Association of unipedal standing time and bone mineral density in community-dwelling Japanese women.

PubMed

Sakai, A; Toba, N; Takeda, M; Suzuki, M; Abe, Y; Aoyagi, K; Nakamura, T

2009-05-01

Bone mineral density (BMD) and physical performance of the lower extremities decrease with age. In community-dwelling Japanese women, unipedal standing time, timed up and go test, and age are associated with BMD while in women aged 70 years and over, unipedal standing time is associated with BMD. The aim of this study was to clarify whether unipedal standing time is significantly associated with BMD in community-dwelling women. The subjects were 90 community-dwelling Japanese women aged 54.7 years. BMD of the second metacarpal bone was measured by computed X-ray densitometry. We measured unipedal standing time as well as timed up and go test to assess physical performance of the lower extremities. Unipedal standing time decreased with increased age. Timed up and go test significantly correlated with age. Low BMD was significantly associated with old age, short unipedal standing time, and long timed up and go test. Stepwise regression analysis revealed that age, unipedal standing time, and timed up and go test were significant factors associated with BMD. In 21 participants aged 70 years and over, body weight and unipedal standing time, but not age, were significantly associated with BMD. BMD and physical performance of the lower extremities decrease with older age. Unipedal standing time, timed up and go test, and age are associated with BMD in community-dwelling Japanese women. In women aged 70 years and over, unipedal standing time is significantly associated with BMD.

Depressive symptoms in community-dwelling elderly Korean immigrants and elderly Koreans: cross-cultural comparison.

PubMed

Sin, Mo-Kyung; Choe, Myoung-Ae; Kim, Jeungim; Chae, Young-Ran; Jeon, Mi-Yang

2010-10-01

Depression among minority older adults is a prevalent underrecognized medical illness. Changes in cultural norms and social conditions because of immigration have a significant influence on mental health. The purpose of this study was to assess the interrelationships between acculturation, geographical location, gender, and depressive symptoms in community-dwelling elderly Korean immigrants and elderly Koreans. In this cross-sectional study, a convenience sample of 88 elderly Korean immigrants and 295 elderly Koreans was recruited separately from senior centers and senior apartments. Depressive symptoms were assessed with the Korean Geriatric Depression Scale-Short Form and acculturation with years of living in the United States. Acculturation had no significant relationship with depressive symptoms (r = 0.01, p = 0.94). Depressive symptoms were highly present in both elderly Korean immigrants and elderly Koreans. The prevalence of depressive symptoms was higher in women. This study provides baseline data for development of culturally specific, community-based intervention programs for better management of mental health of elderly Korean immigrants. Copyright 2010, SLACK Incorporated.

Physiotherapy program through home visits for community-dwelling elderly Japanese women with mild knee pain.

PubMed

Konishi, Isamu; Tanabe, Naohito; Seki, Nao; Suzuki, Hiroshi; Okamura, Taro; Shinoda, Kunihiko; Hoshino, Emiko

2009-10-01

Knee pain is extremely common among the elderly, particularly women. Hence, there is an urgent need for applicable community-based intervention models for halting the progression of knee pain and related disabilities in elderly women. We aimed to assess the efficacy of home-visit physiotherapy as a new intervention model. This non-randomized 5-month-long controlled trial enrolled elderly community-dwelling women (aged 60-83 years) with mild knee pain. The intervention consisted of two home visits by a physiotherapist, with instructions on routinely performing muscle-strengthening exercises at home and implementing simple environmental modifications when necessary. Outcome measures were assessed at baseline and 5 months later. The primary outcomes were measured as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and a newly devised seiza-style sitting score. People in Japan, especially elderly women, are accustomed to seiza-style sitting that involves kneeling on one's lower legs while resting the buttocks on the heels. The secondary outcomes included quadriceps isometric strength, knee alignment in the frontal and sagittal planes, and passive knee extension range. Forty-two subjects (20 in the intervention group and 22 in the control group) completed the study. At baseline, characteristics and the primary outcomes did not significantly differ between the 2 groups. At 5 months, the primary outcomes improved significantly in the intervention group. Estimated differences in the change from baseline for each outcome between the 2 groups were computed, adjusting for outcome variables imbalanced at baseline. Even after the adjustment, the home-visit physiotherapy regimen provides favorable improvement in the seiza-style sitting score.

Constipation in community-dwelling elders: prevalence and associated factors.

PubMed

Song, Hyo Jeong

2012-01-01

The purpose of this study was to measure the prevalence of constipation in community-dwelling elders and to analyze associated factors. The study sample comprised 186 elders from 5 Senior Citizen Centers in Jeju-si. This community-based cross-sectional study used a structured questionnaire to collect data via interviews with respondents. Interviews were completed by the principal investigator and an assistant. Interviews required approximately 20 minutes and were completed in the senior centers. Respondents were queried about demographic characteristics, body mass index, alcohol consumption, level of exercise, depression, and lower urinary tract symptoms including urinary incontinence. Bowel elimination symptoms were queried, and the presence of constipation was established using Rome II criteria. Multiple logistic regression analysis was used to test for associations between potential risk factors and constipation. The prevalence of constipation in this community-dwelling sample population was 25.8%. The most common symptoms were "hard or lumpy stools" reported by 30.8% and "straining during a bowel movement" reported by 27.1%. Analysis via logistic regression found that constipation is associated with lower urinary tract symptoms (odds ratio = 1.1; 95% confidence interval: 1.03-1.14) and obesity (body mass index ≥ 25 kg/m) (odds ratio = 2.4; 95% confidence interval: 1.01-5.57). Slightly more than one quarter of the elderly reported symptoms of constipation. Associated factors were presence of lower urinary tract symptoms and obesity.

[Association between insomnia symptoms, daytime napping, and falls in community-dwelling elderly].

PubMed

Pereira, Alexandre Alves; Ceolim, Maria Filomena; Neri, Anita Liberalesso

2013-03-01

This study focused on associations between insomnia symptoms, daytime napping, and falls in community-dwelling elderly, using a population-based cross-sectional design and probability sample with 689 community-dwelling elders. The protocol consisted of self-reported and physical performance variables. The study used univariate and multivariate logistic regression analysis with statistical significance set at p < 0.05. Prevalence rates for insomnia symptoms and daytime napping were 49.9% (n = 339) and 62.8% (n = 432), respectively. 14.4% reported a single fall and 11.9% reported multiple falls. Falls were associated with female gender (OR = 7.73; 95%CI: 3.03-19.72), age > 80 (OR = 3.48; 95%CI: 1.54-7.85), napping (OR = 2.24; 95%CI: 1.24-4.05), and depressive symptoms (OR = 1.98; 95%CI: 1.11-3.53). The association between daytime napping and falls corroborates data from international research. Identifying modifiable risk factors may help programs to prevent falls in the elderly.

Exercise and Nutritional Supplementation on Community-Dwelling Elderly Japanese Women With Sarcopenic Obesity: A Randomized Controlled Trial.

PubMed

Kim, Hunkyung; Kim, Miji; Kojima, Narumi; Fujino, Ken; Hosoi, Erika; Kobayashi, Hisamine; Somekawa, Shinji; Niki, Yoshifumi; Yamashiro, Yukari; Yoshida, Hideyo

2016-11-01

To investigate the effects of exercise and/or nutritional supplementation on body composition, blood components, and physical function in community-dwelling elderly Japanese women with sarcopenic obesity. Randomized controlled trial. Urban community in Tokyo, Japan. Among 1213 community-dwelling elderly women over 70 years of age, 307 were defined with sarcopenic obesity, and 139 women participated in the study. Participants were randomly assigned to one of four intervention groups. The exercise and nutrition (Ex + N) and exercise only (Ex) groups attended 60-minute exercise classes twice a week for 3 months. The Ex + N and nutrition only (N) groups were provided with essential amino acid supplementation and tea fortified with catechins to be taken daily for 3 months. Health education classes were provided to the control (HE) group every 2 weeks. Bioelectric impedance analysis was used to measure body composition. Skeletal muscle mass index was calculated using measures of muscle mass and height. Physical function measures included grip strength, knee extension strength, usual walking speed, and walking parameters (stride, step length, width, walking angles). Blood samples were obtained to analyze levels of albumin, triglycerides, cholesterol, hemoglobin A1c, leptin, cystatin C, vitamin D, interleukin-6, and high-sensitivity C-reactive protein. Significant between-group × time interactions were observed in usual walking speed (P = .012), stride (P = .004), right step length (P = .003), average number of steps (P = .029), and vitamin D (P < .001). Compared to the HE group, the Ex + N intervention significantly decreased total body fat mass (P = .036) and increased stride (P = .038) and vitamin D (P < .001). Significant reductions in trunk fat were observed in the Ex group compared with HE (P = .014). The Ex + N and Ex interventions were over four times as likely (odds ratio [95% confidence interval]) to reduce body fat mass than the

[Prevalence of elder abuse in Spanish dwelling in community].

PubMed

Pérez-Rojo, Gema; Izal, María; Montorio, Ignacio; Regato, Pilar; Espinosa, Juan Manuel

2013-12-21

Although elder abuse is not a new phenomenon, it remains hidden. There have been carried out various preliminary studies about the prevalence of elder abuse in different countries. The aim of this study is to estimate the prevalence of suspicion of elder abuse in old persons without cognitive impairment, dwelling in community, who were attended in Primary Health Care or Social Services Centres. We carried out a transverse study in which 340 elders participated. We found a 12.1% prevalence of suspicion of elder abuse. Psychological abuse suspicion was the most frequent type and it was very common the simultaneous presence of different types of abuse (psychological and physical and sexual). The suspicion of elder abuse was more frequent in women and spouses were responsible in a high great frequency. The information obtained allows advancing in the knowledge of elder abuse in Spain, where the research about this issue is poor. However, the prevalence found neither has to be considered as a social alarm nor as a social slackness. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Suicidal ideation and associated factors among community-dwelling elders in Taiwan.

PubMed

Yen, Yung-Chieh; Yang, Ming-Jen; Yang, Mei-Sang; Lung, For-Wey; Shih, Chun-Hua; Hahn, Cheng-Yi; Lo, Hsin-Yi

2005-08-01

The purpose of the present study was to explore the suicidal ideation of community-dwelling elderly and the factors associated with their intention to commit suicide. Using a multilevel stratified sampling strategy, 1000 elderly subjects were recruited (aged 65-74 years old) in Taiwan during the year 2001. The degree of depression and its correlates were assessed. Suicidal ideation was measured by asking respondents if they had had any suicidal thoughts in the previous week. In all, 16.7% of respondents reported suicidal ideation within the past week; its occurrence was related to sex, religious belief, employment status, marital status, average family monthly income, physical health status, depressive symptoms, and community activity participation. Further multivariate logistic regression revealed that, aside from depressive symptoms and a lower level of education, no community participation in the past 6 months was significantly associated with the appearance of suicidal ideation. The prevalence of suicidal ideation among the elderly in Taiwan is higher than in Western countries. Participation in social activities is negatively associated with elderly suicidal ideation. The dimension of social participation deserves further exploration and should be considered in community mental health promotion interventions for elderly people.

[Factors related to sarcopenia in community-dwelling elderly subjects in Japan].

PubMed

Tanimoto, Yoshimi; Watanabe, Misuzu; Sugiura, Yumiko; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Kono, Koichi

2013-01-01

This study aimed at determining the factors associated with sarcopenia, defined as low muscle mass and strength and low physical performance, in community-dwelling elderly subjects in Japan. The subjects included 1,074 elderly, community-dwelling Japanese people aged 65 years or older. We measured appendicular muscle mass (AMM) by bioelectrical impedance analysis, grip strength, and usual walking speed. A low muscle mass was defined by the AMM index (AMI, weight [kg]/height [m(2)] as >2 standard deviations below the mean AMI for normal young subjects. The lowest quartile for grip strength and usual walking speed were classified as low muscle strength and low physical performance, respectively. "Sarcopenia" was characterized by a low muscle mass, combined with either a low muscle strength or low physical performance. Subjects without low muscle mass or strength and low physical performance were classified as "normal." Subjects were classified as being "intermediate" if they were neither "sarcopenic" nor "normal." Items in the questionnaire included residential status, past medical history, admission during the past year, smoking and drinking habits, leisure-time physical activity, health status, depression, masticatory ability, and dietary variety score. Sarcopenia was identified in 13.7% of men and 15.5% of women. Among men, a large proportion of subjects with sarcopenia had poor masticatory ability and a low dietary variety score compared with normal or intermediate subjects. Among women, a large proportion of the subjects with sarcopenia lived alone, had poor exercise habits, considered themselves to be unhealthy, and had poor masticatory ability compared with normal or intermediate subjects. A multiple logistic regression analysis showed that age and dietary variety in men and age and masticatory ability in women were associated with sarcopenia. The present study carried out in Japan showed that sarcopenia, assessed by muscle mass, muscle strength, and physical

Association of Personality Traits with Elder Self-Neglect in a Community Dwelling Population

PubMed Central

Dong, XinQi; Simon, Melissa; Wilson, Robert; Beck, Todd; McKinell, Kelly; Evans, Denis

2010-01-01

Objective Elder self-neglect is an important public health issue. However, little is known about the association between personality traits and risk of elder self-neglect among community-dwelling populations. The objectives of this study are: 1) to examine the association of personality traits with elder self-neglect and 2) to examine the association of personality traits with elder self-neglect severity. Methods Population-based study conducted from 1993–2005 of community-dwelling older adults (N=9,056) participating in the Chicago Health Aging Project (CHAP). Subsets of the CHAP participants (N=1,820) were identified for suspected self-neglect by social services agency, which assessed the severity. Personality traits assessed included neuroticism, extraversion, rigidity and information processing. Logistic and linear regressions were used to assess these associations. Results In the bivariate analyses, personality traits (neuroticism, extraversion, information processing, and rigidity) were significantly associated with increased risk of elder self-neglect. However, after adjusting for potential confounders, the above associations were no longer statistically significant. In addition, personality traits were not associated with increased risk of greater self-neglect severity. Furthermore, interaction term analyses of personality traits with health and psychosocial factors were not statistically significant with elder self-neglect outcomes. Conclusion Neuroticism, extraversion, rigidity and information processing were not associated with significantly increased risk of elder self-neglect after consideration of potential confounders. PMID:21788924

[Relationship between Quality of Life (QOL) and cognitive function among community-dwelling elderly].

PubMed

Konagaya, Yoko; Watanabe, Tomoyuki; Ohta, Toshiki; Takata, Kazuko

2009-03-01

It has become important for elderly to live better rather than to live longer. There have been many reports about quality of life (QOL) of the elderly, but we have no knowledge about the relation between the QOL and the cognitive function. We investigated the relationship between the QOL and the cognitive function among community-dwelling elderly. A total of 12,059 community-dwelling elderly were invited to join a cognitive screening study by telephone (TICS-J) combined with a mailed QOL questionnaire. Among them, 1,920 subjects (age 71.87+/-5.50 (mean+/-SD) years old, duration of education 11.08+/-2.61 years) who completed both TICS-J and QOL questionnaire were actually measured. TICS-J was administered by the previously reported method, and the QOL questionnaire was developed based on the component of QOL proposed by Lawton, and consisted of 6 subscales (daily activity, satisfaction with health, satisfaction with human support, satisfaction with economic state, symptoms of depression, and positive mental attitude). Correlations were analyzed among the scores of TICS-J, age, duration of education, and scores on each QOL subscale. Multiple linear regression analysis was conducted after QOL subscale scores, adjusting for gender, age, and duration of education, were entered as dependent variables. Four out of 6 subscales scores of QOL showed significant differences between men and women. All QOL subscale scores showed significant differences between the two groups in the TICS-J scores. Partial correlations were seen among TICS-J scores and each QOL subscale score. Multiple linear regression analysis revealed significant influence of cognitive function by TICS-J on QOL subscales scores. Cognitive function was considered to have more influence on QOL scores than gender or age. TICS-J and the QOL questionnaire in this study were useful to evaluate the outcome of welfare in community-dwelling elderly.

Factors related to mental health and hearing in community-dwelling elderly

PubMed Central

Nabeshima, Sumiyo; Yamada, Kiyomi

2018-01-01

ABSTRACT The purpose of this study was to clarify the factors related to mental health and hearing in community-dwelling elderly. Elderly participants in a project to prevent long-term care need were given a self-administered questionnaire and tested by pure-tone audiometry. One hundred fifty were taken as subjects. Forty-one of these subjects (27.3%) were found to have poor mental health. The results of multiple logistic regression analysis with mental health level as the dependent variable indicated that subjects 65–74 years old who did not think their own hearing was bad had better mental health than those who did think their hearing was bad (odds ratio 10.800). Among subjects 75 years and older, those who had not been certified as needing long-term care had better mental health than those who had been certified (odds ratio 3.937). When planning mental health support for community-dwelling elderly in the future, it will be necessary to consider differences in background due to age group. The present results suggest that appropriate support for awareness of hearing and acceptance of decreased hearing ability in people in early old age (65–74 years old) may help to prevent declining mental health in later old age.

Attentional demands and daily functioning among community-dwelling elders.

PubMed

Jansen, Debra A

2006-01-01

Everyday life is full of numerous demands for attention that can affect the ability to function. For elders, examples of these attentional demands include negotiating public transportation and driving, sensory losses, and physical discomforts and worries that make it harder to concentrate and complete tasks. The purpose of this study was to examine the relation between attentional demands and the ability to manage daily activities requiring concentration for 54 community-dwelling elders (34 women, 20 men). As theorized, attentional demands correlated (r = -.58) significantly with daily functioning: Elders with more attentional demands perceived themselves as having greater difficulty managing tasks requiring concentration. Attentional demands accounted for a significant proportion of variance in functioning (12%), even after partialling out the effects of depressive symptoms and health. Findings support the theorized relation between attentional demands and daily functioning, as well as nursing interventions aimed at decreasing attentional demands to promote effective functioning for elders.

Effects of compound music program on cognitive function and QOL in community-dwelling elderly

PubMed Central

Fujita, Takaaki; Ito, Akemi; Kikuchi, Nana; Kakinuma, Tomohiro; Sato, Yoshihisa

2016-01-01

[Purpose] Interventions using music, physical exercise, and reminiscence therapy are widely used both for rehabilitation and care of the elderly. This study aimed to investigate the effect of structured interventions comprising music, physical exercise, and reminiscence therapy on cognitive function and quality of life of the community-dwelling elderly. [Subjects and Methods] The study included 15 community-dwelling elderly people who used a day-care center. Participants underwent sessions comprising the following three factors: 1) singing songs familiar to the elderly; 2) physical exercise to music; and 3) observation of historical pictures. Sessions were conducted once or twice per week, 30 to 40 min per day, for 10 weeks. Pre and post interventions of the Mini Mental State Examination, the Behavioral Rating Scale for the Elderly, and the SF-8 were compared. [Results] No significant difference was observed between pre- and post-intervention scores on the Mini Mental State Examination and the Behavioral Rating Scale for the Elderly. However, the post intervention physical component summary of SF-8 was significantly higher than the pre intervention summary. [Conclusion] This study suggests that interventions comprising music, physical exercise, and reminiscence therapy may contribute toward the improvement of elderly individuals’ health-related quality of life, especially physical health. PMID:27942151

Parenting style, resilience, and mental health of community-dwelling elderly adults in China.

