 individuals included, 55.73% were women with a mean age of 67.55 (standard deviation [SD] = 8.4) years and 44.27% were men with a mean age of 68.42 (SD = 7.7) years. HGS predicted cognitive decline in both sexes, except for numeracy in men, even after adjustments. The strongest association with HGS in women was in verbal fluency (β = .094; 95% CI = 0.039 to 0.151), whereas the strongest association with HGS in men was in delayed verbal recall (β = .095; 95% CI = 0.039 to 0.151). Conversely, the greatest cognitive predictor of HGS decline was verbal fluency in men (β = .796; 95% CI = 0.464 to 1.128), and in women (β = .801; 95% CI= 0.567 to 1.109).

CONCLUSION

There is a significant and bidirectional association between HGS and different cognitive functions in a European multicentric population. This bidirectional association differed between sexes.

IMPACT

Both men and women who presented with cognitive decline also showed early changes in their HGS measures, and vice versa, but there still were differences between the sexes. These findings reinforce that HGS may be a simple and inexpensive method to identify early signs of cognitive decline, and that studies and rehabilitation strategies should be more sex specific.

Handgrip strength, physical activity and incident mild cognitive impairment and dementia

OBJECTIVE

We analyzed the mediating role of handgrip strength in the association between moderate to vigorous physical activity and incident mild cognitive impairment and dementia.

METHODS

We used prospective data from 14 European countries participating in the Survey of Health, Ageing, and Retirement in Europe. 19,686 participants free of dementia and mild cognitive impairment (64.9 ± 8.7 years) were followed up for a mean of 10.2 years. Moderate to vigorous physical activity was self-reported, and handgrip strength was assessed with a dynamometer. Mild cognitive impairment was defined as 1.5 standard deviations below the mean of the standardized global cognition score, while dementia was determined by physician diagnosis. Gender, age, country, education, presence of chronic diseases, depressive symptoms, limitations in activities of daily living, body mass index, and baseline cognitive levels were used as covariates. Cox proportional hazards as well as mediation models were used.

RESULTS

Moderate to vigorous physical activity for at least 1 day per week was independently associated with lower incident mild cognitive impairment (HR: 0.85; 95%CI: 0.74-0.98). A 10 % increase in handgrip strength was associated a 6 % lower hazard for incident mild cognitive impairment (0.94; 0.92-0.97) and 5 % lower hazard for incident dementia (0.95; 0.93-0.98). Handgrip strength partly mediated the association of moderate to vigorous physical activity with mild cognitive impairment (Coefficient: 0.03; 95%CI: 0.01-0.05; 17.9 %).

CONCLUSIONS

Physical activity is independently associated with a lower incidence of mild cognitive impairment.

Relation of environmental factors with activity limitations and participation restrictions in older adults with diabetes mellitus over time: an international classification of functioning framework perspective

BACKGROUND

Activity limitations and participation restrictions were observed in patients with diabetes, which may impact their quality of life. Environmental factors such as seasonal effects, resources and perceived stress may play important role in activity limitations and participation restrictions. In this study, a variant of International Classification of Functioning (ICF) model was used to clarify the associations of function/structure factors, personal factors and environmental factors with activity limitations and participation restrictions.

METHODS

This was a longitudinal design with 1 year follow-up. The Mini-Mental State Examination (MMSE), Geriatric Depression Scale- short form, Perceived Stress Scale, and Instrumental Activities of Daily Living assessments were measured at 3-month intervals for long-term follow-up in 110 patients with diabetes aged ≥ 65 years.

RESULTS

Hierarchical linear regression models revealed that age (p = 0.001), perceived health status, MMSE scores (p < 0.01), and positive perceived stress (p < 0.001) were predictors of activity limitations (adjusted R2 = 53%). GDS-S (p < 0.05) and positive perceived stress (p < 0.01) were predictors of participation restrictions (adjusted R2 = 30%). Generalized estimating equation analysis indicated that seasonal effects, age, perceived health status, MMSE predicted the changes of slopes in activity limitations. Seasonal effects and GDS-S were predictors of the changes of slopes for participation restrictions (all p < 0.001).

CONCLUSIONS

The ICF can be used to identify the risk factors for activity limitations and participation restrictions in older adults with diabetes. Practitioners should provide individualized interventions with consideration of these risk factors.

