The value of strength training for older adults

Health in older adults can best be measured in terms of functional status. Skeletal muscle strength has been reported to be a determinant of functional status in older individuals. Two major contributors to the decline in muscle function as a person ages are disuse and physical inactivity. Declining muscle function through a loss of muscular strength may decrease functional independence and mobility and increase the risk for falls and injuries, physical frailty, and disability. Older individuals lacking an appropriate amount of muscular strength may not be able to perform various activities of daily living, which are important indicators of independence.

Functional health status as a predictor of mortality in men and women over 65

This study evaluated the effect of functional health status on mortality in a sample of community-dwelling older people. White and African-American self-respondents to the 1986 National Health Interview Survey Functional Health Supplement (n = 5, 320) were included in the study. Functional health status was measured by a ten-item unidimensional activities of daily living-instrumental activities of daily living (ADL-IADL) scale and a three-item cognitive ADL scale. Proportional hazards regression was used to evaluate the effect of increasing score on the ten-item ADL-IADL scale on risk of mortality over a 5-year period while controlling for demographic, social, and health status covariates. In both men and women, increasing score on the ADL-IADL scale was predictive of mortality, adjusting for increasing age, poor self-rated health, low body mass index in women, and being an unmarried man. These findings indicate that a unidimensional scale consisting of both ADL and IADL items is useful in predicting mortality, controlling for the effect of covariates in sex-specific models.

Risk of institutionalization among community long-term care clients with dementia

South Carolina Community Long-Term Care (CLTC) data were used to identify factors increasing the risk of institutionalization in people with dementia. Clients diagnosed with dementia and observed at least twice between June 1993 and December 1994 (N = 786) were studied. Logistic regression determined that clients with a decline in ADL function who were white, had a nonrelative or child as a caregiver, and were diagnosed with Alzheimer's disease were at increased risk of institutionalization. Identifying CLTC clients at increased risk of institutionalization could be useful in designing additional interventions to prevent institutionalization or in planning the transition to institutional care.

Epidemiology of Alzheimer's disease

In summary, while only a few risk factors for Alzheimer's disease have been identified, several large collaborative studies of elderly populations are currently underway. As measurement techniques improve, the ability to diagnose this disease in its early stages will make the search for risk factors more feasible.

Survival of Alzheimer's disease patients with regard to pattern of care in South Carolina, 1988-1993

The length of time from diagnosis of AD to death was compared among three groups of AD patients in South Carolina. Each group received a different pattern of care. The survival time from diagnosis to death was longest among those who lived in institutions (mean three years for men, 4.6 years for women), and shortest among those who lived alone in the community (1.7 years for men, two years for women). The longer survival time of those who receive care (either in the community or in facilities) suggests that persons with AD benefit from personal attention to health needs. Providing additional support to family members of those with AD could help patients remain in the community longer, thus maintaining quality of life. For those who have no support in the community, efforts should be made to increase access to facilities.