PubMed

Zhong, Xue; Wu, Daxing; Nie, Xueqing; Xia, Jie; Li, Mulei; Lei, Feng; Lim, Haikel A; Kua, Ee-Heok; Mahendran, Rathi

2016-07-08

Given the increasing elderly population worldwide, the identification of potential determinants of successful ageing is important. Many studies have shown that parenting style and mental resilience may influence mental health; however, little is known about the psychological mechanisms that underpin this relationship. The current study sought to explore the relationships among mental resilience, perceptions of parents' parenting style, and depression and anxiety among community-dwelling elderly adults in China. In total, 439 community-dwelling elderly Chinese adults aged 60-91 years completed the Personal and Parents' Parenting Style Scale, Connor-Davidson Resilience Scale, Zung Self-Rating Depression Scale, and Zung Self-Rating Anxiety Scale. Elderly adults whose parents preferred positive and authoritative parenting styles had higher levels of mental resilience and lower levels of depression and anxiety. Elderly adults parented in the authoritarian style were found to have higher levels of depression and anxiety, with lower mental resilience. The findings of this study provide evidence related to successful ageing and coping with life pressures, and highlight the important effects of parenting on mental health. The results suggest that examination of the proximal determinants of successful ageing is not sufficient-distal factors may also contribute to the 'success' of ageing by modifying key psychological dispositions that promote adaptation to adversity.

Sarcopenia and falls in community-dwelling elderly subjects in Japan: Defining sarcopenia according to criteria of the European Working Group on Sarcopenia in Older People.

PubMed

Tanimoto, Yoshimi; Watanabe, Misuzu; Sun, Wei; Sugiura, Yumiko; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Tamaki, Junko

2014-01-01

This study assessed the association between sarcopenia (using the definition of the European Working Group on Sarcopenia in Older People) and fall in the past year among community-dwelling Japanese elderly. Subjects were 1110 community-dwelling Japanese aged 65 or older. We used bioelectrical impedance analysis (BIA) to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance in a baseline study. "Sarcopenia" was characterized by low muscle mass and low muscle strength or low physical performance. "Presarcopenia" was characterized only by low muscle mass. Subjects who did not have any of these deficiencies were classified as "normal." We then administered a questionnaire assessing age, sex, household status, chronic illness, lifestyle-related habits, and fall. This study showed the prevalence of fall was 16.9% and 21.3% in men and women, respectively, while that of sarcopenia was 13.4% and 14.9% in men and women, respectively. In men and women, the prevalence of sarcopenia was higher among those who had fallen. A logistic regression analysis using age, body fat, current drinker status, and physical inactivity for men, and age, body fat, smoking, and diabetes for women as covariate variables revealed that sarcopenia was significantly associated with a history of fall. The odds ratio for fall in the sarcopenia group relative to the normal group was 4.42 (95%CI 2.08-9.39) in men and 2.34 (95%CI 1.39-3.94) in women. This study revealed sarcopenia to be associated with falling in elderly Japanese. Sarcopenia prevention interventions may help prevent falls among elderly individuals. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Orofacial pain symptoms and associated disability and psychosocial impact in community-dwelling and institutionalized elderly in Hong Kong.

PubMed

Wan, K Y; McMillan, A S; Wong, M C M

2012-03-01

The study investigated the experience of orofacial pain (OFP) symptoms and associated disability and psychosocial impact in community dwelling and institutionalized elderly people in Hong Kong. A community-based cross-sectional survey involving elders aged 60 years and above. Participants were recruited at social centres for the elderly and homes for the aged throughout Hong Kong. Elders who reported OFP symptoms in the previous four weeks took part. Standard questions were asked about OFP conditions in the previous month and the Manchester Orofacial Pain Disability Scale (MOPDS), the Oral Health Impact Profile (OHIP-14) and the General Health Questionnaire (GHQ-12) were administered. The MOPDS was translated and validated for use in Chinese elders. 200 community dwelling and 200 institutionalized elders participated. Toothache was the most common symptom (62.0%) and burning sensation in the tongue was least common (0.5%). The distribution of pain symptoms, pain duration and severity and pain ratings were similar in both groups. The MOPDS (Chinese elders version) had good reliability and construct validity. The MOPDS and OHIP-14 summary scores was significantly higher in the institutionalized elderly (p < 0.001 and p < 0.013, respectively). Psychological distress (GHQ-12 score > or = 4) was more common among the institutionalized elderly (11%) than the community dwelling elderly (4.0%, p = 0.002). Orofacial pain symptoms were associated with significant disability and had a detrimental impact on psychological distress level and quality of life, particularly in the institutionalized elderly. There is a need to improve access to professional care and health-related outreach services generally for elderly people in Hong Kong.

Hearing handicap predicts the development of depressive symptoms after 3 years in older community-dwelling Japanese.

PubMed

Saito, Hideyuki; Nishiwaki, Yuji; Michikawa, Takehiro; Kikuchi, Yuriko; Mizutari, Kunio; Takebayashi, Toru; Ogawa, Kaoru

2010-01-01

To examine the association between hearing handicap and depressive symptoms in older community-dwelling Japanese. Community-based cohort study. Kurabuchi Town, Gunma Prefecture, Japan. Five hundred eighty residents (261 men, 319 women) aged 65 and older without depressive symptoms. In a baseline examination performed in 2005/06, participants answered the 10-item screening version of the Hearing Handicap Inventory for Elderly (HHIE-S). They were divided into two groups according to their scores: a group with no hearing handicap (HHIE-S scores of < or =8) and a hearing handicap group (HHIE-S scores of > or =10). The Geriatric Depression Scale was used to identify depressive symptoms in face-to-face home visit interviews conducted in 2008, and the association between hearing handicap and depressive symptoms was assessed using logistic regression. The incidence of depressive symptoms was 19.6% in the group with a hearing handicap and 8.0% in the group without a hearing handicap. When compared with the subjects without hearing handicap, subjects with a hearing handicap had a multiadjusted odds ratio of depressive symptoms of 2.45 (95% confidence interval=1.26-4.77). The association remained significant even when hearing impairment measured with pure-tone audiometry was added to the multiadjusted model. A hearing handicap can predict future depressive symptoms in older community-dwelling people.

Estimation of prevalence of sarcopenia by using a new bioelectrical impedance analysis in Chinese community-dwelling elderly people.

PubMed

Wang, Hui; Hai, Shan; Cao, Li; Zhou, Jianghua; Liu, Ping; Dong, Bi-Rong

2016-12-28

The aim of the present study was to validate the usefulness of the new octapolar multifrequency bioelectrical impedance analysis (BIA) for assessment of appendicular skeletal muscle mass (ASM) by comparing it with that of dual-energy X-ray absorptiometry (DXA) and to investigate the prevalence of sarcopenia in Chinese community-dwelling elderly according to Asian Working Group for Sarcopenia (AWGS) definition. A cross-sectional study was conducted in communities of Chengdu, China. A total of 944 community-dwelling elderly adults aged ≥60 years were included. ASM was measured by using DXA as a criterion method to validate a standing eight-electrode multifrequency BIA (InBody 720), followed by a further estimation of the prevalence of sarcopenia according the AWGS definition. In the Bland-Altman analysis, no significant difference was found between DXA and BIA based on the ASM measurements. The prevalence of AWGS-defined sarcopenia was 12.5% in the elderly women and 8.2% in the elderly men. BIA is suitable for body composition monitoring (ASM) in elderly Chinese as a fast, noninvasive, and convenient method; therefore, it may be a better choice in large epidemiological studies in the Chinese population. The prevalence of AWGS-defined sarcopenia was approximately 10.4% and increased with age in the Chinese community-dwelling elderly in this study.

[Fall risk factors and sex differences among community-dwelling elderly individuals in Japan. A Kameoka study].

PubMed

Masumoto, Taeko; Yamada, Yosuke; Yamada, Minoru; Nakaya, Tomoki; Miyake, Motoko; Watanabe, Yuya; Yoshida, Tsukasa; Yokoyama, Keiichi; Yamagata, Emi; Date, Heiwa; Nanri, Hinako; Komatsu, Mitsuyo; Yoshinaka, Yasuko; Fujiwara, Yoshinori; Okayama, Yasuko; Kimura, Misaka

2015-01-01

Although factors associated with falls might differ between men and women, no large-scale studies were conducted to examine the sex difference of risk factors for falls in Japanese elderly. The purpose of this study was to examine fall risk factors and sex differences among community-dwelling elderly individuals using a complete survey of the geriatric population in Kameoka city. A self-administered questionnaire survey was conducted with 18,231 community-dwelling elderly individuals aged 65 years or over in Kameoka city, Kyoto Prefecture, between July and August 2011, excluding people who were publicly certified with a long-term care need of grade 3 or higher. The questionnaire was individually distributed and collected via mail. Out of 12,159 responders (recovery rate of 72.2%), we analyzed the data of 12,054 elderly individuals who were not certified as having long-term care needs. The questionnaire was composed of basic attributes, a simple screening test for fall risk, the Kihon Check List with 25 items, and the Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence with 13 items. These items were grouped into nine factors: motor function, malnutrition, oral function, houseboundness, forgetfulness, depression, Instrumental Activity of Daily Living (IADL), intellectual activities, and social role. Of all the respondents, 20.8% experienced falls within the last year, and 26.6% were classified as having high fall risk. Fall risk increased with age in both sexes, and risk in all age groups was higher for women than for men. All factors were significantly associated with fall risk in both sexes. After controlling for these factors, a significant relationship was found between fall risk and motor function, malnutrition, oral function, forgetfulness, depression, and IADL in men and motor function, oral function, forgetfulness, depression, and IADL in women. The deterioration of motor function was associated with three-times-higher risk than non

Association between the nutritional status and the severity of sarcopenia among community-dwelling elderly Japanese people.

PubMed

Komai, Satsuki; Watanabe, Yutaka; Fujiwara, Yoshinori; Kim, Hunkyung; Edahiro, Ayako; Kawai, Hisashi; Yoshida, Hideyo; Obuchi, Shuichi; Tanaka, Yayoi; Hirano, Hirohiko

2016-01-01

To investigate the association between nutritional evaluation indices (body mass index, albumin, and weight loss) and sarcopenia severity among community-dwelling elderly people in Japan. The subjects consisted of 758 community-dwelling elderly people ≥65 years of age, categorized into two groups by based on Operation of long life medical care system (medical care system for elderly in the latter stage of life), the cut-off value for age used was 75. The outcome measures were basic characteristics, anthropometric measures, physical function, and blood biochemistry (five assessments). The appendicular skeletal muscle mass was calculated via a bioelectrical impedance analysis. The subjects were categorized into three groups by the body mass index (BMI) [BMI 3 group]. The cut-off value for albumin used was 3.8 g/dL [A1b 2 group]. Weight loss was assessed using item 11 on the Kihon check list: "Have you experienced more than 2-3 kg weight loss over the past 6 months? Yes=1, No=0." [weight loss 2 group]. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People definition, using the Asian Working Group for Sarcopenia cut-off values. All subjects were then categorized into four groups based on their sarcopenia status: non-sarcopenic (non-), pre-sarcopenic (pre-), sarcopenic (sarco-), or severely sarcopenic (severe-) [sarco4 group]. The prevalence of sarcopenia and severe sarcopenia in men was 5.6% (n=18) and 1.2% (n=4), respectively, and in women was 7.8% (n=34) and 1.6% (n=7), respectively. The analysis showed that, among the people (>75 years of age) with normal BMI (18.5-25.0), 10.4%-15.6% were in the Sarco group. Further, among women over 75 years of age with BMI >25.0, 5.7% (n=2) were in the Sarco group. There was a significant association between weight loss and sarcopenia severity in older men. No significant association between albumin levels and sarcopenia severity was observed. 80.0% of weight-loss was presented in above BMI 18

Screening for Malnutrition in Community Dwelling Older Japanese: Preliminary Development and Evaluation of the Japanese Nutritional Risk Screening Tool (NRST).

PubMed

Htun, N C; Ishikawa-Takata, K; Kuroda, A; Tanaka, T; Kikutani, T; Obuchi, S P; Hirano, H; Iijima, K

2016-02-01

Early and effective screening for age-related malnutrition is an essential part of providing optimal nutritional care to older populations. This study was performed to evaluate the adaptation of the original SCREEN II questionnaire (Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II) for use in Japan by examining its measurement properties and ability to predict nutritional risk and sarcopenia in community-dwelling older Japanese people. The ultimate objective of this preliminary validation study is to develop a license granted full Japanese version of the SCREEN II. The measurement properties and predictive validity of the NRST were examined in this cross-sectional study of 1921 community-dwelling older Japanese people. Assessments included medical history, and anthropometric and serum albumin measurements. Questions on dietary habits that corresponded to the original SCREEN II were applied to Nutritional Risk Screening Tool (NRST) scoring system. Nutritional risk was assessed by the Geriatric Nutrition Risk Index (GNRI) and the short form of the Mini-Nutritional Assessment (MNA-SF). Sarcopenia was diagnosed according to the criteria of the European Working Group on Sarcopenia in Older People. The nutritional risk prevalences determined by the GNRI and MNA-SF were 5.6% and 34.7%, respectively. The prevalence of sarcopenia was 13.3%. Mean NRST scores were significantly lower in the nutritionally at-risk than in the well-nourished groups. Concurrent validity analysis showed significant correlations between NRST scores and both nutritional risk parameters (GNRI or MNA-SF) and sarcopenia. The areas under the receiver operating characteristic curves (AUC) of NRST for the prediction of nutritional risk were 0.635 and 0.584 as assessed by GNRI and MNA-SF, respectively. AUCs for the prediction of sarcopenia were 0.602 (NRST), 0.655 (age-integrated NRST), and 0.676 (age and BMI-integrated NRST). These results indicate that the NRST is a

Relationship between periodontal status and intellectual function among community-dwelling elderly persons.

PubMed

Moriya, Shingo; Tei, Kanchu; Toyoshita, Yoshifumi; Koshino, Hisashi; Inoue, Nobuo; Miura, Hiroko

2012-06-01

The aim of this study was to indicate the relationship between periodontal status and intellectual function in the elderly. Periodontal status has been shown to be related to demographic, socioeconomic, and psychological status. Intellectual function is a significant indicator of health status. Nevertheless, the relationship between periodontal status and intellectual function has not been elucidated in detail among the elderly. A total of 152 community-dwelling elderly persons, aged 70-74 years, were enrolled in the study. Periodontal status was evaluated using the WHO Community Periodontal Index of Treatment Needs (CPITN). Intellectual function was assessed by four neuropsychological tests: Raven's Coloured Progressive Matrices (RCPM) test, the Verbal Paired Associates 1 (VerPA) task and the Visual Paired Associates 1 (VirPA) task, extracted from the Wechsler Memory Scale Revised Edition, and the Block Design subtest, extracted from the Wechsler Adult Intelligence Scales, Third Edition. Correlations between CPITN and each test were examined using Spearman rank correlation coefficients. The ordinal regression model was constructed with CPITN as the dependent variable and neuropsychological test as the principal independent variable to adjust for demographic factors, general health, lifestyle and oral health behaviour. Significant correlations were found between the RCPM test, the VerPA task, the Visual Paired Associates 1 and CPITN. In the ordinal regression model, CPITN was significantly related to measures of RCPM after adjusting for demographic factors, general health status, lifestyle and oral health behaviour. Intellectual function is considered a significant indicator of periodontal status among community-dwelling elderly persons. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

Household characteristics and influenza vaccination uptake in the community-dwelling elderly: a cross-sectional study

PubMed Central

Chan, Denise P.C.; Wong, Ngai Sze; Wong, Eliza L.Y.; Cheung, Annie W.L.; Lee, Shui Shan

2015-01-01

Elderly people are at higher risk of influenza diseases. The morbidity benefit of vaccination is often offset by its low and variable coverage in elderly people in the community. To assess household and individual factors associated with influenza vaccination uptake in the community-dwelling elderly of age ≥ 65, data from a cross-sectional Thematic Household Survey conducted in 2011/12 in Hong Kong were analysed, using vaccination in the past 12 months as the outcome variable. Households comprising an elderly person living with non-elderly member(s) of age ≤ 64 were also evaluated. Data fields included socio-demographics, household structures, health status, eligibility to financial subsidy, and subscription to health insurance. The influenza vaccination rate was 27% in 4204 elderly persons from 3224 households. Being male, being economically active, attaining primary education, having smoking behaviours were negatively associated with vaccination, while chronic illness and age ≥ 70 were positively associated factors. Elderly people living alone gave a variable rate of vaccination ranging from 16.4% in males of age 65–69 to 36.3% in females ≥ 70. Household size per se was not associated with vaccination, but a positive correlation could be seen if the household was composed of vaccinated non-elderly member(s). Influenza vaccination uptake in the community-dwelling elderly is dependent on both individual and household characteristics, the latter including the influence of vaccinated non-elderly member(s). The low vaccination coverage of “younger” (age 65–69) elderly men living alone is particularly worrisome. Interventions focusing on vulnerable elderly people and their social networks would be desirable. PMID:26844153

Physical Function Decline and the Risk of Elder Self-Neglect in a Community-Dwelling Population

ERIC Educational Resources Information Center

Dong, XinQi; Simon, Melissa; Fulmer, Terry; de Leon, Carlos F. Mendes; Rajan, Bharat; Evans, Denis A.

2010-01-01

Purpose: This longitudinal study examines the association between physical function decline and the risk of elder self-neglect in a community-dwelling population. Design and Methods: Of the 5,570 participants in the Chicago Health Aging Project, 1,068 were reported to social services agency for suspected elder self-neglect from 1993 to 2005. The…

Sleep-Wake Disturbances in Sedentary Community-Dwelling Elders With Functional Limitations

PubMed Central

Vaz Fragoso, Carlos A.; Miller, Michael E.; Fielding, Roger A.; King, Abby C.; Kritchevsky, Stephen B.; McDermott, Mary M.; Myers, Valerie; Newman, Anne B.; Pahor, Marco; Gill, Thomas M.

2014-01-01

OBJECTIVES To evaluate sleep-wake disturbances in sedentary community-dwelling elders with functional limitations. DESIGN Cross-sectional. SETTING Lifestyle Interventions and Independence in Elder (LIFE) Study. PARTICIPANTS 1635 community-dwelling persons, mean age 78.9, who spent <20 minutes/week in the past month of regular physical activity and <125 minutes/week of moderate physical activity, and had a Short Physical Performance Battery (SPPB) score <10. MEASUREMENTS Mobility was evaluated by the 400-meter walk time (slow gait speed defined as <0.8 m/s) and SPPB score (≤7 defined moderate-to-severe mobility impairment). Physical inactivity was defined by sedentary time, as percent of accelerometry wear time with activity <100 counts/min); top quartile established high sedentary time. Sleep-wake disturbances were evaluated by the Insomnia Severity Index (ISI) (range 0–28; ≥8 defined insomnia), Epworth Sleepiness Scale (ESS) (range 0–24; ≥10 defined daytime drowsiness), Pittsburgh Sleep Quality Index (PSQI) (range 0–21; >5 defined poor sleep quality), and Berlin Questionnaire (high risk of sleep apnea). RESULTS Prevalence rates were 43.5% for slow gait speed and 44.7% for moderate-to-severe mobility impairment, with 77.0% of accelerometry wear time spent as sedentary time. Prevalence rates were 33.0% for insomnia, 18.1% for daytime drowsiness, 47.8% for poor sleep quality, and 32.9% for high risk of sleep apnea. Participants with insomnia, daytime drowsiness, and poor sleep quality had mean values of 12.1 for ISI, 12.5 for ESS, and 9.2 for PSQI, respectively. In adjusted models, measures of mobility and physical inactivity were generally not associated with sleep-wake disturbances, using continuous or categorical variables. CONCLUSION In a large sample of sedentary community-dwelling elders with functional limitations, sleep-wake disturbances were prevalent but only mildly severe, and were generally not associated with mobility impairment or physical

Factors related to falls among community dwelling elderly.