Accelerated cognitive decline after the COVID-19 pandemic in a community population of older persons with cognitive impairment: A 4-year time series analysis in the Tokyo Metropolis area

AIM

The coronavirus disease 2019 (COVID-19) pandemic has led to lifestyle restrictions and might be associated with long-term changes in cognitive function. The aim of the present study was to elucidate the overall effect of the COVID-19 pandemic on the cognitive trajectory of a cohort of patients with cognitive impairment.

METHODS

We enrolled 160 patients who had been making regular visits to a medical center for dementia. Cognitive function was assessed based on changes in scores on the Mini-Mental State Examination before and during the COVID-19 pandemic throughout a 4-year period. The trajectory of cognitive decline was determined by carrying out a time series analysis using a state-space model.

RESULTS

Crude analysis showed that the Mini-Mental State Examination scores decreased from 20.9 ± 4.4 points (mean ± SD) at the time of the initial cognitive assessments to 17.5 ± 5.6 points at the time of the final assessments, and the decline rate was 1.15 ± 1.78 points per year (P < 0.0001). The time series analysis showed an accelerated cognitive trajectory after the COVID-19 outbreak, and the average decline in the Mini-Mental State Examination scores was 0.46 points (95% confidence interval 0.034-0.91) per year before the COVID-19 pandemic, and a steeper decline of 1.87 points (95% confidence interval 1.34-2.67) per year after the outbreak.

CONCLUSIONS

The COVID-19 pandemic accelerated the rate of cognitive decline in patients with cognitive impairment fourfold in comparison with before the pandemic. Specific strategies designed for cognitively older people in the "new normal" will reconcile both requirements, reducing the risk of infection, and maintaining their physical and psychological well-being. Geriatr Gerontol Int 2023; 23: 200-204.

Investigating the Link Between IADL and Depressive Symptoms in Older Adults: A Cross-Sectional Serial Mediation Model

OBJECTIVES

There is a dearth of research on the psychological processes that underlie the negative relation between impaired instrumental activities of daily living (IADL) and depressive symptoms in older adults. Drawing on the stress process model and the resilience framework, we investigated whether purpose in life and resilience serially mediate the relationship between impaired IADL and depressive symptoms.

METHODS

We recruited 111 cognitively healthy community-dwelling older adults (ages 54-85; M = 66.5) who scored a minimum of 25 points on the Mini-Mental State Examination.

RESULTS

We found that purpose in life and resilience serially mediated the relationship between IADL and depressive symptomatology in older adults. This association held true when we controlled for covariates. Additional sensitivity analyses also supported these findings.

CONCLUSIONS

This study extends our understanding of how IADL limitations contribute to depressive symptoms. Using a community-dwelling, cognitively healthy sample, we demonstrate that functional limitations indirectly influence older adults' depressive symptoms through a decreased sense of purpose in life and decreased resilience.

CLINICAL IMPLICATIONS

Our findings have implications for intervention programs that aim to alleviate IADL limitations and mental health issues in an aging population and promote healthy aging by improving psychosocial resources (i.e., purpose in life and resilience).

Determinants of Self-Perceived Health: The Importance of Physical Well-Being but Also of Mental Health and Cognitive Functioning

With life expectancy increasing for the general population, public health promotion activities should be a priority to aim at a reduction of the burden and costs of hospitalization, disability, and lifelong treatment. This study aimed to explore the influence of parameters pertaining to different aspects of well-being, including physical and mental health and cognitive functioning, on self-perceived health, a predictor of chronic disease prevalence and mortality. We used data from the Survey of Health, Aging and Retirement in Europe (SHARE) project gathered between 2013 and 2017, obtaining a sample of 96,902 participants (63.23 ± 6.77 years). We found a strong association between the self-perceived health rating and not only physical health aspects but also mental health and cognitive functioning. In particular, BMI, chronic diseases and medications, muscle strength, and mobility issues had a strong effect on self-perceived health, as also did the quality of life, depression, and verbal fluency, while other aspects, such as individual characteristics, limitations in daily activities, and pain, among others only had a small effect. These results show that public health and prevention interventions should prioritize the targeting of all aspects of well-being and not only of physical health, acknowledging self-perceived health rating as a simple tool that could help provide a complete overview of psycho-physical well-being and functional status.