PubMed

Kuhirunyaratn, Piyathida; Prasomrak, Prasert; Jindawong, Bangonsri

2013-09-01

Falls among the elderly can lead to disability, hospitalization and premature death. This study aimed to determine the factors related to falls among community dwelling elderly. This case-control study was conducted at the Samlium Primary Care Unit (SPCU), Khon Kaen, Thailand. Cases were elderly individuals who had fallen within the previous six months and controls were elderly who had not fallen during that same time period. Subjects were taken from elderly persons registered at the SPCU. The sample size was calculated to be 111 cases and 222 controls. Face to face interviews were conducted with subjects between May and June, 2011. The response rate was 100%. On bivariate analysis, the statistically significant factors related to falls were: regular medication use, co-morbidities, mobility, depression, cluttered rooms, slippery floors, unsupported toilets (without a hand rail), sufficient exercise, rapid posture change and wearing slippers. When controlling for others significant factors, multiple logistic regression revealed significant factors were: regular medication use (AOR: 2.22; 95%CI: 1.19 - 4.12), depression (AOR: 1.76, 95% CI: 1.03 - 2.99), sufficient exercise (AOR: 0.34; 95% CI: 0.19 - 0.58) and wearing slippery shoes (AOR: 2.31; 95% CI: 1.24 - 4.29). Interventions need to be considered to modify these significant factors associated with falls and education should be provided to these at risk.

[The Effects of a Health Mentoring Program in Community-dwelling Vulnerable Elderly Individuals with Diabetes].

PubMed

Sung, Ki Wol; Kang, Hye Seung; Nam, Ji Ran; Park, Mi Kyung; Park, Ji Hyeon

2018-04-01

This study aimed to estimate the effects of a health mentoring program on fasting blood sugar, total cholesterol, triglyceride, physical activity, self care behavior and social support changes among community-dwelling vulnerable elderly individuals with diabetes. A non-equivalent control group pre-post-test design was used. Participants were 70 community-dwelling vulnerable elderly individuals with diabetes. They were assigned to the experimental (n=30) or comparative (n=30) or control group (n=28). The experimental group participated in the health mentoring program, while the comparative group participated in health education program, the control group did not participate in any program. Data analyses involved a chi-square test, Fisher's exact test, a generalized linear model, and the Bonferroni correction, using SPSS 23.0. Compared to the control group, the experimental and comparative groups showed a significant decrease in fasting blood sugar, total cholesterol, and triglyceride. Compared to the comparative and control groups, the experimental group showed significant improvement in self care behavior. However, there were no statistical differences in physical activity or social support among the three groups. These findings indicate that the health mentoring program is an effective intervention for community-dwelling vulnerable elderly individuals with diabetes. This program can be used as an efficient strategy for diabetes self-management within this population. © 2018 Korean Society of Nursing Science.

Association of sarcopenia with depressive symptoms and functional status among ambulatory community-dwelling elderly.

PubMed

Kilavuz, Asli; Meseri, Reci; Savas, Sumru; Simsek, Hatice; Sahin, Sevnaz; Bicakli, Derya Hopanci; Sarac, Fulden; Uyar, Mehmet; Akcicek, Fehmi

Sarcopenia, functional disability, and depression are common problems in the elderly. Sarcopenia is associated with physical disability, functional impairment, depression, cardiometabolic diseases, and even mortality. This study aims to determine the association of sarcopenia with depression and functional status among ambulatory community-dwelling elderly aged 65 years and older. The sample of this cross-sectional study consisted of 28,323 people, aged 65 years and older, living in Bornova, Izmir. Multi-stage sample selection was performed to reach 1007 individuals. However, 966 elderly people could be reached, and 861 elderly people who can walk were included in the study. The data were collected by the interviewers at home through face-to-face interview. The mean age was 72.2 ± 5.8 (65-100) years. The prevalence of functional disability, depressive symptoms, and sarcopenia were 21.7%, 25.2%, and 4.6%, respectively. In multivariate analysis depression was associated with sarcopenia, being illiterate and divorced, perception of the economic situation as poor/moderate, increased number of chronic diseases, and having at least one physical disability. IADL associated functional disability with sarcopenia, being illiterate/literate and female, increased age and number of medications, and the BMI. Sarcopenia in ambulatory community-dwelling elderly is significantly associated with depressive symptoms and functional disability. Elderly people at high risk of sarcopenia should be screened for functional disability and depression. Appropriate interventions should also be implemented. Copyright © 2018 Elsevier B.V. All rights reserved.

The Role of Meaning in Life for the Quality of Life of Community-Dwelling Chinese Elders With Low Socioeconomic Status

PubMed Central

2018-01-01

Objectives: There is limited research on the meaning in life among Chinese elders. This study aims to examine the association among functional disabilities, meaning in life, social network, and quality of life in community-dwelling Chinese elders with low socioeconomic status. Methods: A cross-sectional survey was used to collect data from 339 poor community-dwelling Chinese elders aged 60 and above. Results: The results showed that meaning in life and social network were significantly related to quality of life. Moreover, social network was a mediator to the relationship between functional disability and quality of life, and meaning in life was a partial mediator to the relationship between social network and quality of life. Conclusion: Workshops should be organized by the elderly service providers for Chinese elders facing deterioration in health and activity levels to learn to live intentionally and purposefully. A social network among elders should also be fostered in the community. PMID:29780856

Relationship between occlusal force and falls among community-dwelling elderly in Japan: a cross-sectional correlative study.

PubMed

Eto, Maki; Miyauchi, Shinji

2018-05-09

Falls may cause serious health conditions among older population. Fall-related physical factors are thought to be associated with occlusal conditions. However, few studies examined the relationship between occlusal force and falls. To identify the association between occlusal force and falls among community-dwelling elderly individuals in Japan, public health nurses conducted a cross-sectional descriptive study. We performed extensive physical assessments of five items: maximum occlusal force, handgrip strength, maximal knee extensor strength, one-leg standing time with eyes open and body sway. We also conducted a questionnaire survey concerning the participants' demographic characteristics, health status and fall experience during the past year. Mean scores and standard deviations were calculated for age and the total points of the index of activities of daily living. Associations were examined using Mann-Whitney tests and logistic regression. We examined 159 community-dwelling people aged ≥65 years, who were independent and active, including 38 participants (24.5%) with experience of falls in the past year. Maximum occlusal force had significant correlation with handgrip strength, maximal knee extensor strength, and one-leg standing time and body sway (P < .05, respectively). We found weak associations between participants with and without a history of falls in terms of the five physical measurements. Logistic regression analysis showed that fall experience was significantly associated with maximum occlusal force (P = 0.004). This is the first study, led by public health nursing researchers, to examine the associations between maximum occlusal force and falls among community-dwelling elderly in Japan. The results showed that maximum occlusal force was significantly related to the other four extensive physical assessments, and might also suggest that maximum occlusal force assessment by public health nurses could contribute to more sophisticated and

National estimates of exposure to prescription drugs with addiction potential in community-dwelling elders.

PubMed

Simoni-Wastila, Linda; Zuckerman, Ilene H; Singhal, Puneet K; Briesacher, Becky; Hsu, Van Doren

2005-03-01

The use of prescription drugs with addiction potential is an overlooked and growing problem among today's elderly. This paper provides national prevalence estimates of exposure to prescription drugs with addiction potential among community-dwelling elders and explores risk factors for such exposure. Using the Medicare Current Beneficiary Survey, a nationally-representative database of Medicare eligibles, we calculated the prevalence of abusable prescription drug use, overall, by therapeutic class, and by drug. Nearly 22% (7.22 million) of all community-dwelling Medicare elders used at least one prescription medication with addiction potential. Opioid analgesics were used most frequently (14.9%; 95% CI 14.0, 15.8%); central nervous system (CNS) depressants were used by 10.4% of the nation's elders (95% CI 9.5, 10.8%). Using logistic regression analysis, we examined the association of explanatory variables with three outcome variables: any controlled substances use, any opioid analgesic use, and any CNS depressant use. We found that females, whites, those aged 65-79, and those with non-spousal others, were significantly more likely to use one or more prescription drugs with addiction potential, controlling for health status and severity-of-illness. The significance and magnitude of several explanatory variables, including age, race, ethnicity, living arrangement, and health status, varied by therapeutic category. This paper provides an important first step in acknowledging the widespread use of abusable prescription drugs in elders, and provides a foundation for future research and practical solutions to preventing subsequent problem use of prescription drugs.

Insomnia among community dwelling elderly in Alexandria, Egypt.

PubMed

Ayoub, Abla I; Attia, Medhat; El Kady, Heba M; Ashour, Ayat

2014-12-01

Insomnia is a common problem in the elderly population. Poor sleep quality is associated with decreased memory and concentration, increased risk of falls, cognitive decline, and higher rate of mortality. Inadequate sleep hygiene such as irregular sleep schedules, use of stimulants, and daytime naps may predispose to insomnia. The aim of this study was to determine the prevalence of insomnia among community dwelling elderly in Alexandria and to assess some of the risk factors and comorbid conditions related to insomnia. This is a cross-sectional study conducted among 380 elderly people taken from different clubs in Alexandria using a predesigned structured interview questionnaire. Data on sociodemographic characteristics, medical history, and personal and sleeping habits were collected. The Insomnia Severity Index was used to assess insomnia and the Depression Anxiety Stress Scale was used to measure depression, anxiety, and stress. One-third (33.4%) of the elderly suffered from insomnia. On logistic regression, the most independent factors that were significantly associated with insomnia were number of chronic diseases [odds ratio (OR)=7.25 for having ≥5 diseases], being female (OR=2.37), anxiety (OR=1.91), watching television in bed before sleeping (OR=1.90), depression (OR=1.74), nocturia (OR=1.13), and daily sunlight exposure (OR=0.57). Insomnia is a common problem among the elderly in Alexandria. Female sex, chronic diseases, mental health problems, and bad sleep hygiene practice increase the risk for insomnia. Improving knowledge among the elderly about the prevalence and risk factors of insomnia could help the development of effective public health prevention and intervention programs for better sleep quality.

Comprehensive assessment of nutritional status and associated factors in the healthy, community-dwelling elderly.

PubMed

Iizaka, Shinji; Tadaka, Etsuko; Sanada, Hiromi

2008-03-01

Malnutrition among the elderly has become a serious problem as their population increases in Japan. To approach the risk of malnutrition in the healthy, community-dwelling elderly is important for early prevention of malnutrition. The nutritional status and mutable associated factors with poor nutritional status specific to the healthy elderly were examined comprehensively. One hundred and thirty healthy elderly people from a senior college in Tokyo, Japan were eligible for this study. Nutritional status was evaluated by Mini-Nutritional Assessment (MNA). The demographic status and potential correlates with poor nutritional status, including the physical factors (mobility, cognitive impairment and oral status) and the psychosocial factors (depression, self-efficacy, attitudes toward health, instrumental activities of daily living, public health service knowledge, and difficulty and dissatisfaction with meal preparation) were investigated. The multiple linear regression analysis using a stepwise procedure adjusted for demographic status was performed to detect independent associated factors. There were 16 participants (12.6%) at risk of malnutrition. The independent associated factors with lower MNA scores were depression (beta = -0.27, P = 0.005), lower self-efficacy (beta = 0.25, P = 0.009), lower attitudes toward health scores (beta = 0.21, P = 0.02) and difficulty with meal preparation (beta = -0.18, P = 0.03). The prevalence of the healthy elderly at the initial risk of malnutrition was relatively high and should not be overlooked. The comprehensive geriatric screening and intervention including mental health, health management and life-situation will be important for the healthy, community-dwelling elderly.

Rural Community-Dwelling Elders' Reports of Access to Care: Are There Hispanic versus Non-Hispanic White Disparities?

ERIC Educational Resources Information Center

Borders, Tyrone F.

2004-01-01

Consumer reports can provide useful information about the dimensions of access in need of improvement for particular population subgroups. To determine if there are Hispanic versus non- Hispanic white disparities in rural elders' reports of their health care access. A telephone survey was conducted among 2,097 rural community-dwelling elders in…

Quality of prescribing in community-dwelling elderly patients in France: an observational study in community pharmacies.

PubMed

Bourcier, E; Mille, F; Brunie, V; Korb-Savoldelli, V; Lafortune, C; Buyse, M; Fernandez, C; Hindlet, P

2017-12-01

Background In order to ensure safer prescriptions in the elderly, lists of potentially inappropriate medications (PIMs) and guidelines have been introduced. Whereas the effectiveness of these measures has been well studied in hospitals, data are sparse for the community-dwelling patients. Objective To assess the quality of prescriptions among community-dwelling elderly patients, and potential associations between prescription patterns, patient characteristics and medication adherence. Setting Community pharmacies in France. Method We conducted a prospective observational study between January and June 2013. Patients aged 75 and over coming to the community pharmacy with a prescription from a general practitioner were invited to participate to the study. The compliance of the prescription was assessed with regards to Beers Criteria and French Health Authority guidelines (FHA) for prescription in the elderly, the degree of adherence was assessed with the Girerd score. Main outcome measure Percentage of prescriptions compliant with Beers Criteria and FHA guidelines. Results Among the 1206 prescriptions analysed, 67.49% (n = 814) contained a PIM. Only 12.77% (n = 154) complied with mandatory requirements of the FHA. Prescriptions were ordered by therapeutic field in 51.24% (n = 618) of cases. Dosing regimen was incomplete in 57.21% (n = 690) of prescriptions. Only 29.19% (n = 352) of patients reported no difficulty with regard to adherence (Girerd score = 0). The use of International Non-proprietary Name was associated with an increased risk of nonadherence (adjusted OR = 1.59 [95% CI = 1.13-2.23] and 1.68 [95% CI = 1.12-2.49] respectively). Patient satisfaction with formulation was associated with a lower risk of non-adherence (adjusted OR = 0.63 [95% CI = 0.45-0.90]). Conclusion A substantial proportion of patients are exposed to PIMs and prescriptions that do not comply with the FHA Guidelines. This issue, as well as identified risk factors for

How accurate are self-reported height, weight, and BMI among community-dwelling elderly Japanese?: Evidence from a national population-based study.

PubMed

Yong, Vanessa; Saito, Yasuhiko

2012-04-01

The aims of this study are to investigate the accuracy of self-reported height, weight, and derived BMI of community-dwelling Japanese aged 70 and older, and to assess the concordance between report-based and measurement-based BMI categories. We compared self-reported height and weight with physical measurements from data from a nationally representative sample (n = 1634). Self-reported values were strongly correlated with measured values (Pearson's r: 0.92 and 0.89 for men and women, respectively, for height; 0.96 for both sexes for weight; 0.93 and 0.91 for men and women, respectively, for BMI). The differences in mean values were small. On average, height was overreported by 0.93 cm (SD = 2.48) for men and 1.23 cm (SD = 2.84) for women. Weight was underreported by 1.08 kg (SD = 2.55) for men and 0.88 kg (SD = 2.45) for women. BMI was underestimated by 0.68 kg/m(2) (SD = 1.16) for men and 0.79 kg/m(2) (SD = 1.49) for women. As age increases, height overreporting increased, particularly among women, but weight underreporting decreased for women. BMI underestimation increased for both sexes. Weighted kappa values showed a reasonably high concordance at 0.715 and 0.670 for men and women, respectively (P < 0.0001). Overweight (BMI 25.0 to 29.9) and obesity (BMI ≥ 30) prevalence rates were underestimated, with better specificity (range: 94.4-100%) than sensitivity (range: 59.3-65.1%). The accuracy of self-reported height and weight is reasonably high among elderly Japanese, suggesting that the information can be used in epidemiological surveys. However, caution should be exercised for the oldest age group (age 85+), as the accuracy declined. © 2011 Japan Geriatrics Society.

Regular Exercise and Depressive Symptoms in Community-Dwelling Elders in Northern Taiwan.

PubMed

Chang, Shu-Hung; Chien, Nai-Hui; Chen, Miao-Chuan

2016-12-01

According to World Health Organization, depressive disorder will be a Top 2 disease in the world by 2020. In light of Taiwan's rapidly increasing elderly population, elderly psychological health is expected to become an increasingly important issue in healthcare. This study examines the association between regular exercise and depressive symptoms in community-dwelling older adults by gender in northern Taiwan. The participants were selected using a probability-proportional-to-size procedure from community-dwelling adults who were aged 65 years or older and living in northern Taiwan. A cross-sectional study and interviews were used to collect information about their exercise behaviors, depressive symptoms, and the factors influencing the depressive symptoms. Percentage, chi-square, t test, and logistic regression were used to analyze the data. One thousand twenty elderly individuals completed the questionnaires. Among the participants with the average age of 73.5 years, 44.5% were men, and 55.5% were women. Two hundred seventeen of the participants (21.3%) had depressive symptoms. Five hundred eighty-five of the participants (57.4%) exercised regularly. The result of logistic regression showed that regular exercise was a significant predictor of depressive symptoms in elderly individuals (odds ratio = 3.54, 95% confidence interval [1.76, 7.12]). Other factors such as gender, chronicle diseases, and health status were not related to depressive symptoms. Moreover, both for male and female individuals, regular exercise was a significant predictor of depressive symptoms (odds ratio = 4.76, 95% confidence interval [1.65, 13.72] and odds ratio = 3.03, 95% confidence interval [1.18, 7.69], respectively). Other factors were not related to depressive symptoms. This study shows regular exercise to be a significant predictor of depressive symptoms in both men and women. Therefore, senior citizens should be encouragedto exercise regularly as a way to promote good mental health.

Validation Analysis of a Geriatric Dehydration Screening Tool in Community-Dwelling and Institutionalized Elderly People

PubMed Central

Rodrigues, Susana; Silva, Joana; Severo, Milton; Inácio, Cátia; Padrão, Patrícia; Lopes, Carla; Carvalho, Joana; do Carmo, Isabel; Moreira, Pedro

2015-01-01

Dehydration is common among elderly people. The aim of this study was to perform validation analysis of a geriatric dehydration-screening tool (DST) in the assessment of hydration status in elderly people. This tool was based on the DST proposed by Vivanti et al., which is composed by 11 items (four physical signs of dehydration and seven questions about thirst sensation, pain and mobility), with four questions extra about drinking habits. The resulting questionnaire was evaluated in a convenience sample comprising institutionalized (n = 29) and community-dwelling (n = 74) elderly people. Urinary parameters were assessed (24-h urine osmolality and volume) and free water reserve (FWR) was calculated. Exploratory factor analysis was used to evaluate the scale’s dimensionality and Cronbach’s alpha was used to measure the reliability of each subscale. Construct’s validity was tested using linear regression to estimate the association between scores in each dimension and urinary parameters. Two factors emerged from factor analysis, which were named “Hydration Score” and “Pain Score”, and both subscales showed acceptable reliabilities. The “Hydration Score” was negatively associated with 24-h urine osmolality in community-dwelling; and the “Pain Score” was negatively associated with 24-h urine osmolality, and positively associated with 24-h urine volume and FWR in institutionalized elderly people. PMID:25739005

Characteristics of depression in community-dwelling elderly people as indicated by the tree-drawing test.

PubMed

Murayama, Norio; Endo, Tadashi; Inaki, Koichiro; Sasaki, Shinsai; Fukase, Yuko; Ota, Kazumi; Iseki, Eizo; Tagaya, Hirokuni

2016-07-01

The tree-drawing test (TDT) is a typical projective method, but previous studies have paid little attention to it for elderly people. We investigated the characteristics of depression in community-dwelling elderly people as indicated by the TDT. This study was a complete enumeration survey of elderly people conducted through home visits. The contents of the survey included gender, age, presence or absence of housemates, frequency of going out, the 15-item Geriatric Depression Scale, and TDT. The subjects were divided into three groups (normal, depressed tendency, and depressed) according to the total 15-item Geriatric Depression Scale score. In TDT, no significant difference was observed in drooping crown, shadow of the whole tree, or shadow near the base, which have been regarded as indices of depression in younger people. However, the values concerning the size of the tree, such as the height and width of the whole tree, height and width of the crown, and number of occupied areas (of the paper), were significantly lower in the depressed group than in the other groups. In addition, the width of the trunk was significantly smaller in the depressed group than in the normal group. Subjects were classified as being in a 'depressed state' if they used 40 or fewer areas for drawing (i.e. occupied areas) and a 'non-depressed state' if they used 41 or more areas. This enabled depression to be detected (sensitivity: 71.4%; specificity: 79.9%). The size of the tree in TDT is suggested to reflect characteristics of depression in elderly people, such as introversion, reserve, antisocial attitude, a feeling of inferiority, weakness of ego, and lack of vigour. Furthermore, the numbers of occupied areas were found to be relatively useful in detecting depression in elderly people. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

Poor correlation between handgrip strength and isokinetic performance of knee flexor and extensor muscles in community-dwelling elderly women.

PubMed

Felicio, Diogo Carvalho; Pereira, Daniele Sirineu; Assumpção, Alexandra Miranda; de Jesus-Moraleida, Fabianna Resende; de Queiroz, Barbara Zille; da Silva, Juscelio Pereira; de Brito Rosa, Naysa Maciel; Dias, João Marcos Domingues; Pereira, Leani Souza Máximo

2014-01-01

To investigate the correlation between handgrip strength and performance of knee flexor and extensor muscles determined using an isokinetic dynamometer in community-dwelling elderly women. This was a cross-sectional study. Sample selection for the study was made by convenience, and 221 (71.07 ± 4.93 years) community-dwelling elderly women were included. Knee flexor and extensor muscle performance was measured using an isokinetic dynamometer Biodex System 3 Pro. The isokinetic variables chosen for analysis were peak torque, peak torque/bodyweight, total work/bodyweight, total work, average power, and agonist/antagonist ratio at the angular velocities of 60°/s and 180°/s. Assessment of handgrip strength was carried out using the Jamar dynamometer. Spearman's correlation coefficient was calculated to identify intervariable correlations. Only knee flexor peak torque (60°/s) and average power (60°/s), and knee extensor peak torque (180°/s) and total work (180°/s) were significantly (P < 0.05), yet poorly, correlated with handgrip strength (r < 0.30). The majority of analyses did not show any correlation between variables assessed by isokinetic dynamometer and handgrip dynamometer. Caution is required when generalizing handgrip strength as a predictor of global muscle strength in community-dwelling elderly women. © 2013 Japan Geriatrics Society.

Efficacy of Biofeedback Therapy in the Treatment of Dyssynergic Defecation in Community-Dwelling Elderly Women.

PubMed

Simón, Miguel A; Bueno, Ana M

The aim of this study was to evaluate the efficacy of biofeedback therapy in the treatment of dyssynergic defecation in chronically constipated community-dwelling elderly women. After an initial assessment phase carried out during 1 month, 20 chronically constipated women with dyssynergic defecation were randomly assigned to either electromyographic biofeedback (EMG-BF) group (n=10) or control group (n=10). Outcome measures used to evaluate the efficacy of treatment were weekly stool frequency, sensation of incomplete evacuation, difficulty evacuation level, mean EMG-activity (μV) of the external anal sphincter during straining to defecate and Anismus index. The results obtained in this randomized controlled trial showed significant differences between the groups in all the dependent variables after 1 month of treatment. Moreover, there was no difference between the groups neither in age nor in the duration of chronic constipation symptoms. At the follow-up, 3 months later, clinical gains were maintained. This study demonstrates that the EMG-BF is an effective behavioral therapy for the treatment of dyssynergic defecation in community-dwelling elderly women.

Sleep Disordered Breathing and White Matter Hyperintensities in Community-Dwelling Elders.

PubMed

Rostanski, Sara K; Zimmerman, Molly E; Schupf, Nicole; Manly, Jennifer J; Westwood, Andrew J; Brickman, Adam M; Gu, Yian

2016-04-01

To examine the association between markers of sleep-disordered breathing (SDB) and white matter hyperintensity (WMH) volume in an elderly, multiethnic, community-dwelling cohort. This is a cross-sectional analysis from the Washington Heights-Inwood Columbia Aging Project (WHICAP), a community-based epidemiological study of older adults. Structural magnetic resonance imaging was obtained starting in 2004; the Medical Outcomes Study-Sleep Scale (MOS-SS) was administered to participants starting in 2007. Linear regression models were used to assess the relationship between the two MOS-SS questions that measure respiratory dysfunction during sleep and quantified WMH volume among WHICAP participants with brain imaging. A total of 483 older adults had both structural magnetic resonance imaging and sleep assessment. Self-reported SDB was associated with WMH. After adjusting for demographic and vascular risk factors, WMH volumes were larger in individuals with frequent snoring (β = 2.113, P = 0.004) and among those who reported waking short of breath or with headache (β = 1.862, P = 0.048). In community-dwelling older adults, self-reported measures of SDB are associated with larger WMH volumes. The cognitive effects of SDB that are increasingly being recognized may be mediated at the small vessel level. © 2016 Associated Professional Sleep Societies, LLC.

Wheel of Wellness Counseling in Community Dwelling, Korean Elders: A Randomized, Controlled Trial.

PubMed

Kwon, So Hi

2015-06-01

The purpose of this study was to investigate the effects of Wheel of Wellness counseling on wellness lifestyle, depression, and health-related quality of life in community dwelling elderly people. A parallel, randomized controlled, open label, trial was conducted. Ninety-three elderly people in a senior welfare center were randomly assigned to two groups: 1) A Wheel of Wellness counseling intervention group (n=49) and 2) a no-treatment control group (n=44). Wheel of Wellness counseling consisted of structured, individual counseling based on the Wheel of Wellness model and provided once a week for four weeks. Wellness lifestyle, depression, and health-related quality of life were assessed pre-and post-test in both groups. Data from 89 participants were analyzed. For participants in the experimental group, there was a significant improvement on all of the wellness-lifestyle subtasks except realistic beliefs. Perceived wellness and depression significantly improved after the in the experimental group (n=43) compared to the control group (n=46) from pre- to post-test in the areas of sense of control (p=.033), nutrition (p=.017), exercise (p=.039), self-care (p<.001), stress management (p=.017), work (p=.011), perceived wellness (p=.019), and depression (p=.031). One participant in the intervention group discontinued the intervention due to hospitalization and three in the control group discontinued the sessions. Wheel of Wellness counseling was beneficial in enhancing wellness for the community-dwelling elderly people. Research into long-term effects of the intervention and health outcomes is recommended.

Is the useful field of view a good predictor of at-fault crash risk in elderly Japanese drivers?

PubMed

Sakai, Hiroyuki; Uchiyama, Yuji; Takahara, Miwa; Doi, Shun'ichi; Kubota, Fumiko; Yoshimura, Takayoshi; Tachibana, Atsumichi; Kurahashi, Tetsuo

2015-05-01

Although age-related decline in the useful field of view (UFOV) is well recognized as a risk factor for at-fault crash involvement in elderly drivers, there is still room to study its applicability to elderly Japanese drivers. In the current study, we thus examined the relationship between UFOV and at-fault crash history in an elderly Japanese population. We also explored whether potential factors that create awareness of reduced driving fitness could be a trigger for the self-regulation of driving in elderly drivers. We measured UFOV and at-fault crash history from 151 community-dwelling Japanese aged 60 years or older, and compared UFOV of at-fault crash-free and crash-involved drivers. We also measured self-evaluated driving style using a questionnaire. UFOV in crash-involved drivers was significantly lower than that in crash-free drivers. No significant difference was found in self-evaluated driving style between crash-free and crash-involved drivers. In addition, there was no significant association between UFOV and self-evaluated driving style. The present study showed that UFOV is a good predictor of at-fault crash risk in elderly Japanese drivers. Furthermore, our data imply that it might be difficult for elderly drivers to adopt appropriate driving strategies commensurate with their current driving competence. © 2014 Japan Geriatrics Society.

Perspectives on the Happiness of Community-Dwelling Elderly in Korea

PubMed Central

Jeon, Sang Won; Lee, Jongha; Lim, JaeHyoung; Jeong, Hyun-Ghang; Park, Moon Ho; Ko, Young-Hoon; Pae, Chi-Un; Kim, Seung Hyun; Joe, Sook-Haeng; Steffens, David C.

2016-01-01

Objective A community survey was performed to investigate the factors and perspectives associated with happiness among the elderly in Korea (≥60 years). Methods Eight hundred volunteers selected from participants in the Ansan Geriatric study (AGE study) were enrolled, and 706 completed the survey. The Happiness Questionnaire (HQ), which asks four questions about happiness, was administered. To explore the relationship between happiness and depression, the Geriatric Depression Scale (GDS) and the Beck Depression Inventory (BDI) also were administered. Results The participants' average level of happiness, determined using a 100-mm visual analogue scale (VAS) of the HQ, was 64.7±26.0. The happiest situations for most people were "getting together with family" (23.8%) and "living in peace with family members (well-being)" (13.2%). Frequent reasons for not being happy were "worsened health condition" (28.7% of the not-happy group), "economic problems of their own" (16.5%), and "economic problems of their children" (14.8%). The participants' choices regarding the essential conditions for happiness were "good health" (65.3%) and "being with family" (20.5%). The BDI and GDS scores were negatively related to the happiness score. A preliminary scale [Happy (Haeng-Bok, 幸福) aging scale] based on the HQ for measuring the happiness level of the Korean elderly was suggested for follow-up studies. Conclusion The most important factors determining the happiness of the community-dwelling elderly in Korea were good family relationships, economic stability, and good health. A higher depression score negatively impacted happiness among Korean elders. Further studies on the factors in their happiness are required. PMID:26766946

Nutritional status and dysphagia risk among community-dwelling frail older adults.

PubMed

Takeuchi, K; Aida, J; Ito, K; Furuta, M; Yamashita, Y; Osaka, K

2014-04-01

Although the presence of dysphagia is a key determinant of nutritional status among older adults, few studies have focused on the association between malnutrition and dysphagia risk in community-dwelling frail older adults. This study estimated the prevalence of malnutrition and quantified the association between malnutrition and dysphagia risk among community-dwelling older Japanese adults requiring long-term care. Cross-sectional study. This study was conducted with the cooperation of the Japan Dental Association and local dental associations in all 47 prefectures from January to February 2012. Individuals aged ≥65 years capable of oral nutrient intake who were living at home and receiving home dental care and treatment. Individual demographic characteristics and factors associated with health loss-related functional decline were obtained through interviews by home-visit dentists and self-administered questionnaires. Nutritional status and dysphagia risk were evaluated using the Mini Nutritional Assessment Short Form and the Dysphagia Risk Assessment for the Community-dwelling Elderly. Among 874 respondents (345 men and 529 women), 24.6% were malnourished, 67.4% were at risk of malnutrition, and 8.0% were well nourished. Dysphagia risk was related to an increased likelihood of malnutrition at an old age, even after adjusting for covariates (PR = 1.30, 95% CI = 1.01-1.67). Malnutrition is highly prevalent among community-dwelling frail older adults, and dysphagia risk is independently associated with malnutrition. Dysphagia may be an important predictor of malnutrition progression in aged populations.

Comparison of Happiness and Spiritual Well-Being among the Community Dwelling Elderly and those who Lived in Sanitariums.

PubMed

Adib-Hajbaghery, Mohsen; Faraji, Mona

2015-07-01

Several studies are available on the lifestyle, psychological and mental health of the elderly adults. This study aimed to compare the spiritual well-being and happiness in the elderly who lived in sanitariums with those lived in the community. A comparative study was conducted on 384 elderly adults. A census sampling was used in sanitariums and a convenience sampling was performed to select the community dwelling (CD) older adults. A demographic questionnaire, the Pauloutzian and Ellison's spiritual well-being scale and the Oxford happiness questionnaire were used in this study. Descriptive statistics and Kolmogorov-Smirnov, Chi-square and Mann-Whitney U tests and Spearman correlation coefficient were employed for data analysis, using the SPSS software, version 13.0. From the total participants, 56% were CD elderly and 44% were in sanitariums. Among the CD older adults, no one was at a high level of spiritual well-being while in sanitariums 24.4% were at a high level of spiritual well-being. Also, 71.2% of the community dwelling older adults were at a high level of happiness while only 3.6% of those living in sanitariums expressed a high level of happiness. A significant association was found between the level of spiritual well-being and happiness in those who lived in sanitariums (r=0.177, P<0.021). Most of the elderly living in the community and in sanitariums showed moderate spiritual well-being and low happiness. Therefore, nurses and health authorities are responsible not only to inform the community about the importance of spiritual well-being and happiness, but also to establish some strategies in this regard.

Age differences and interindividual variation in cognition in community-dwelling elderly.

PubMed

Christensen, H; Mackinnon, A; Jorm, A F; Henderson, A S; Scott, L R; Korten, A E

1994-09-01

The cognitive test performance of 897 community-dwelling elderly Ss, aged 70 years and over, was examined for age trends and interindividual variation. Data were subjected to factor analysis, and 3 factors emerged (Crystallized Intelligence, Fluid Intelligence, and Memory). Over the age span sampled, Crystallized Intelligence, Fluid Intelligence, and Memory all decreased with the decrease being greatest for Fluid Intelligence and least for Crystallized Intelligence. Interindividual variation increased for Fluid Intelligence and Memory, but not for Crystallized Intelligence. These findings give support to the view that crystallized intelligence is lower in the very old and that there is a greater degree of variability in test performance with advancing age.

Effects of home-based tele-exercise on sarcopenia among community-dwelling elderly adults: Body composition and functional fitness.

PubMed

Hong, Jeeyoung; Kim, Jeongeun; Kim, Suk Wha; Kong, Hyoun-Joong

2017-01-01

This study aims to develop a form of tele-exercise that would enable real-time interactions between exercise instructors and community-dwelling elderly people and to investigate its effects on improvement of sarcopenia-related factors of body composition and functional fitness among the elderly. Randomized, controlled trial, with a 12-week intervention period. Community-dwelling senior citizens in Gangseo-gu, Seoul, South Korea. The participants were 23 elderly individuals (tele-exercise group: 11, control group: 12), aged 69 to 93years. The tele-exercise program was developed utilizing a 15-in. all-in-one PC and video conferencing software (Skype™), with broadband Internet connectivity. The tele-exercise group performed supervised resistance exercise at home for 20-40min a day three times per week for 12weeks. The remote instructor provided one-on-one instruction to each participant during the intervention. The control group maintained their lifestyles without any special intervention. The sarcopenia-related factors of body composition and functional fitness were examined prior to, as well as following, a 12-week intervention period. The data were analyzed with a two-way repeated measures ANOVA. There were significant improvements in lower limb muscle mass (p=0.017), appendicular lean soft tissue (p=0.032), total muscle mass (p=0.033), and chair sit-and-reach length (p=0.019) for the tele-exercise group compared to the control group. No group×time interaction effects were detected for the 2-min step, chair stand, and time effects (p<0.05). Video conferencing-based supervised resistance exercise had positive effects on sarcopenia-related factors such as total-body skeletal muscle mass, appendicular lean soft tissue, lower limb muscle mass, and the chair sit-and-reach scores among community-dwelling elderly adults. These results imply that tele-exercise can be a new and effective intervention method for increasing skeletal muscle mass and the physical functioning

Cross-linked fibrin degradation products (D-dimer), plasma cytokines, and cognitive decline in community-dwelling elderly persons.

PubMed

Wilson, Craig J; Cohen, Harvey Jay; Pieper, Carl F

2003-10-01

To investigate the effect of coagulation and inflammatory pathway activation on future cognitive decline in older persons. Prospective cohort study. Rural and urban communities in North Carolina. Community-dwelling older people enrolled in the Duke Established Populations for Epidemiologic Studies of the Elderly in 1986. In 1992, blood was drawn for assay of D-dimer (1,723 subjects), Interleukin-6 (1,726 subjects), and other cytokines (1,551 subjects). Cognitive and functional assessments were performed in 1986, 1989, 1992, and 1996. Cognition was measured using the Short Portable Mental Status Questionnaire. Cognitive decline over a 4-year period was significantly correlated (P<.001) with D-dimer, age, race, and physical performance status as measured using the Rosow-Breslau and Nagi instruments. After controlling for demographics, functional status, and comorbidities, D-dimer remained predictive of cognitive decline. Proinflammatory cytokines were not associated with current cognitive status in cross-sectional analyses or with incident cognitive decline in prospective analyses. In a large sample of community-dwelling elders, higher levels of D-dimer were predictive of cognitive decline over a 4-year period. No clinically significant associations were found between age-related peripheral cytokine dysregulation and cognition.

The role of social relationships among elderly community-dwelling and nursing-home residents: findings from a quality of life study.

PubMed

Scocco, Paolo; Nassuato, Mario

2017-07-01

In Western countries, older adults' needs are often managed through institutionalization. Based on the assumption that quality of life, particularly social relationships, may be perceived differently according to residential setting, the aims of this study were to compare World Health Organization Quality of Life brief version (WHOQOL-BREF) scores of elderly community-dwelling residents and nursing home residents. A sample of 207 older adults (135 community-dwelling residents, 72 nursing home residents) was evaluated with Mini-Mental State Examination (MMSE), WHOQOL-BREF, and Geriatric Depression Scale (GDS). Nursing home residents achieved lower WHOQOL-BREF scores on the physical health scale only (P = 0.002). In a linear regression model, physical score correlated negatively with GDS score (P = 0.0001) and Mini-Mental State Examination score (P = 0.04), but positively with male gender (P = 0.02) and community-dwelling residence (P = 0.001); psychological score correlated negatively with GDS score (P = 0.0001) and being married (P = 0.03), but positively with male gender (P = 0.009) and being unmarried (P = 0.03). The social relationships score correlated negatively with the GDS score (P = 0.0001) and male gender (P = 0.02), but positively with high education level (P = 0.04). The environment score negatively correlated with GDS score (P = 0.0001). In a logistic regression model, living in a nursing home correlated with female gender (P = 0.001), age (P = 0.0001), a lower physical score (P = 0.0001), and a higher social relationships score (P = 0.02). Depressive symptoms correlated with low scores in all WHOQOL-BREF domains. The variables that correlated with living conditions in a nursing home were older age, male gender, lower physical domain scores, and higher social relationship scores. Opportunities for socialization in nursing homes may thus improve perception of quality of life in this domain. © 2017 Japanese Psychogeriatric Society.

Reliability and validity of the Japanese version of the Community Integration Measure for community-dwelling people with schizophrenia.