Functional Capacity and Difficulties in Activities of Daily Living From a Cross-National Perspective

Objectives: This study investigated whether physical and cognitive functioning predicts developing difficulties in basic or instrumental activities of daily living (ADL/IADL), and whether country-level factors moderated the associations. Methods: 69,227 adults aged 50+ from 19 countries were followed for up to 14 years. Cox regression and meta-regression analyses were used. Results: Higher grip strength was associated with a 45% lower risk of developing ADL limitations and a 47% lower risk of IADL limitations. The corresponding values were 22% and 23% for peak flow, 20% and 23% for word recall, and 20% and 24% for temporal orientation. The associations were similar and statistically significant in most countries, but some associations were weaker in countries with lower GDP and lower service coverage. Discussion: Good physical and cognitive functional capacity protects from ADL and IADL limitations consistently across Western countries. The associations may be stronger in countries with more resources.

Association between disability, social support and depressive symptoms in Chinese older adults: A national study

Objective

Disability and social support can impact depressive symptoms of the elderly. Yet, studies infrequently discuss the moderating role of social support when evaluating the association between disability and depressive symptoms. The purpose of this study was to explore the association between disability, social support, and depressive symptoms among the Chinese elderly, and further examine the moderating effect of social support.

Materials and methods

Using the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) data set, we finally selected 9,231 Chinese elderly after screening. The Center for Epidemiologic Studies Depression Scale (CESD-10) was used to evaluate depressive symptoms in the elderly. Disability was measured by basic activities of daily living (B-ADL) and instrumental activities of daily living (I-ADL). Social support included contact with family and friends, sick care, and money received, measured by five self-reported questions. We used multiple linear regression and moderating model to explore the association between disability, social support, and depressive symptoms.

Results

A total of 9,231 patients were included in this study, and approximately 26.75% of the elderly had depressive symptoms. Study found that depressive symptoms were associated with social support (β B-ADL = -0.108, 95% CI: -0.168- -0.047; β I-ADL = -0.098, 95% CI: -0.156- -0.039), β B-ADL (β = 0.296, 95% CI: 0.248-0.343) and I-ADL (β = 0.174, 95% CI: 0.152-0.195). Moreover, the result also showed that social support moderated the effects of B-ADL (β B - A D L * s o c i a l s u p p o r t = 0.034, 95% CI: 0.014-0.053, F = 11.57, p = 0.001) and I-ADL (β I - A D L * s o c i a l s u p p o r t = 0.025, 95% CI: 0.017-0.033) on depressive symptoms.

Conclusions

The study suggests that disability and social support can affect depressive symptoms, and social support moderates the effect of disability on depressive symptoms. Therefore, taking effective measures to reduce the elderly disability rate of disability and increase their social support are necessary condition for realizing mental health.

Subjective views of aging in very old age: Predictors of 2-year change in gains and losses

This study examined trajectories of awareness of age-related change (AARC; Diehl & Wahl, 2010) across 2 years in a large representative sample of very old adults. We also examined the predictive role of health, functional status, cognitive functioning, and engagement with life for AARC change. The initial sample comprised 1,863 individuals aged 80 years or older. Of the 1,612 individuals recontacted 2 years later, 912 took part in the follow-up. Measures included the AARC-Short Form, assessing perceived AARC Gains and AARC Losses. Measures of multimorbidity and functional health, a cognitive screening test, and indicators of engagement with life (e.g., leisure activity) were examined as predictors of AARC change, using semi-cross-lagged fixed effects modeling. Higher overall levels of AARC Gains were observed compared to AARC Losses for all but respondents aged 90 years or older. Intra-individual levels of AARC Gains decreased significantly over the 2-year period, whereas a significant increase was found for AARC Losses. AARC Losses across time were predicted by loss of instrumental activities of daily living (IADL) independence, but not by change in multimorbidity, cognitive performance, or engagement with life. One indicator of engagement with life, reduced leisure activity, predicted smaller AARC Gains at wave 2. These results were robust in models controlling for potential reverse causation. These findings suggest that a significant increase in perceived AARC Losses appears to be an inherent characteristic of very old age. Very old age may be a stage in life in which changes in multimorbidity and cognitive performance no longer impact individuals' views on aging. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Limitations in activities of daily living and support needs - Analysis of GEDA 2019/2020-EHIS