PubMed

Shioda, Ai; Tadaka, Etsuko; Okochi, Ayako

2017-01-01

Community integration is an essential right for people with schizophrenia that affects their well-being and quality of life, but no valid instrument exists to measure it in Japan. The aim of the present study is to develop and evaluate the reliability and validity of the Japanese version of the Community Integration Measure (CIM) for people with schizophrenia. The Japanese version of the CIM was developed as a self-administered questionnaire based on the original version of the CIM, which was developed by McColl et al. This study of the Japanese CIM had a cross-sectional design. Construct validity was determined using a confirmatory factor analysis (CFA) and data from 291 community-dwelling people with schizophrenia in Japan. Internal consistency was calculated using Cronbach's alpha. The Lubben Social Network Scale (LSNS-6), the Rosenberg Self-Esteem Scale (RSE) and the UCLA Loneliness Scale, version 3 (UCLALS) were administered to assess the criterion-related validity of the Japanese version of the CIM. The participants were 263 people with schizophrenia who provided valid responses. The Cronbach's alpha was 0.87, and CFA identified one domain with ten items that demonstrated the following values: goodness of fit index = 0.924, adjusted goodness of fit index = 0.881, comparative fit index = 0.925, and root mean square error of approximation = 0.085. The correlation coefficients were 0.43 (p < 0.001) with the LSNS-6, 0.42 (p < 0.001) with the RSE, and -0.57 (p < 0.001) with the UCLALS. The Japanese version of the CIM demonstrated adequate reliability and validity for assessing community integration for people with schizophrenia in Japan.

Relationship of perceived environmental barriers and disability in community-dwelling elderly in Taiwan – a population-based study

PubMed Central

2014-01-01

Background To identify the relationship between perceived environmental barriers and disability in community-dwelling elderly. Methods Cross-sectional study in two community service centers in Tainan. We enrolled 200 community-dwelling residents, aged above 65 years, who had resided in the same community for at least 12 months. Basic activity of daily living (BADL) and instrumental activity of daily living (IADL) were assessed using the Hierarchy of Care Required (HCR). There were 59 participants in BADL disability and 109 in IADL disability. Perceived environmental barriers were assessed using the Craig Hospital Inventory of Environmental Factors (CHIEF). We used multinomial logistic regression to examine the relationship of perceived environmental barriers and disability. Results The presence of perceived environmental barriers was related to BADL disability (OR = 4.39, 95% CI = 1.01-19.11) and IADL disability (IADL with difficulty in 1–2 tasks: OR = 9.93, 95% CI = 3.22-30.56; IADL with difficulty in more than 2 tasks: OR = 8.40, 95% CI = 1.83-38.51). The presence of physically/structurally perceived environmental barriers was related to BADL disability (OR = 4.90, 95% CI = 1.01-23.86) and IADL disability (IADL with difficulty in 1–2 tasks: OR = 4.61, 95% CI = 1.27-16.76; IADL with difficulty in more than 2 tasks: OR = 17.05, 95% CI = 2.82-103.30). Conclusions Perceived environmental barriers are related to disability in community-dwelling elderly. PMID:24885956

Association of Physical Performance and Pain With Fear of Falling Among Community-Dwelling Japanese Women Aged 65 Years and Older.

PubMed

Tomita, Yoshihito; Arima, Kazuhiko; Kanagae, Mitsuo; Okabe, Takuhiro; Mizukami, Satoshi; Nishimura, Takayuki; Abe, Yasuyo; Goto, Hisashi; Horiguchi, Itsuko; Aoyagi, Kiyoshi

2015-09-01

Our aim was to explore the association of physical performance and pain with fear of falling among community-dwelling Japanese women.The subjects were 278 women aged 65 years and over. We collected information on fear of falling, painful joints, comorbidities, falls in the previous year, and cataracts. Walking time (distance of 6 m), chair stand time (5 times), grip strength, the timed up and go test (TUG), and functional reach were measured.The prevalence of fear of falling was 36.3%, and it increased with age, but it was not significant (P = 0.081). Multivariate logistic regression analysis showed that poor physical performance (longer walking time, longer chair stand time, weaker grip strength, and longer TUG) and pain (low back, and upper and lower extremity pain) were significantly associated with fear of falling after adjusting for age, body mass index, comorbidities, falls in the previous year, and cataracts.Maintaining physical functioning and managing pain may be important for elderly women with fear of falling.

Assessments of functional status, comorbidities, polypharmacy, nutritional status and sarcopenia in Turkish community-dwelling male elderly.

PubMed

Bahat, Gulistan; Tufan, Fatih; Bahat, Zumrut; Aydin, Yucel; Tufan, Asli; Akpinar, Timur Selcuk; Erten, Nilgun; Karan, Mehmet Akif

2013-06-01

Functionality, comorbidities, polypharmacy, nutritional status and sarcopenia affect the prognosis of elderly excessively. These parameters are influenced by the population, living settings and age. We aimed to study these parameters in Turkish community-dwelling male elderly. We studied 274 male elderly ≥60 years of age admitted to our Geriatrics outpatient clinics. Mean age was 74.4 ± 7.1 years; 47.4% of the subjects were ≥75 years, 24.1% were ≥80 years. Mean activities-of-daily-living (ADL) and instrumental ADL (IADL) scores were 9.4 and 11.1, respectively. Patients with at least one-dependence at ADL-IADL were 22.6%-47.2%, and more than half-dependence at ADL-IADL were 2.8%-17.9%, respectively. Mean number of comorbidities were 2.6. Most common diagnosis was hypertension with 65%; mean number of drugs were 4.5; 55.3% were using ≥4 chronic drugs. Prevalences of malnutrition were 3.7%-6.9%, malnutrition risk were 23.5%-26.7% by the mini nutritional assessment test-long form and short form, respectively. Calf circumference was measured <31 cm in 10.5%. Our findings suggest that Turkish community-dwelling male elderly may have greater prevalences of functional dependence, sarcopenia but lower rates of malnutrition and similar rates of polypharmacy compared with the western developing countries and developed countries. This study emphasized the geographical differences in and/or between the individual countries highlighting the need for studies both country- and world-wide.

[Relationship between cognitive function and physical activities: a longitudinal study among community-dwelling elderly].

PubMed

Konagaya, Yoko; Watanabe, Tomoyuki; Ohta, Toshiki

2012-01-01

The purpose of this study was to evaluate whether physical activities reduce the risk of cognitive decline in community-dwelling elderly. We investigated correlations between cognitive functions at baseline and physical activities, correlations between cognitive functions at baseline and cognitive decline over 4 years, as well as correlations between physical activity at baseline and cognitive decline over 4 years. At baseline, 2,431 community-dwelling elderly completed the cognitive screening by telephone (TICS-J), and answered the questionnaires about physical activities. Of these, 1,040 subjects again completed the TICS-J over 4 years. Physical activities contained moving ability, walking frequency, walking speed, the exercise frequency. At baseline, 870 elderly (age 75.87±4.96 (mean±SD) years, duration of education 11.05±2.41) showed normal cognitive functions and 170 (79.19±6.22, 9.61±2.23) showed cognitive impairment. The total TICS-J score was significantly higher in cognitive normal subjects compared with that of cognitive impaired subjects (36.02±1.89, 30.19±2.25, respectively, p<0.001). Logistic regression analyses showed that moving ability significantly reduced the risk of cognitive impairment in an unadjusted model, and walking speed also reduced the risk of cognitive impairment at baseline even in an adjusted model. Cognitive function at baseline might be a predictor of cognitive function over 4 years. The longitudinal study revealed that walking speed and exercise frequency significantly correlate with maintenance of cognitive function over 4 years. This study provides that physical activities, especially walking speed have significant correlation with cognitive function.

Cross-cultural adaptation and construct validity of the Korean version of a physical activity measure for community-dwelling elderly.

PubMed

Choi, Bongsam

2018-01-01

[Purpose] This study aimed to cross-cultural adapt and validate the Korean version of an physical activity measure (K-PAM) for community-dwelling elderly. [Subjects and Methods] One hundred and thirty eight community-dwelling elderlies, 32 males and 106 female, participated in the study. All participants were asked to fill out a fifty-one item questionnaire measuring perceived difficulty in the activities of daily living (ADL) for the elderly. One-parameter model of item response theory (Rasch analysis) was applied to determine the construct validity and to inspect item-level psychometric properties of 51 ADL items of the K-PAM. [Results] Person separation reliability (analogous to Cronbach's alpha) for internal consistency was ranging 0.93 to 0.94. A total of 16 items was misfit to the Rasch model. After misfit item deletion, 35 ADL items of the K-PAM were placed in an empirically meaningful hierarchy from easy to hard. The item-person map analysis delineated that the item difficulty was well matched for the elderlies with moderate and low ability except for high ceilings. [Conclusion] Cross-cultural adapted K-PAM was shown to be sufficient for establishing construct validity and stable psychometric properties confirmed by person separation reliability and fit statistics.

Loneliness, social support networks, mood and wellbeing in community-dwelling elderly.

PubMed

Golden, Jeannette; Conroy, Ronán M; Bruce, Irene; Denihan, Aisling; Greene, Elaine; Kirby, Michael; Lawlor, Brian A

2009-07-01

Both loneliness and social networks have been linked with mood and wellbeing. However, few studies have examined these factors simultaneously in community-dwelling participants. The aim of this study was to examine the relationship between social network, loneliness, depression, anxiety and quality of life in community dwelling older people living in Dublin. One thousand two hundred and ninety-nine people aged 65 and over, recruited through primary care practices, were interviewed in their own homes using the GMS-AGECAT. Social network was assessed using Wenger's typology. 35% of participants were lonely, with 9% describing it as painful and 6% as intrusive. Similarly, 34% had a non-integrated social network. However, the two constructs were distinct: 32% of participants with an integrated social network reported being lonely. Loneliness was higher in women, the widowed and those with physical disability and increased with age, but when age-related variables were controlled for this association was non-significant. Wellbeing, depressed mood and hopelessness were all independently associated with both loneliness and non-integrated social network. In particular, loneliness explained the excess risk of depression in the widowed. The population attributable risk (PAR) associated with loneliness was 61%, compared with 19% for non-integrated social network. Taken together they had a PAR of 70% Loneliness and social networks both independently affect mood and wellbeing in the elderly, underlying a very significant proportion of depressed mood.

Prevalence of lumbar spondylosis and its association with low back pain among community-dwelling Japanese women.

PubMed

Tsujimoto, Ritsu; Abe, Yasuyo; Arima, Kazuhiko; Nishimura, Takayuki; Tomita, Masato; Yonekura, Akihiko; Miyamoto, Takashi; Matsubayashi, Shohei; Tanaka, Natsumi; Aoyagi, Kiyoshi; Osaki, Makoto

2016-12-01

Lumbar spondylosis is more prevalent among the middle-aged and elderly, but few population-based studies have been conducted, especially in Japan. The purpose of this study was to explore the prevalence of lumbar spondylosis and its associations with low back pain among community-dwelling Japanese women. Lateral radiographs of the lumbar spine were obtained from 490 Japanese women ≥ 40 years old, and scored for lumbar spondylosis using the Kellgren-Lawrence (KL) grade at lumbar intervertebral level from L1/2 to L5/S1. Height and weight were measured, and body mass index (BMI) was calculated. Low back pain in subjects was assessed using a self-administered questionnaire. Stiffness index (bone mass) was measured at the calcaneal bone using quantitative ultrasound. Prevalence of radiographic lumbar spondylosis for KL ≥ 2, KL ≥ 3 and low back pain were 76.7%, 38.8% and 20.0%, respectively. Age was positively associated with radiographic lumbar spondylosis (KL = 2, KL ≥ 3) and low back pain. Greater BMI was associated with lumbar spondylosis with KL = 2, but not with KL ≥ 3. Stiffness index was associated with neither radiographic lumbar spondylosis nor low back pain. Multiple logistic regression analysis identified radiographic lumbar spondylosis (KL ≥ 3) at L3/4, L4/5 and L5/S1 was associated with low back pain, independent of age, BMI and stiffness index. Severe lumbar spondylosis at the middle or lower level may contribute to low back pain.

[Association between cerumen impaction, cognitive function and hearing in Japanese elderly].

PubMed

Sugiura, Saiko; Uchida, Yasue; Nakashima, Tsutomu; Nishita, Yukiko; Tange, Chikako; Ando, Fujiko; Shimokata, Hiroshi

2012-01-01

In this study we aimed to evaluate the frequency of cerumen impaction in Japanese elderly and clarify the associations between cerumen, cognitive function, and hearing impairment. The subjects enrolleded in this study were participants in the National Institute for Longevity Sciences, Longitudinal Study of Aging (NILS-LSA). The data of 792 community-dwelling participants aged 60 to 88 years old were collected. All had taken the Mini-Mental State Examination (MMSE) and had undergone pure tone audiometry (PTA) assessment and video recording of an otoscopic examination. We then analyzed associations between the incidence of the cerumen impaction of better-hearing ear, hearing level and MMSE scores using a general linear model. Cerumen impaction of the better-hearing ear was observed in 10.7% of all participants. In participants with an MMSE score of less than 24, the frequency of cerumen impaction was 23.3%. Cerumen was significant associated with poorer hearing after adjustment for sex and age (p=0.0001). Cerumen impaction also showed a significant association with a low MMSE score after adjustment for sex, age, hearing level and education (p=0.02). The frequency of cerumen impaction in Japanese elderly was estimated to be approximately 10%. The existence of cerumen impaction was associated with poorer hearing level and lower MMSE score.

Functional and cognitive changes in community-dwelling elderly: longitudinal study.

PubMed

Figueiredo, Carolina S; Assis, Marcella G; Silva, Silvia L A; Dias, Rosângela C; Mancini, Marisa C

2013-01-01

The relationship between aging and increased life expectancy in the overall population likely contributes to a higher frequency rate and incidence of illnesses and functional disabilities. Physical dependence and cognitive impairment might hinder the performance of activities and result in an overload of care duties for the patient's family and the healthcare system. The aim of this study was to compare the functional and cognitive changes exhibited by the elderly over a 6-month period. This longitudinal and observational study was conducted in a sample of 167 elderly people, who were selected from the database of the Network of Studies on Frailty in Brazilian Elderly, Universidade Federal de Minas Gerais - UFMG. The participants submitted to the Mini Mental State Examination (MMSE), Katz Index, Lawton and Brody's scale and responded to items on Advanced Activities of Daily Living (AADLs). We analyzed the data using multivariate regression models. The participants' functional capacity exhibited reduced performance of specific instrumental activities of daily living (IADLs), p=0.002, and basic activities of daily living (BADLs), p=0.038. Living alone (odds ratio (OR), 2.53; 95% confidence interval (CI), 1.09-5.87) and work status (OR, 2.52; 95% CI, 1.18-5.41) were associated with changes in the IADLs. The scores in the AADL scale (p=0.163) and MMSE (p=0.059) did not exhibit any significant difference during the study period. The participants with better cognitive function were more independent in their performance of AADLs and IADLs. The results depict specific patterns of loss and stability of functional capacity in community-dwelling elderly.

Fall risks assessment among community dwelling elderly using wearable wireless sensors

NASA Astrophysics Data System (ADS)

Lockhart, Thurmon E.; Soangra, Rahul; Frames, Chris

2014-06-01

Postural stability characteristics are considered to be important in maintaining functional independence free of falls and healthy life style especially for the growing elderly population. This study focuses on developing tools of clinical value in fall prevention: 1) Implementation of sensors that are minimally obtrusive and reliably record movement data. 2) Unobtrusively gather data from wearable sensors from four community centers 3) developed and implemented linear and non-linear signal analysis algorithms to extract clinically relevant information using wearable technology. In all a total of 100 community dwelling elderly individuals (66 non-fallers and 34 fallers) participated in the experiment. All participants were asked to stand-still in eyes open (EO) and eyes closed (EC) condition on forceplate with one wireless inertial sensor affixed at sternum level. Participants' history of falls had been recorded for last 2 years, with emphasis on frequency and characteristics of falls. Any participant with at least one fall in the prior year were classified as faller and the others as non-faller. The results indicated several key factors/features of postural characteristics relevant to balance control and stability during quite stance and, showed good predictive capability of fall risks among older adults. Wearable technology allowed us to gather data where it matters the most to answer fall related questions, i.e. the community setting environments. This study opens new prospects of clinical testing using postural variables with a wearable sensor that may be relevant for assessing fall risks at home and patient environment in near future.

Greater milk intake is associated with lower bone turnover, higher bone density, and higher bone microarchitecture index in a population of elderly Japanese men with relatively low dietary calcium intake: Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) Study.

PubMed

Sato, Y; Iki, M; Fujita, Y; Tamaki, J; Kouda, K; Yura, A; Moon, J-S; Winzenrieth, R; Iwaki, H; Ishizuka, R; Amano, N; Tomioka, K; Okamoto, N; Kurumatani, N

2015-05-01

The effects of milk intake on bone health are not clear in elderly Asian men with low dietary calcium intake. This study showed that greater milk intake is associated with lower bone turnover, higher bone density, and higher bone microarchitecture index in community-dwelling elderly Japanese men. The consumption of milk or dairy products is widely recommended for maintaining bone health regardless of gender or age. However, little evidence exists on the beneficial effects of milk intake on bone health in elderly Japanese men characterized with relatively low dietary calcium intake. Here we examined whether or not greater milk intake was associated with lower bone turnover, higher bone density, and stronger bone microarchitecture in community-dwelling elderly Japanese men. Interviews were conducted to obtain information on medical history and lifestyle, including the amount of habitual milk intake, nutrient intake calculations based on a 1-week food diary, and measurements of areal bone mineral density (aBMD) at the lumbar spine (LS), total hip (TH), and femoral neck (FN) by dual-energy x-ray absorptiometry (DXA), trabecular bone score (TBS) using DXA images at LS, and biochemical markers of bone turnover in sera. Participants with a history of diseases or medications that affect bone metabolism, or with missing data, were excluded from the analysis. The median intake of milk in the 1479 participants (mean age, 73.0 ± 5.1 years) was one glass of milk per day. Bone turnover markers showed a decreasing trend (p < 0.05) and aBMD at TH (p = 0.0019) and FN (p = 0.0057) and TBS (p = 0.0017) showed increasing trends with greater milk intake after adjusting for demographic and behavioral confounding factors. This association was attenuated after further adjusting for nutrient intake, in particular, calcium intake. Greater milk intake was associated with lower bone turnover, higher aBMD, and higher TBS in community-dwelling elderly Japanese men.

Sheltered housing or community dwelling: quality of life and ageism among elderly people.

PubMed

Bodner, Ehud; Cohen-Fridel, Sara; Yaretzky, Abraham

2011-10-01

Previous studies have found correlations between negative perceptions of old age and perceived quality of life (QoL) among elderly people. It has also been suggested that a denial of aging mechanism is employed and might support ageist attitudes among private-sheltered housing tenants compared with elderly people who live in the community and experience intra-generational interactions. Therefore, we hypothesized that tenants of sheltered housing will report more ageist attitudes towards people of their own age, and report a lower QoL than elderly people who live in the community. The sample included 126 volunteers, aged between 64 and 94 years, who live in private-sheltered housing (n = 32) or in the community (n = 94). The participants completed the Fraboni scale of ageism, and a QoL Inventory (SF-36). People, and men in particular, who live in sheltered housing, reported more intergenerational ageist attitudes than men and women who live in the community. Tenants in sheltered housing expressed lower evaluations of their mental health, but higher evaluations on "social functioning" (QoL scales). Women from sheltered housing reported better mental health than men. Gender and some QoL scales were associated with higher ageism. Differences in ageist attitudes between both dwelling places can be interpreted according to Social Identity Theory, which refers to the impact of the ingroup on social attitudes. Differences in QoL can be understood by the accessibility of social activities in private-sheltered housing. Gender differences in ageism and QoL can be explained by women's better social adjustment. Findings should be regarded with caution because of the small sample.

The Impacts of Social Support and Cognitive Function on Depression among Community-Dwelling Older Japanese Americans.

PubMed

Kim, Bum Jung; Nakaoka, Susan; Underwood, Charna

2017-02-17

Research has demonstrated a relationship between social support, cognitive function, and depression among older adults, yet fewer studies have explored this association with Japanese American elders. This study aims to examine depression and describe its relationship with social support, cognitive function, and socioeconomic condition among Japanese American elders. A cross-sectional study of 205 Japanese American elders was conducted in Honolulu and Los Angeles County. A hierarchical regression model was used with depression as a dependent variable and with independent variables such as social support, cognitive function, and socioeconomic status. The study found that social support and cognitive function were significantly associated with depression for Japanese American elders. Also age and education were significantly associated with depression. Based on the findings, the study indicates the importance of developing preventive strategies to reduce the depression issue using culturally tailored programs to the study population.

Prevalence of sarcopenia in healthy community-dwelling elderly in an urban area of Barcelona (Spain).

PubMed

Masanes, F; Culla, A; Navarro-Gonzalez, M; Navarro-Lopez, M; Sacanella, E; Torres, B; Lopez-Soto, A

2012-02-01

The purpose of this study was to evaluate the prevalence of sarcopenia in a cohort of healthy community-dwelling elderly in an urban area in Barcelona (Spain) for native benchmarks and compare them with those published in other geographical areas. We prospectively evaluated a series of 200 healthy elderly in the community with preserved functional capacity and absence of cognitive impairment. We performed a comprehensive geriatric assessment and determined anthropometric data, muscle mass (MM) and the muscle mass index (MMI). Assessment of muscle mass was performed by bioelectrical impedance analysis (BIA). The cut-off point for defining sarcopenia MMI was established as less than 2 SD of the mean of a reference group comprising 220 healthy volunteers (20-42 years) in the same area. Results were compared with studies undertaken in the USA, France and Taiwan. The cut-off points obtained were 8.31 Kg/m(2) for men and 6.68 Kg/m2 for women, being similar to those observed in France and Taiwan but different from the USA. The prevalence of sarcopenia observed was 33% for elderly women and 10% for males. On comparison of the prevalence of sarcopenia in the four populations, we observed some differences, particularly in males. We have defined reference values for sarcopenia, determined by BIA, in our setting. We also observed a remarkable prevalence of sarcopenia in the healthy elderly community, especially in females, showing some differences from those in other geographical regions.

Establishing the reliability and concurrent validity of physical performance tests using virtual reality equipment for community-dwelling healthy elders.

PubMed

Griswold, David; Rockwell, Kyle; Killa, Carri; Maurer, Michael; Landgraff, Nancy; Learman, Ken

2015-01-01

The aim of this study was to determine the reliability and concurrent validity of commonly used physical performance tests using the OmniVR Virtual Rehabilitation System for healthy community-dwelling elders. Participants (N = 40) were recruited by the authors and were screened for eligibility. The initial method of measurement was randomized to either virtual reality (VR) or clinically based measures (CM). Physical performance tests included the five times sit to stand, Timed Up and Go (TUG), Forward Functional Reach (FFR) and 30-s stand test. A random number generator determined the testing order. The test-re-test reliability for the VR and CM was determined. Furthermore, concurrent validity was determined using a Pearson product moment correlation (Pearson r). The VR demonstrated excellent reliability for 5 × STS intraclass correlation coefficient (ICC) = 0.931(3,1), FFR ICC = 0.846(3,1) and the TUG ICC = 0.944(3,1). The concurrent validity data for the VR and CM (ICC 3, k) were moderate for FFR ICC = 0.682, excellent 5 × STS ICC = 0.889 and excellent for the TUG ICC = 0.878. The concurrent validity of the 30-s stand test was good ICC = 0.735(3,1). This study supports the use of VR equipment for measuring physical performance tests in the clinic for healthy community-dwelling elders. Virtual reality equipment is not only used to treat balance impairments but it is also used to measure and determine physical impairments through the use of physical performance tests. Virtual reality equipment is a reliable and valid tool for collecting physical performance data for the 5 × STS, FFR, TUG and 30-s stand test for healthy community-dwelling elders.

The impact of exercise and vitamin D supplementation on physical function in community-dwelling elderly individuals: A randomized trial.

PubMed

Aoki, Kana; Sakuma, Mayumi; Endo, Naoto

2018-04-25

We investigated the impact of exercise and vitamin D supplementation on physical function and locomotor dysfunction in community-dwelling elderly individuals. In total, 148 community-dwelling elderly individuals (aged ≥60 years) who were not taking osteoporosis medications participated in a 24-week intervention. The participants were randomly divided into an exercise group, vitamin D group, and exercise and vitamin D group. The participants and outcome-assessing staff were not blinded to group assignment. Exercise comprised three daily sets each of single-leg standing (1 min/leg/set) and squatting (5-6 repetitions/set); vitamin D supplementation was 1000 IU/day. Participants were contacted every 2 weeks to check on their condition and encourage continued participation. The primary outcome was lower limb muscle strength and mass; secondary outcomes were several physical function measurements, serum 25-hydroxyvitamin D levels, and results of a self-assessment questionnaire completed pre- and post-intervention. We analyzed data from 45, 42, and 43 participants in the exercise, vitamin D, and exercise and vitamin D groups, respectively, who completed the intervention. Locomotive syndrome, which involves reduced mobility due to locomotive organ impairment, was diagnosed in 99 participants (76.2%). Many physical function measurements improved in all groups. Lower limb muscle mass increased significantly in all three groups, with no significant differences between the groups in the degree of change. The average serum 25-hydroxyvitamin D of all vitamin D-supplemented participants increased from 28.1 ng/ml to 47.3 ng/ml after vitamin D supplementation. Both exercise and vitamin D supplementation independently improved physical function and increased muscle mass in community-dwelling elderly individuals. Moreover, the combination of exercise and vitamin D supplementation might further enhance these positive effects. UMIN Clinical Trial, UMIN000028229. Copyright © 2018

Reduced Flexibility Associated with Metabolic Syndrome in Community-Dwelling Elders

PubMed Central

Chang, Ke-Vin; Hung, Chen-Yu; Li, Chia-Ming; Lin, Yu-Hung; Wang, Tyng-Guey; Tsai, Keh-Sung; Han, Der-Sheng

2015-01-01

Background The ageing process may lead to reductions in physical fitness, a known risk factor in the development of metabolic syndrome. The purpose of the current study was to evaluate cross-sectional and combined associations of metabolic syndrome with body composition and physical fitness in a community based geriatric population. Methods A total of 628 community-dwelling elders attending a geriatric health examination were enrolled in the study. The diagnosis of metabolic syndrome was based on the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criterion with Asian cutoff of waist girth was adopted in this study. Body composition was obtained using bioimpedance analysis, and physical fitness was evaluated through the measurement of muscle strength (handgrip force), lower extremity muscle endurance (sit-to-stand test), flexibility (sit-and-reach test), and cardiorespiratory endurance (2-minute step test). Multivariable logistic regression and correlation analysis were performed to determine the association of metabolic syndrome with body composition and functionality variables. Results Metabolic syndrome was associated with increased skeletal muscle index (SMI) (odds ratio (OR), 1.61, 95% confidence interval (CI), 1.25–2.07) and decreased flexibility (OR, 0.97, 95% CI, 0.95–0.99) compared with those without metabolic syndrome. When body mass index was accounted for in the analysis, the association of SMI with metabolic syndrome was reduced. Waist circumference was positively correlated with SMI but negatively correlated with flexibility, whereas high density lipoprotein was positively correlated with flexibility but negatively correlated with SMI. Conclusion Reduced flexibility was positively associated with metabolic syndrome independent of age, gender, body composition, and functionality measurements in a community based geriatric population. Significant associations between metabolic syndrome with muscle strength

Reduced flexibility associated with metabolic syndrome in community-dwelling elders.

PubMed

Chang, Ke-Vin; Hung, Chen-Yu; Li, Chia-Ming; Lin, Yu-Hung; Wang, Tyng-Guey; Tsai, Keh-Sung; Han, Der-Sheng

2015-01-01

The ageing process may lead to reductions in physical fitness, a known risk factor in the development of metabolic syndrome. The purpose of the current study was to evaluate cross-sectional and combined associations of metabolic syndrome with body composition and physical fitness in a community based geriatric population. A total of 628 community-dwelling elders attending a geriatric health examination were enrolled in the study. The diagnosis of metabolic syndrome was based on the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criterion with Asian cutoff of waist girth was adopted in this study. Body composition was obtained using bioimpedance analysis, and physical fitness was evaluated through the measurement of muscle strength (handgrip force), lower extremity muscle endurance (sit-to-stand test), flexibility (sit-and-reach test), and cardiorespiratory endurance (2-minute step test). Multivariable logistic regression and correlation analysis were performed to determine the association of metabolic syndrome with body composition and functionality variables. Metabolic syndrome was associated with increased skeletal muscle index (SMI) (odds ratio (OR), 1.61, 95% confidence interval (CI), 1.25-2.07) and decreased flexibility (OR, 0.97, 95% CI, 0.95-0.99) compared with those without metabolic syndrome. When body mass index was accounted for in the analysis, the association of SMI with metabolic syndrome was reduced. Waist circumference was positively correlated with SMI but negatively correlated with flexibility, whereas high density lipoprotein was positively correlated with flexibility but negatively correlated with SMI. Reduced flexibility was positively associated with metabolic syndrome independent of age, gender, body composition, and functionality measurements in a community based geriatric population. Significant associations between metabolic syndrome with muscle strength and cardiorespiratory fitness in the elderly

Anxiety and mortality risk in community-dwelling elderly people.

PubMed

Carrière, Isabelle; Ryan, Joanne; Norton, Joanna; Scali, Jacqueline; Stewart, Robert; Ritchie, Karen; Ancelin, Marie Laure

2013-09-01

There are conflicting data on the role of anxiety in predicting mortality. To evaluate the 10-year mortality risk associated with anxiety in community-dwelling elderly people. Using data from 718 men and 1046 women aged 65 years and over, gender-stratified associations of anxiety symptoms (Spielberger State-Trait Anxiety Inventory, third tertile) and current DSM-IV anxiety disorder including generalised anxiety disorder (GAD) and phobia with all-cause and cardiovascular mortality were determined. In women, mortality risk was increased for anxiety disorder and GAD in multivariate Cox models (hazard ratio (HR) = 1.53, 95% CI 1.02-2.27 and HR = 2.04, 95% CI 1.08-3.86 respectively), whereas for phobia it was nearly significant (HR = 1.52, 95% CI 0.94-2.47). Anxiety trait symptoms became non-significant as a result of the confounding effect of depressive symptoms. Anxiety disorder was associated with cardiovascular mortality in univariate analysis (HR = 2.42, 95% CI 1.16-5.07). No significant associations were found in men. Our study suggests a gender-specific association of anxiety and mortality.

[Degree of dry mouth and factors influencing oral health-related quality of life for community-dwelling elders].

PubMed

Park, Myung Sook; Ryu, Se Ang

2010-10-01

This study was conducted to investigate the degree of dry mouth and oral health-related quality of life and to identify factors contributing to oral health-related quality of life for community-dwelling elders. A descriptive correlational study design was used. Participants were 156 older adults from two senior welfare centers. Data were collected on February 21, 22 and 29, 30, 2009 using structured questionnaires. Enter type multiple regression analysis was used to identify factors influencing oral health-related quality of life according to general and oral health characteristics. There were significant differences in oral health-related quality of life according to living arrangement, insurance, smoking, number of natural teeth, and denture type. The oral health-related quality of life had significant correlations with the number of chronic disease, number of medications, and dry mouth. Factors influencing oral health-related quality of life for community-dwelling older adults were dry mouth, number of chronic disease, and medical aid, which explained about 47.9% of total variance. These results indicate that in order to promote oral health-related quality of life for older adults, prevention or management of chronic diseases as well as oral health and dry mouth are needed for this population, and especially economically poor elders.

Low-frequency group exercise improved the motor functions of community-dwelling elderly people in a rural area when combined with home exercise with self-monitoring

PubMed Central

Matsubayashi, Yoshito; Asakawa, Yasuyoshi; Yamaguchi, Haruyasu

2016-01-01

[Purpose] This study examined whether low-frequency group exercise improved the motor functions of community-dwelling elderly people in a rural area when combined with home exercise with self-monitoring. [Subjects] The subjects were community-dwelling elderly people in a rural area of Japan. [Methods] One group (n = 50) performed group exercise combined with home exercise with self-monitoring. Another group (n = 37) performed group exercise only. Low-frequency group exercise (warm-up, exercises for motor functions, and cool-down) was performed in seven 40 to 70-minute sessions over 9 weeks by both groups. Five items of motor functions were assessed before and after the intervention. [Results] Significant interactions were observed between groups and assessment times for all motor functions. Improvements in motor functions were significantly greater in the group that performed group exercise combined with home exercise with self-monitoring than in the group that performed group exercise only. Post-hoc comparisons revealed significant differences in 3 items of motor functions. No significant improvements were observed in motor functions in the group that performed group exercise only. [Conclusions] Group exercise combined with home exercise with self-monitoring improved motor functions in the setting of low-frequency group exercise for community-dwelling elderly people in a rural area. PMID:27065520

The linear relationship between the Vulnerable Elders Survey-13 score and mortality in an Asian population of community-dwelling older persons.

PubMed

Wang, Jye; Lin, Wender; Chang, Ling-Hui

2018-01-01

The Vulnerable Elders Survey-13 (VES-13) has been used as a screening tool to identify vulnerable community-dwelling older persons for more in-depth assessment and targeted interventions. Although many studies supported its use in different populations, few have addressed Asian populations. The optimal scaling system for the VES-13 in predicting health outcomes also has not been adequately tested. This study (1) assesses the applicability of the VES-13 to predict the mortality of community-dwelling older persons in Taiwan, (2) identifies the best scaling system for the VES-13 in predicting mortality using generalized additive models (GAMs), and (3) determines whether including covariates, such as socio-demographic factors and common geriatric syndromes, improves model fitting. This retrospective longitudinal cohort study analyzed the data of 2184 community-dwelling persons 65 years old or older from the 2003 wave of the national-wide Taiwan Longitudinal Study on Aging. Cox proportional hazards models and Generalized Additive Models (GAMs) were used. The VES-13 significantly predicted the mortality of Taiwan's community-dwelling elders. A one-point increase in the VES-13 score raised the risk of death by 26% (hazard ratio, 1.26; 95% confidence interval, 1.21-1.32). The hazard ratio of death increased linearly with each additional VES-13 score point, suggesting that using a continuous scale is appropriate. Inclusion of socio-demographic factors and geriatric syndromes improved the model-fitting. The VES-13 is appropriate for an Asian population. VES-13 scores linearly predict the mortality of this population. Adjusting the weighting of the physical activity items may improve the performance of the VES-13. Copyright © 2017 Elsevier B.V. All rights reserved.

Plasma amyloid β, depression, and dementia in community-dwelling elderly.

PubMed

Direk, Nese; Schrijvers, Elisabeth M C; de Bruijn, Renée F A G; Mirza, Saira; Hofman, Albert; Ikram, M Arfan; Tiemeier, Henning

2013-04-01

Plasma amyloid β (Aβ) levels have been associated with an increased risk of Alzheimer's disease (AD). As depression is common before the onset of AD, a few clinical studies tested the cross-sectional association of Aβ levels with depression in elderly and showed incongruous findings. Hence, we tested the longitudinal association between Aβ levels and depressive symptoms in community-dwelling elderly. The study is embedded in a population-based cohort of 980 participants aged 60 years or older from the Rotterdam Study with Aβ levels. Participants were evaluated for depressive symptoms with the Centre for Epidemiological Studies-Depression scale at baseline and repeatedly over the mean follow-up of 11 years. We first performed cross-sectional analyses. Then, we tested the longitudinal association between Aβ levels and depressive symptoms after excluding participants with dementia during follow-up. In cross-sectional analyses, persons with high Aβ(1-40) levels had more clinically relevant depressive symptoms. However, this association was accounted for by persons with clinically relevant depressive symptoms who developed dementia within the next 11 years. In longitudinal analyses, persons with low levels of Aβ(1-40) and Aβ(1-42) without dementia had a higher risk of clinically relevant depressive symptoms during the follow-up. These findings suggest that the cross-sectional association between high plasma Aβ levels and clinically relevant depressive symptoms in the elderly is due to prodromal dementia. In contrast, the longitudinal association between low plasma Aβ levels and depressive symptoms could not be explained by dementia during follow-up suggesting that Aβ peptides may play a distinct role on depression etiology. Copyright © 2013 Elsevier Ltd. All rights reserved.

Screening for frailty in community-dwelling elderly subjects: Predictive validity of the modified SEGA instrument.

PubMed

Oubaya, N; Dramé, M; Novella, J-L; Quignard, E; Cunin, C; Jolly, D; Mahmoudi, R

2017-11-01

To study the capacity of the SEGAm instrument to predict loss of independence among elderly community-dwelling subjects. The study was performed in four French departments (Ardennes, Marne, Meurthe-et-Moselle, Meuse). Subjects aged 65 years or more, living at home, who could read and understand French, with a degree of autonomy corresponding to groups 5 or 6 in the AGGIR autonomy evaluation scale were included. Assessment included demographic characteristics, comprehensive geriatric assessment, and the SEGAm instrument at baseline. Subjects had follow-up visits at home at 6 and 12 months. During follow-up, vital status and level of independence were recorded. Logistic regression was used to study predictive validity of the SEGAm instrument. Among the 116 subjects with complete follow-up, 84 (72.4%) were classed as not very frail at baseline, 23 (19.8%) as frail, and 9 (7.8%) as very frail; 63 (54.3%) suffered loss of at least one ADL or IADL at 12 months. By multivariable analysis, frailty status at baseline was significantly associated with loss of independence during the 12 months of follow-up (OR=4.52, 95% CI=1.40-14.68; p=0.01). We previously validated the SEGAm instrument in terms of feasibility, acceptability, internal structure validity, reliability, and discriminant validity. This instrument appears to be a suitable tool for screening frailty among community-dwelling elderly subjects, and could be used as a basis to plan early targeted interventions for subjects at risk of adverse outcome. Copyright © 2017 Elsevier B.V. All rights reserved.

Nutritional status is strongly correlated with grip strength and depression in community-living elderly Japanese.

PubMed

Kaburagi, Tomoko; Hirasawa, Reiko; Yoshino, Haruka; Odaka, Yukino; Satomi, Mariko; Nakano, Mana; Fujimoto, Eka; Kabasawa, Kazuyuki; Sato, Kazuto

2011-11-01

To evaluate the utility of the Mini-Nutritional Assessment (MNA) in assessing nutritional, physical and psychosocial functions in community-living elderly individuals. A cross-sectional study of elderly individuals investigated in August 2007 and August-September 2008. Nutritional status was assessed using serum biomarkers, anthropometric measurements and the MNA. Physical function was assessed by measuring grip strength and both usual and maximum walking speeds. The Geriatric Depression Scale (GDS) was used to measure the individual's depressive state. Elder-care facilities in Tokyo, Japan. Community-living elderly individuals aged ≥65 years (n 130). The MNA evaluation classified twenty-seven (20·8 %) individuals as being at risk for malnutrition (MNA score ≤23·5); these at-risk individuals included a high proportion of the elderly aged ≥75 years. MNA scores correlated with nutritional biomarkers (total protein, albumin, cholinesterase, Hb) and anthropometric measurements (triceps skinfold, subscapular skinfold, mid-arm muscle area) and exhibited a strong correlation with grip strength and GDS score. Multivariate analysis revealed that grip strength, GDS score, marital status and maximum walking speed are strong predictors of MNA score. The MNA is considerably useful in providing a comprehensive assessment of nutritional status in elderly, community-living Japanese. However, larger-scale epidemiological studies are needed to determine the utility and the appropriate cut-off point of the MNA as a screen for risk of malnutrition.