Being able to perform activities of daily living is an important component of a person's ability to function. If these activities are impaired, support is needed. Using data from GEDA 2019/2020-EHIS, we present how many people aged 55 and older living in private households in Germany experience limitations in activities of daily living. Severe limitations in basic (fundamental) activities (e.g. food intake) are reported by 5.8% of women and 3.7% of men. The proportion increases with age as 13.4% of women and 9.0% of men aged 80 and older experience limitations. Severe limitations of instrumental activities of daily living (e.g. grocery shopping) are rather rare in participants less than 80 years of age. But at age 80 and older the proportion rises to 35.9% of women and 21.0% of men. A total of 68.1% of afflicted women and 57.5% of men receive help and support related to limitations of basic activities. Women are also more likely to report a lack of support (48.8% vs. 43.2%). The situation is slightly better with regard to instrumental activities. The results of GEDA 2019/2020-EHIS show in which areas of daily life older and very old people are impaired, give an impression of who is affected particularly strongly and indicate where support services are insufficient. As such, these results provide clues as to where support can be provided to enable older people to keep living in their own homes for a long time.

Aging Adults' Motivation to Use Embodied Conversational Agents in Instrumental Activities of Daily Living: Results of Latent Profile Analysis

The rapidly increasing share of ageing adults in the population drives the need and interest in assistive technology, as it has the potential to support ageing individuals in living independently and safely. However, technological development rarely reflects how needs, preferences, and interests develop in different ways while ageing. It often follows the strategy of “what is possible” rather than “what is needed” and “what preferred”. As part of personalized assistive technology, embodied conversational agents (ECAs) can offer mechanisms to adapt the technological advances with the stakeholders’ expectations. The present study explored the motivation among ageing adults regarding technology use in multiple domains of activities of daily living. Participants responded to the questionnaire on the perceived importance of instrumental activities of daily living and acceptance of the idea of using ECAs to support them. Latent profile analysis revealed four profiles regarding the motivation to use ECAs (i.e., a low motivation profile, two selective motivation profiles with an emphasis on physical and psychological well-being, and a high motivation profile). Profiles were compared in terms of their acceptance of ECA usage in various life domains. The results increase the knowledge needed in the development of assistive technology adapted to the expectations of ageing adults.

Health disparities, and health behaviours of older immigrants & native population in Norway

We aimed to investigate and compare activities of daily living (ADL), instrumental ADL (IADL), poor self-rated health and the health behaviours among immigrants and the native population in Norway. We present results from analysis of two Norwegian surveys, (Living Conditions Survey on Health from 2015, Living Conditions Survey among Immigrants 2016). Using logistic regression models, odds ratios were estimated for functional ability, self-reported health, and health behavior among immigrants, with Norwegian born being the reference category. The first model was controlled for age and gender and the second model was additionally adjusted for educational level. Our analysis included 5343 participants, 2853 men (913 immigrants), and 2481 women (603 immigrants), aged 45–79 years. The age-group 45–66 years includes n = 4187 (immigrants n = 1431, men n = 856; women n = 575) and 67–79 years n = 1147 (immigrants n = 85, men n = 57; women n = 28). The percentage of Norwegians having ≥ 14 years of education was 86%, as compared to 56% among immigrants. The percentage of immigrants with no education at all was 11%. The employment rate among the Norwegian eldest age group was nearly double (14%) as compared to the immigrant group. Adjusted for age, gender and education, immigrants had higher odds than Norwegian of ADL and IADL, chronic diseases and overweight. There were no differences between immigrants and Norwegians in prevalence of poor self-reported health and smoking. Overall elderly immigrants are worse-off than Norwegians in parameters of health and functioning. Knowledge about health and functioning of elderly immigrants can provide a basis for evidence-based policies and interventions to ensure the best possible health for a growing number of elderly immigrants. Furthermore, for a better surveillance, planning of programs, making policies, decisions and improved assessment and implementation, ADL and IADLs limitations should be included as a variable in public health studies.

Organizing and Analyzing Data from the SHARE Study with an Application to Age and Sex Differences in Depressive Symptoms

The SHARE study contains health, lifestyle, and socioeconomic data from individuals ages 50 and older in European countries collected over several waves. Leveraging these data for research purposes can be daunting due to the complex structure of the longitudinal design. The two aims of our study are (1) to develop a framework and R code for data management of the SHARE data to prepare for data analysis, and (2) to demonstrate how to apply the framework to a specific research question, where the aim is to model the presence of clinically significant depression assessed by the 12-item Europe depression scale. The result is a framework that substantially reduces the time to initiate research studies using SHARE data, facilitating the data extraction, data preparation and initial data analysis, with reproducible R code. Further, we illustrate the extensive work required to prepare an analysis-ready data set to ensure the validity of the modeling results. This underlines the importance of carefully considering and recording data management decisions that have to be built into the research process. The results about sex differences in the probability of depression are consistent with previous literature. Our findings about age-associated changes can be opportunities for adequate treatment interventions.