Lower Jump Power Rather Than Muscle Mass Itself is Associated with Vertebral Fracture in Community-Dwelling Elderly Korean Women.

PubMed

Lee, Eun Young; Lee, Su Jin; Kim, Kyoung Min; Seo, Da Hea; Lee, Seung Won; Choi, Han Sol; Kim, Hyeon Chang; Youm, Yoosik; Kim, Chang Oh; Rhee, Yumie

2017-06-01

Sarcopenia is considered to be a risk factor for osteoporotic fracture, which is a major health problem in elderly women. In this study, we aimed to investigate the association of sarcopenia, with regard to muscle mass and function, with prevalent vertebral fracture in community-dwelling elderly women. We recruited 1281 women aged 64 to 87 years from the Korean Urban Rural Elderly cohort study. Muscle mass and function were measured using bioimpedance analysis and jumping mechanography. Skeletal muscle index (SMI) and jump power were used as an indicator of muscle mass and function, respectively. Among the participants, we observed 282 (18.9%) vertebral fractures and 564 (44.0%) osteoporosis. Although age, body mass index, and prevalence of osteoporosis increased as both SMI and jump power decreased, prevalence of vertebral fracture increased only when jump power decreased. In univariate analysis, compared with the highest quartile of jump power, the lowest quartile had a significant odds ratio of 2.80 (95% CI 1.79-4.36) for vertebral fracture. This association between jump power and vertebral fracture remained significant, with an odds ratio of 3.04 (95% CI 1.77-5.23), even after adjusting for other risk factors including age, bone mineral density, previous fracture, and cognitive function. In contrast, there was no association between SMI and vertebral fracture. Based on our results, low jump power, but not SMI, is associated with vertebral fracture in community-dwelling elderly Korean women. This finding suggests that jump power may have a more important role than muscle mass itself for osteoporotic fracture.

Advance Care Planning and Health Care Preferences of Community-Dwelling Elders: The Framingham Heart Study

PubMed Central

McCarthy, Ellen P.; Pencina, Michael J.; Kelly-Hayes, Margaret; Evans, Jane C.; Oberacker, Elizabeth J.; D’Agostino, Ralph B.; Burns, Risa B.; Murabito, Joanne M.

2009-01-01

Objectives To describe self-reported advance care planning, health care preferences, use of advance directives, and health perceptions in a very elderly community-dwelling sample. Methods Surviving participants of the original cohort of the Framingham Heart Study who were cognitively intact and attended a routine research exam between February 2004 and October 2005. Participants were queried about discussions about end of life care, preferences for care, documentation of advance directives, and health perceptions. Results Among 220 community-dwelling respondents, 67% were women with a mean age of 88 years (range 84-100). Overall 69% discussed their wishes for medical care at the end of life with someone, but only 17% discussed their wishes with a physician or health care provider. Two-thirds had a health care proxy, 55% had a living will, and 41% had both. Most (80%) respondents preferred comfort care over life-extending care, and 71% preferred to die at home; however, substantially fewer respondents said they would rather die than receive specific life-prolonging interventions [chronic ventilator (63%) or feeding tube (64%)]. Many were willing to endure distressing health states, with less than half indicating that they would rather die than live out their life in a great deal of pain (46%) or be confused/forgetful (45%) all of the time. Conclusions Although the vast majority of very elderly community-dwellers in this sample appear to prefer comfort measures at the end of life, many said they were willing to endure specific life-prolonging interventions and distressing health states to avoid death. Our results highlight the need for physicians better understand patients’ preferences and goals of care to help them make informed decisions at the end of life. PMID:18840800

Prescription patterns of diuretics in Dutch community-dwelling elderly patients

PubMed Central

Van Kraaij, Dave J W; Jansen, René W M M; De Gier, Johan J; Gribnau, Frank W J; Hoefnagels, Willibrord H L

1998-01-01

Aims To describe age-and gender-related prescription patterns of diuretics in community-dwelling elderly, and to compare diuretics to other cardiovascular (CV) medications. Methods Cross-sectional study of patient-specific prescription data derived from a panel of 10 Dutch community pharmacies. Determination of proportional prescription rates and prescribed daily dose (PDD) of diuretics, cardiac glycosides, nitrates, angiotensin converting enzyme (ACE) inhibitors, β-adrenoceptor blockers, and calcium channel blockers in all 5326 patients aged 65 years or older dispensed CV medications between August 1st, 1995 and February 1st, 1996. Results Diuretics were prescribed to 2677 of 5326 patients (50.3%), 1325 patients (24.9%) using thiazides and 1198 patients (22.5%) using loop diuretics. Prescription rates of loop diuretics increased from 15.1% in patients aged 65–74 years to 37.2% in patients aged 85 years or older. Rates also increased for digoxin and nitrates. Rates for thiazide diuretics remained unchanged with age; rates for β-adrenoceptor blockers, ACE inhibitors and calcium channel blockers declined with age. Thiazides were prescribed to 30.1% of women compared with 16% of men (P<0.001). Average PDD was 135±117% of defined daily dose (DDD) for loop diuretics, and highest for bumetanide (245±2.01% of DDD, equivalent to 2.5±2.0 mg). Average PDD was 74±40% of DDD for thiazides, and highest for chlorthalidone (100±49% of DDD, equivalent to 25±12 mg). Conclusions Important characteristics of diuretic usage patterns in this elderly population were a steep increase in loop diuretic use in the oldest old, a large gender difference for thiazide use, and high prescribed doses for thiazides. PMID:9803990

Cognitive Impairment as a Strong Predictor of Incident Disability in Specific Adl-Iadl Tasks among Community-Dwelling Elders: The Azuchi Study

ERIC Educational Resources Information Center

Dodge, Hiroko H.; Kadowaki, Takashi; Hayakawa, Takehito; Yamakawa, Masanobu; Sekikawa, Akira; Ueshima, Hirotugu

2005-01-01

Purpose: We examined differential effects of cognitive impairment on each of the activities of daily living (ADL) and instrumental activities of daily living (IADL) tasks. Design and Methods: In a 3-year follow-up of community-dwelling elderly persons in Azuchi, Japan, we assessed cognition by using the Hasegawa Dementia Scale. We examined (a) the…

Chinese community-dwelling elders' needs: promoting ageing in place.

PubMed

Cao, M J; Guo, X L; Yu, H; Chen, L Y; McDonald, T A

2014-09-01

'Ageing in place' is widely promoted as a response to global ageing and increased demand for services, but little evidence is available about what older people think they need in terms of services and supports to remain at home. To investigate older people's needs when ageing in place in order to provide evidence to inform policies and strategies promoting the option of ageing in place. A total of 568 elderly persons in Hangzhou, China, were surveyed in 2009-2011 using a modified questionnaire validated in the USA and China. Overall, 88.9% of older adults were satisfied with the community in which they live; 97.2% were satisfied with life quality. Health problems and healthcare access difficulty increased with age. House repairs and housework were the most troubling. Respondents identified high need for social and health promotion services and this varied across age groups. Cultural adaptation and validation of the questionnaire could have been influenced by differences in socioeconomic and cultural factors. The sample excluded older adults with disabilities, bed-ridden and/or unable to communicate thus limiting the scope of relevance. A majority of older adult respondents ageing at home lived a relatively healthy life; however, they required more comprehensive health insurance to cover costs of long-term health problems and access to home care support. The needs of community-dwelling older Chinese people in the Xiacheng District are not being fully met and much remains be done to increase community and regional capacity before ageing in place can be promoted as a policy strategy. More generally, nursing and health policies geared to enhance the self-sufficiency of older people residing in their communities must draw upon evidence of assessed needs and client perspectives of their requirements before services can be designed and delivered. © 2014 International Council of Nurses.

[A study of factors influenced by self-efficacy for exercise among community-dwelling elderly men in urban areas].

PubMed

Takai, Itsushi

2012-01-01

It is important to promote self-efficacy for exercise for developing exercise habit. The purpose of this study was to investigate factors influenced by self-efficacy for exercise among community-dwelling elderly men in urban areas. The subjects were 69 elderly men (mean age of 74.2±2.0 SD) who had given approval for participation in the study. We examined the following factors: family situation, history of falls, frequency of going out, stage model of a change, self-efficacy for exercise, fall efficacy scale (FES), geriatric depression scale (GDS), subjective health, functional ability and motor function (5 m walking time, chair stand test-5times). Analysis of variance was used to assess a stage model of a change differences in self-efficacy for exercise and other measures. Correlation analysis and multiple regression analysis were performed to determine the relationships between self-efficacy for exercise and other measures. We found that self-efficacy of exercise, FES, GDS (p<0.01) and CST (p<0.05) vary depending on the stage model of change. Self-efficacy for exercise was found to correlate with psychological factors and functional ability (|r|=0.47-0.67). Multiple regression analysis revealed that the independent factors related to self-efficacy for exercise were FES and GDS. FES and GDS were found to be significant and independent predictors of self-efficacy for exercise in community-dwelling elderly men in urban areas. We should consider not only the approach based on behavioral science but also mental support for depression and fear of falling to promote exercise self-efficacy.

Elder Self-Neglect in a Community-Dwelling U.S. Chinese Population: Findings from the Population Study of Chinese Elderly in Chicago (PINE) Study

PubMed Central

Dong, XinQi

2014-01-01

Objectives To examine the prevalence of self-neglect and its specific behaviors in a community-dwelling U.S. Chinese aging population. Design Population-based cohort study. Setting Community-dwelling population of Chinese older adults. Participants 3,159 Chinese older adults in the greater Chicago area interviewed from 2011-2013. Measurements Participant’s personal and home environment was rated based on prevalence of hoarding behavior, personal hygiene, repairs needed on the home, sanitary condition of the home, and adequacy of utilities. Prevalence estimates were presented across self-reported quality-of-life. Results Prevalence of self-neglect was 18.2% for mild self-neglect and 10.9% for moderate/severe self-neglect among Chinese older adults. In terms of specific phenotypes, unsanitary conditions (17.0%) was the most prevalent, followed by need of home repair (16.3%), hoarding behavior (14.9%), poor personal hygiene (11.3%), and inadequate utilities (4.2%). The prevalence of elder self-neglect of all severities and its phenotypes was higher among older adults with fair or poor quality-of-life as compared to that of older adults with good or very good quality-of-life. Lower quality-of-life was significantly associated with and increased risk for self-neglect of all severities (mild self-neglect: OR 1.93, 95% CI 1.26-2.96, p<0.001; moderate/severe self-neglect: OR 3.58, 95% CI 1.79-7.13, p<0.001) and specific personal and environmental hazards. Conclusion Elder self-neglect is prevalent, especially among those with lower levels of quality-of-life. Future research is needed to examine risk/protective factors associated with elder self-neglect. PMID:25439674

Association of low serum 25-hydroxyvitamin D levels with the frailty syndrome in Mexican community-dwelling elderly.

PubMed

Gutiérrez-Robledo, Luis Miguel; Ávila-Funes, José Alberto; Amieva, Hélène; Meillon, Céline; Acosta, José Luis; Navarrete-Reyes, Ana Patricia; Torres-Carrillo, Norma; Muñoz-Valle, José Francisco; Torres-Carrillo, Nora Magdalena

2016-01-01

Since vitamin D is an important regulator of muscle function, the effect of vitamin D deficiency on frailty syndrome has been recently studied. This cross-sectional study aimed to determine the association between 25(OH)-vitamin D levels and frailty status in Mexican community-dwelling elderly. Sample of 331 community-dwelling elderly aged 70 or older, a subset of those included in the "Coyoacán cohort" were included. 25(OH)-vitamin D assay and frailty status were measured. Mean age was 79.3 years and 54.1% were women. Those classified as frail were more likely to have lower Mini-Mental State Examination score (p = 0.015), more disability for instrumental activities of daily living (p < 0.001) and for activities of daily living (p < 0.001). Serum 25(OH)-vitamin D levels were lower in the frail subgroup when compared with the non-frail one (p < 0.001). Multivariate logistic regression analyses showed a significant association between intermediate tertile [odds ratios (OR) = 4.13; 95% confidence intervals (CI) 2.00-8.56] or insufficient tertile (OR = 8.95; 95% CI 2.41-33.30) of vitamin D levels and frailty even after adjusting for potential confounders. These results suggest that older adults with low 25(OH)-vitamin D levels are associated with the probability to being frail compared with those with sufficient vitamin D levels.

A Longitudinal Study of Symptoms of Oropharyngeal Dysphagia in an Elderly Community-Dwelling Population.

PubMed

Nimmons, Danielle; Michou, Emilia; Jones, Maureen; Pendleton, Neil; Horan, Michael; Hamdy, Shaheen

2016-08-01

Dysphagia has been estimated to affect around 8-16 % of healthy elderly individuals living in the community. The present study investigated the stability of perceived dysphagia symptoms over a 3-year period and whether such symptoms predicted death outcomes. A population of 800 and 550 elderly community-dwelling individuals were sent the Sydney Swallow Questionnaire (SSQ) in 2009 and 2012, respectively, where an arbitrary score of 180 or more was chosen to indicate symptomatic dysphagia. The telephone interview cognitive screen measured cognitive performance and the Geriatric Depression Scale measured depression. Regression models were used to investigate associations with dysphagia symptom scores, cognition, depression, age, gender and a history of stroke; a paired t test was used to examine if individual mean scores had changed. A total of 528 participants were included in the analysis. In 2009, dysphagia was associated with age (P = 0.028, OR 1.07, CI 1.01, 1.13) and stroke (P = 0.046, OR 2.04, CI 1.01, 4.11) but these associations were no longer present in 2012. Those who had symptomatic dysphagia in 2009 (n = 75) showed a shift towards improvement in swallowing (P < 0.001, mean = -174.4, CI -243.6, -105.3), and for those who died from pneumonia, there was no association between the SSQ derived swallowing score and death (P = 0.509, OR 0.10, CI -0.41, -0.20). We conclude that swallowing symptoms are a temporally dynamic process, which increases our knowledge on swallowing in the elderly.

Effect of Pet Insects on the Psychological Health of Community-Dwelling Elderly People: A Single-Blinded, Randomized, Controlled Trial.

PubMed

Ko, Hae-Jin; Youn, Chang-Ho; Kim, Seong-Hyun; Kim, So-Yun

2016-01-01

There is evidence that animal-assisted therapy has positive effects on mental health, especially in elderly people. Caring for insects is easy, relatively inexpensive, and does not require much space. The aim of this 8-week randomized, controlled, single-blinded study was to investigate the effect of pet insects on the psychological health of community-dwelling elderly people. Elderly subjects (≥65 years old) attending a community center in Daegu, Korea, were enrolled in the study between April and May 2014 and randomized at a 1:1 ratio to receive insect therapy and health advice or only health advice. The insect group received 5 crickets in a cage with sufficient fodder and a detailed instruction manual. At baseline and at 8 weeks, all subjects underwent psychometric tests via a direct interview [Beck Anxiety Inventory, Geriatric Depression Scale (GDS-15), Mini-Mental State Examination (MMSE), 36-Item Short Form Health Survey, Insomnia Severity Index, Fatigue Severity Scale, and Brief Encounter Psychosocial Instrument] and laboratory analyses of inflammatory and oxidative stress markers (erythrocyte sedimentation rate, high-sensitivity C-reactive protein, biological antioxidant potential, and derivatives of reactive oxygen metabolites). The insect-caring (n = 46) and control (n = 48) groups did not differ in baseline characteristics. The insect-caring group had significantly lower GDS-15 scores at week 8 (3.20 vs. 4.90, p = 0.004) and, after adjustment for baseline values, a significantly greater change in GDS-15 scores relative to baseline (-1.12 vs. 0.20, p = 0.011). They also had a significantly greater change in MMSE scores relative to baseline (1.13 vs. 0.31, p = 0.045). The two groups did not differ in terms of other psychometric and laboratory tests. No serious risks or adverse events were reported. Caring for insects, which is cost-effective and safe, was associated with a small to medium positive effect on depression and cognitive function in community-dwelling

Association of neuropsychiatric symptoms and sub-syndromes with cognitive impairment in community-dwelling Asian elderly.

PubMed

Xu, Xin; Ang, Seow Li; Hilal, Saima; Chan, Qun Lin; Wong, Tien Yin; Venketasubramanian, Narayanaswamy; Ikram, Mohammad Kamran; Chen, Christopher Li-Hsian

2015-11-01

To investigate the presence of neuropsychiatric symptoms (NPS) and sub-syndromes in elderly community-dwelling Asians with varying severity of cognitive impairment. Chinese and Malay participants (n = 613) from the Epidemiology of Dementia in Singapore (EDIS) Study aged ≥ 60 years underwent clinical examination, neuropsychological testing, and NPS assessment using the Neuropsychiatric Inventory (NPI). Diagnosis of no cognitive impairment (NCI), cognitive impairment-no dementia (CIND), including CIND-mild and CIND-moderate, and dementia were made using established criteria. A significant increase in the numbers of NPS was observed accompanying with increasing severity of cognitive impairment (p < 0.001). Compared to those with NCI/CIND-mild, participants with CIND-moderate [Odds ratio (OR): 4.2, 95% confidence interval (CI): 1.8-10.0] or dementia [OR: 9.2, 95% CI: 2.3-36.0] were more likely to have two or more neuropsychiatric sub-syndromes. Participants with CIND-moderate were more likely to have hyperactivity [OR: 2.0, 95% CI: 1.0-3.8] and apathy [OR: 2.9, 95% CI: 1.0-8.4] sub-syndromes, whereas patients with dementia were more likely to have psychosis [OR: 6.9, 95% CI: 2.4-20.1], affective (OR: 8.7, 95% CI: 1.8-42.9), and hyperactivity (OR: 5.4, 95% CI: 1.8-16.1). Furthermore, executive dysfunction and visual memory impairment were associated with the presence of three neuropsychiatric sub-syndromes; whist language and visuomotor speed impairment were related to the presence of two sub-syndromes. By contrast, impairment in attention, verbal memory, and visuoconstruction were not associated with any of the sub-syndromes. The presence of NPS and sub-syndromes increase with increasing severities of cognitive impairment, and different neuropsychiatric syndromes are associated with specific impairment on cognitive domains in community-dwelling Asian elderly.

Effects of a mutual recovery intervention on mental health in depressed elderly community-dwelling adults: a pilot study.