Relationship between average daily rehabilitation time and decline in instrumental activity of daily living among older patients with heart failure: A preliminary analysis of a multicenter cohort study, SURUGA-CARE

Background

Limitation of instrumental activity of daily living (IADL) is independently associated with an adverse prognosis in older heart failure (HF) patients.

Aims

This multicenter study aims to examine the relationship between average daily rehabilitation time (ADRT) and risk of IADL decline during acute hospitalization in older patients with HF.

Methods

Four hundred eleven older patients who were hospitalized due to acute HF and underwent rehabilitation were divided into three groups based on the tertile of the ADRT: short, intermediate, and long groups. IADL was assessed by the National Center for Geriatrics and Gerontology Activities of Daily Living (NCGG-ADL) scale. Change in NCGG-ADL (Δ NCGG-ADL) was calculated by subtracting the pre-hospitalization score from the at-discharge score and IADL decline was defined as Δ NCGG-ADL < = −1 point. Logistic regression analysis was carried out examining the association between ADRT and occurrence of IADL decline.

Results

The ADRT was 23.9, 32.0, and 38.6 minutes in short, intermediate, and long group, respectively. The proportion of patients with IADL decline during hospitalization was 21% among all subjects and short group had the highest proportion of IADL decline (33%) and long group had the lowest proportion (14%). The long group had significantly lower odds of IADL decline compared with the short group (OR:0.475, 95% CI:0.231–0.975, P = 0.042). Among the items of NCGG-ADL scale, significant decreases in the “go out by oneself”, “travel using a bus or train”, “shop for necessities”, “vacuum”, and “manage medication” were observed at discharge compared to pre-hospitalization in the short group (p<0.01, p<0.01, p<0.01, p<0.05, and p<0.05).

Conclusions

The present study demonstrated that short of ADRT may be associated with the risk of IADL decline during hospitalization in older patients with HF.

Self-reported quality of activities of daily living task performance in four diagnostic groups with chronic conditions

Background/aims

To design intervention programmes addressing activities of daily living task performance problems in individuals with chronic conditions, more knowledge about the types of challenges these individuals experience is needed. The aim of this study was to examine the types of activities of daily living tasks, as well as the types of problems related to the quality of task performance, that individuals with chronic conditions report and determine similarities and differences in four diagnostic sub-groups.

Methods

Data on self-reported quality of activities of daily living task performance were collected among 593 individuals with rheumatological disease, incurable cancer, chronic obstructive pulmonary disease and schizophrenia, using the ADL-Interview. Activities of daily living tasks most frequently reported as problematic were identified within each sub-group. Sub-group profiles were generated to identify similarities and differences in quality of performance.

Results

Participants reported problems performing similar types of activities of daily living tasks across diagnostic sub-groups, especially within instrumental activities of daily living. Moreover, participants mainly reported a decreased quality of performance in terms of using extra time and/or increased physical effort while performing personal activities of daily living.

Conclusions

As individuals across four chronic conditions reported somewhat similar problems related to activities of daily living task performance, generic activities of daily living interventions addressing these problems seem appropriate, especially interventions addressing problems related to use of extra time and increased effort.

Fatores associados à incapacidade funcional de idosos com catarata: revisão integrativa

Resumo Objetivo identificar as evidências científicas disponíveis na literatura sobre os fatores associados à incapacidade funcional de idosos com catarata. Métodos revisão integrativa da literatura realizada nas bases de dados PubMed, Web of Science, LILACS e CINAHL. Incluíram-se os artigos originais que responderam à questão norteadora: quais as evidências científicas sobre os fatores associados à incapacidade funcional de idosos com catarata? Resultados foram incluídos seis artigos, a maioria foi publicada a partir do ano 2000 (n=4) e realizada na América (n=3). Predominaram os estudos do tipo longitudinal (n=3) com nível de evidência IV, e transversal (n=3) com nível de evidência VI, e que realizaram análise de caminhos (n=3). Com base nos achados, emergiram três categorias temáticas: características demográficas; relacionadas à saúde ocular, física e mental, e comportamentais. Conclusão a incapacidade funcional de idosos com catarata pode ser resultante de características demográficas, relacionadas à saúde ocular, física e mental, e comportamentais.