PubMed

Wang, Chao; Hua, Yujie; Fu, Hua; Cheng, Longfeng; Qian, Wen; Liu, Junyang; Crawford, Paul; Dai, Junming

2017-01-03

The prevalence of depression in the elderly is growing worldwide, and the population aging in China makes depression a major health problem for the elderly adults and a tremendous burden to the society. Effective interventions should be determined to provide an approach solving the problem and improving the situation. This study examined the effectiveness of a mutual recovery program intervention on depressive symptom, sleep quality, and well-being in community-dwelling elderly adults with depressive symptom in Shanghai. Recruitment was performed between July 2012 and August 2012. Using a cluster randomized wait-list controlled design, we randomized 6 communities (n = 237) into either the intervention group (3 communities, n = 105) or to a wait-list control group (3 communities, n = 132). All participants met the inclusion criteria for depression, which were defined by The Geriatric Depression Scale (GDS-15). From March to May of 2013, participants in the intervention group underwent a 2-month mutual recovery program intervention. The intervention included seven 90-min, weekly sessions that were based on a standardized self-designed schedule. Depression was used as primary outcome at three measurement moments: baseline (T1), before intervention at 24 weeks (T2), and immediately after intervention at 32 weeks (T3). Well-being and sleep quality were used as the secondary outcomes, and were evaluated based on the WHO-5 Well-being Index (WHO-5) and the Self-administered Sleep Questionnaire (SSQ). Finally, a total of 225 participants who completed all the sessions and the three measurements entered the final analysis. Mixed-model repeated measures ANOVAs were performed to estimate the intervention effects. There was no significant difference in gender, marriage, age structure, post-work type, and education background between the intervention and control group at baseline. Multivariate ANOVAs showed that there was no significant difference within the groups

History and mobility exam index to identify community-dwelling elderly persons at risk of falling.

PubMed

Covinsky, K E; Kahana, E; Kahana, B; Kercher, K; Schumacher, J G; Justice, A C

2001-04-01

Falls are common in community-dwelling elderly persons and are a frequent source of morbidity. Simple indices to prospectively stratify people into categories at different fall-risk would be useful to health care practitioners. Our goal was to develop a fall-risk index that discriminated between people at high and low risk of falling. We evaluated the risk of falling over a one-year period in 557 elderly persons (mean age 81.6) living in a retirement community. On the baseline interview, we asked subjects if they had fallen in the previous year and evaluated risk factors in six additional conceptual categories. On the follow-up interview one year later, we again asked subjects if they had fallen in the prior year. We evaluated risk factors in the different conceptual categories and used logistic regression to determine the independent predictors of falling over a one-year period. We used these independent predictors to create a fall-risk index. We compared the ability of a prior falls history with other risk factors and with the combination of a falls history and other risk factors to discriminate fallers from nonfallers. A fall in the previous year (OR = 2.42, 95% CI = 1.49-3.93), a symptom of either balance difficulty or dizziness (OR = 1.83, 95% CI = 1.16-2.89), or an abnormal mobility exam (OR = 2.64, 95% CI = 1.64-4.26) were independent predictors of falling over the subsequent year. These three risk factors together (c statistic =.71) discriminated fallers from nonfallers better than previous history of falls alone (c statistic =.61) or the symptomatic and exam risk factors alone (c statistic =.68). When combined into a risk index, the three independent risk factors stratify people into groups whose risk for falling over the subsequent year ranges from 10% to 51%. A history of falling over the prior year, a risk factor that can be obtained from a clinical history (balance difficulty or dizziness), and a risk factor that can be obtained from a physical exam

Factors associated with poor nutritional status among community dwelling Lebanese elderly subjects living in rural areas: results of the AMEL study.

PubMed

Boulos, C; Salameh, P; Barberger-Gateau, P

2014-05-01

This study aimed to assess the nutritional status, measured by MNA, and its association with socio-demographic indicators and health related characteristics of a representative sample of community dwelling elderly subjects. Cross-sectional study. Community dwelling elderly individuals living in rural communities in Lebanon. 1200 elderly individuals aged 65 years or more. Socio-demographic indicators and health related characteristics were recorded during a standardized interview. Nutritional status was assessed through Mini Nutritional Assessment (MNA). The 5-item GDS score and the WHO-5-A score were used to assess mood, whereas Mini Mental Status (MMS) was applied to evaluate cognitive status. The prevalence of malnutrition and risk of malnutrition was 8.0% respective 29.1% of the study sample. Malnutrition was significantly more frequent in elderly subjects aged more than 85 years, in females, widowed and illiterate people. Moreover, participants who reported lower financial status were more often malnourished or at risk of malnutrition. Regarding health status, poor nutritional status was more common among those reporting more than three chronic diseases, taking more than three drugs daily, suffering from chronic pain and those who had worse oral health status. Also, depressive disorders and cognitive dysfunction were significantly related to malnutrition. After multivariate analysis following variables remained independently associated to malnutrition: living in the governorate of Nabatieh (ORa 2.30, 95% CI 1.35 -3.93), reporting higher income (ORa 0.77, 95% CI 0.61-0.97), higher number of comorbidities (ORa 1.22, 95% CI 1.12-1.32), chronic pain (ORa 1.72, 95% CI 1.24-2.39), and depressive disorders (ORa 1.66, 95% CI 1.47-1.88). On the other hand, better cognitive functioning was strongly associated with decreased nutritional risk (ORa 0.27, 95%CI 0.17-0.43). Our results highlighted the close relationship between health status and malnutrition. The

Prospective Study on the Impact of Fear of Falling on Functional Decline among Community Dwelling Elderly Women.

PubMed

Choi, Kyungwon; Jeon, Gyeong-Suk; Cho, Sung-Il

2017-04-27

Fear of falling (FOF) is expected to have effects on functional decline in the elderly. In this study, we examined over 2 years the effect of change in FOF on functional decline in community dwelling elderly. We conducted a secondary analysis using data from elderly women, 70 years of age and older, who participated in the Korean Longitudinal Study of Aging (KLoSA). Participants were divided into four categories according to change in FOF between the 2010 and 2012 surveys. Multiple logistic regression analysis was conducted regarding the effects of changes in FOF on functional decline after controlling for variables as known risk factors for functional decline. Rates of functional decline were highest in the "consistently having FOF" group, whereas they were lowest in the "consistently no FOF" group in both 2010 and 2012. Characteristics independently associated with functional decline were change in FOF, depressive symptoms, low frequency of meeting friends, and fear-induced activity avoidance. Longer exposure to FOF was associated with an increased risk of functional decline. FOF is an important health problem that deserves attention in its own right. Public health approaches for elderly persons should address early detection, prevention, and intervention programs for FOF.

Prevalence of Sarcopenia and Associated Factors in Chinese Community-Dwelling Elderly: Comparison Between Rural and Urban Areas.

PubMed

Gao, Langli; Jiang, Jiaojiao; Yang, Ming; Hao, Qiukui; Luo, Li; Dong, Birong

2015-11-01

To compare the prevalence of sarcopenia in urban and rural Chinese elderly adults and to identify the risk factors related to sarcopenia. A cross-sectional study. Urban and rural communities in western China. A total of 887 community-dwelling elderly adults aged 60 years or older. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS). Cognitive function, depression, and nutrition status were assessed using the Chinese version of the Mini-Mental Status Examination (MMSE), the Chinese version of the 30-item Geriatric Depression Scale (GDS-30), and the revised Mini Nutritional Assessment short-form (MNA-SF), respectively. A total of 612 individuals aged 70.6 ± 6.7 years (range, 60-91 years) were included in this study. The prevalence of sarcopenia in the study population was 9.8% (women, 12.0%; men, 6.7%; P = .031). The prevalence of sarcopenia was 13.1% in rural elders and 7.0% in urban elders (P = .012). Age (odds ratio [OR] 1.22; 95% confidence interval [CI] 1.15-1.29), women (OR 1.71; 95% CI 1.20-5.65), malnutrition or at risk for malnutrition (OR 3.53; 95% CI 1.68-7.41), rural residence (OR 2.15; 95% CI 1.33-4.51), and the number of medications (OR 1.23; 95% CI 1.06-1.44) were independently associated with sarcopenia. Rural elders are more vulnerable to sarcopenia than urban elders in a sample of western China's elderly population. More attention should focus on rural populations in future sarcopenia studies. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

[Productive activities and well-being among community-dwelling elderly].

PubMed

Okamoto, Hideaki

2009-10-01

This study examined the association between engagement in productive activities and well-being among community-dwelling elderly. Data for 576 older adults were obtained from a mail survey in Osaka City. The productive activities was measured with reference to three domains (paid work, unpaid work at home, and unpaid work outside the home) and the number of productive roles. Well-being was assessed by two measures: life satisfaction (LSIK) and self-rated health. The author used multivariate analyses with each of the two measures of well-being as dependent variables, and each of the productive activities as independent variables. The analyses were conducted separately for men and women, controlling for sociodemographic variables, IADL(instrumental activities of daily living) and social relationships. Multivariate analyses revealed the following findings. Paid work was positively associated with life satisfaction of women and self-rated health of men and women. Unpaid work at home was not significantly associated with life satisfaction or self-rated health for either men or women. However, unpaid work outside the home was related to higher scores for life satisfaction and self-rated health among women. The numbers of productive roles were positively associated with life satisfaction of women and self-rated health of men and women. Productive engagement was generally beneficial to older women's well-being except for unpaid work at home. Among men, only paid work out of the three activity domains and the number of productive roles were associated with better self-rated health. Public health policies and programs that bring older women into productive engagement outside the home may thus improve their well-being and generate benefits for communities.

Comparison of the measurement properties of the Functional Independence and Difficulty Scale with the Barthel Index in community-dwelling elderly people in Japan.

PubMed

Saito, Takashi; Izawa, Kazuhiro P; Matsui, Nobuko; Arai, Kenji; Ando, Makoto; Morimoto, Kazuhiro; Fujita, Naoki; Takahashi, Yuki; Kawazoe, Moe; Watanabe, Shuichiro

2017-04-01

The new Functional Independence and Difficulty Scale (FIDS) is a tool for assessing the performance of basic activities of daily living (BADL). Because many BADL measures already exist, it is important to know whether FIDS can offer added benefit over the existing measures. This study compared measurement properties between the FIDS and a representative BADL assessment tool, the Barthel Index (BI). Recruitment of the participants was done on the basis of convenience sampling. Participants were community-dwelling elderly Japanese subjects (n = 314; age ≥65 years) divided into a healthy elderly group [n = 225; subjects not using long-term care insurance (LTCI) services] and frail elderly group (n = 89; subjects using LTCI services). For each group, ceiling effect (percent participation with the maximum score) was calculated, and it was compared between the two scales. Associations between the FIDS, BI and Medical Outcomes Study Short Form 8 Health Survey (SF-8) were evaluated by Spearman correlation coefficient and partial correlations. Partial correlations coefficients to SF-8 were compared between the two scales. FIDS showed a relatively small ceiling effect compared to the BI. Compared to the BI, FIDS showed a significant positive partial correlation with the broader aspect of the SF-8 subscales, but the strength of correlation between FIDS and SF-8 was weak to negligible. The FIDS might be less affected by ceiling effect than the BI. Additional studies using a sufficient number of probability samples are needed to clarify whether FIDS has any benefit over BI in terms of correlations with the SF-8.

Dietary Variety and Decline in Lean Mass and Physical Performance in Community-Dwelling Older Japanese: A 4-year Follow-Up Study.

PubMed

Yokoyama, Y; Nishi, M; Murayama, H; Amano, H; Taniguchi, Y; Nofuji, Y; Narita, M; Matsuo, E; Seino, S; Kawano, Y; Shinkai, S

2017-01-01

To examine associations of dietary variety with changes in lean mass and physical performance during a 4-year period in an elderly Japanese population. Four-year prospective study. The Hatoyama Cohort Study and Kusatsu Longitudinal Study, Japan. 935 community-dwelling Japanese aged 65 years or older. Dietary variety was assessed using a 10-item food frequency questionnaire. Body composition was determined by multifrequency bioelectrical impedance analysis, and physical performance (grip strength and usual gait speed) was measured in surveys at baseline and 4 years later. Longitudinal analysis included only participants who were originally in the upper three quartiles of lean body mass, appendicular lean mass, grip strength, and usual gait speed. The outcome measures were decline in lean body mass, appendicular lean mass, grip strength, and usual gait speed, defined as a decrease to the lowest baseline quartile level at the 4-year follow-up survey. Associations of dietary variety with the outcome measures were examined by logistic regression analysis adjusted for potential confounders. In the fully adjusted model, the odds ratios for decline in grip strength and usual gait speed were 0.43 (95% confidence interval, 0.19-0.99) and 0.43 (confidence interval, 0.19-0.99), respectively, for participants in the highest category of dietary variety score as compared with those in the lowest category. Dietary variety was not significantly associated with changes in lean body mass or appendicular lean mass. Among older adults, greater dietary variety may help maintain physical performance, such as grip strength and usual gait speed, but not lean mass.

Preparedness for Protecting the Health of Community-Dwelling Vulnerable Elderly People in Eastern and Western Japan in the Event of Natural Disasters.

PubMed

Tsukasaki, Keiko; Kanzaki, Hatsumi; Kyota, Kaoru; Ichimori, Akie; Omote, Shizuko; Okamoto, Rie; Kido, Teruhiko; Sakakibara, Chiaki; Makimoto, Kiyoko; Nomura, Atsuko; Miyamoto, Yukari

2016-01-01

We clarified the preparedness necessary to protect the health of community-dwelling vulnerable elderly people following natural disasters. We collected data from 304 community general support centres throughout Japan. We found the following in particular to be challenging: availability of disaster-preparedness manuals; disaster countermeasures and management systems; creation of lists of people requiring assistance following a disaster; evacuation support systems; development of plans for health management following disasters; provision of disaster-preparedness guidance and training; disaster-preparedness systems in the community; disaster information management; the preparedness of older people themselves in requiring support; and support from other community residents.

Examining the association between participation in late-life leisure activities and cognitive function in community-dwelling elderly Chinese in Hong Kong.

PubMed

Leung, Grace T Y; Fung, Ada W T; Tam, Cindy W C; Lui, Victor W C; Chiu, Helen F K; Chan, W M; Lam, Linda C W

2010-02-01

Growing evidence suggests that participation in late-life leisure activity may have beneficial effects on cognitive function. The objective of the study was to evaluate the association between leisure activity participation and cognitive function in an elderly population of community-dwelling Hong Kong Chinese. 512 participants were assessed in the follow-up study of a population-based community survey of the prevalence of cognitive impairment among Hong Kong Chinese aged 60 years and over. Leisure activities were classified into four categories (physical, intellectual, social and recreational). Information regarding leisure activity participation, cognitive function and other variables was collected. Multivariate linear regression analyses were performed to examine the association between leisure activity participation and cognitive function. A higher level of late-life leisure activity participation, particularly in intellectual activities, was significantly associated with better cognitive function in the elderly, as reflected by the results of the Cantonese Mini-mental State Examination (p = 0.007, 0.029 and 0.005), the Category Verbal Fluency Test (p = 0.027, 0.003 and 0.005) and digit backward span (p = 0.031, 0.002 and 0.009), as measured by the total frequency, total hours per week and total number of subtypes, respectively; the Chinese Alzheimer's Disease Assessment Scale-Cognitive Subscale (p = 0.045) and word list learning (p = 0.003), as measured by the total number of subtypes; and digit forward span (p = 0.007 and 0.015), as measured by the total hours per week and total number of subtypes, respectively. Late-life intellectual activity participation was associated with better cognitive function among community-dwelling Hong Kong elderly Chinese.

Ipsative imputation for a 15-item Geriatric Depression Scale in community-dwelling elderly people.

PubMed

Imai, Hissei; Furukawa, Toshiaki A; Kasahara, Yoriko; Ishimoto, Yasuko; Kimura, Yumi; Fukutomi, Eriko; Chen, Wen-Ling; Tanaka, Mire; Sakamoto, Ryota; Wada, Taizo; Fujisawa, Michiko; Okumiya, Kiyohito; Matsubayashi, Kozo

2014-09-01

Missing data are inevitable in almost all medical studies. Imputation methods using the probabilistic model are common, but they cannot impute individual data and require special software. In contrast, the ipsative imputation method, which substitutes the missing items by the mean of the remaining items within the individual, is easy and does not need any special software, but it can provide individual scores. The aim of the present study was to evaluate the validity of the ipsative imputation method using data involving the 15-item Geriatric Depression Scale. Participants were community-dwelling elderly individuals (n = 1178). A structural equation model was constructed. The model fit indexes were calculated to assess the validity of the imputation method when it is used for individuals who were missing 20% of data or less and 40% of data or less, depending on whether we assumed that their correlation coefficients were the same as the dataset with no missing items. Finally, we compared path coefficients of the dataset imputed by ipsative imputation with those by multiple imputation. When compared with the assumption that the datasets differed, all of the model fit indexes were better under the assumption that the dataset without missing data is the same as that that was missing 20% of data or less. However, by the same assumption, the model fit indexes were worse in the dataset that was missing 40% of data or less. The path coefficients of the dataset imputed by ipsative imputation and by multiple imputation were compatible with each other if the proportion of missing items was 20% or less. Ipsative imputation appears to be a valid imputation method and can be used to impute data in studies using the 15-item Geriatric Depression Scale, if the percentage of its missing items is 20% or less. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

Prospective Study on the Impact of Fear of Falling on Functional Decline among Community Dwelling Elderly Women

PubMed Central

Choi, Kyungwon; Jeon, Gyeong-Suk; Cho, Sung-il

2017-01-01

Fear of falling (FOF) is expected to have effects on functional decline in the elderly. In this study, we examined over 2 years the effect of change in FOF on functional decline in community dwelling elderly. We conducted a secondary analysis using data from elderly women, 70 years of age and older, who participated in the Korean Longitudinal Study of Aging (KLoSA). Participants were divided into four categories according to change in FOF between the 2010 and 2012 surveys. Multiple logistic regression analysis was conducted regarding the effects of changes in FOF on functional decline after controlling for variables as known risk factors for functional decline. Rates of functional decline were highest in the “consistently having FOF” group, whereas they were lowest in the “consistently no FOF” group in both 2010 and 2012. Characteristics independently associated with functional decline were change in FOF, depressive symptoms, low frequency of meeting friends, and fear-induced activity avoidance. Longer exposure to FOF was associated with an increased risk of functional decline. FOF is an important health problem that deserves attention in its own right. Public health approaches for elderly persons should address early detection, prevention, and intervention programs for FOF. PMID:28448461

Tooth-related risk factors for periodontal disease in community-dwelling elderly people.

PubMed

Hirotomi, Toshinobu; Yoshihara, Akihiro; Ogawa, Hiroshi; Miyazaki, Hideo

2010-06-01

While most previous epidemiological studies have focused on subject-level risk factors for periodontal destruction, tooth-related factors have not been fully explored. The purpose of this study was to evaluate both tooth-related and subject-related factors affecting periodontal disease progression using a two-level multilevel model. A longitudinal survey over a period of 10 years was carried out on 286 community-dwelling elderly subjects aged 70 years at baseline. Clinical attachment level (CAL) was measured at six sites per tooth on all teeth present and periodontal disease progression was defined as CAL> or =3 mm. Periodontal disease progression was found in 79% of the subjects and most frequently in maxillary molars. Multilevel logistic regressions revealed that subjects wearing removable dentures were significantly at risk for periodontal disease progression. Abutment teeth for removable/fixed dentures were also significantly more likely to suffer periodontal breakdown. Furthermore, the following tooth-related variables were found to be possible risk factors for periodontal disease progression: maxillary and multirooted teeth. Multirooted teeth and abutments for a fixed denture were possible risk factors for periodontal disease progression.

Stress, loneliness, and depression in Taiwanese rural community-dwelling elders.

PubMed

Wang, J J; Snyder, M; Kaas, M

2001-06-01

This study examined the stressors and stress levels, loneliness, and depression experienced by Taiwanese rural elders and determine if differences in the level of stress were associated with specific person-environmental characteristics. The relationship between stress and depression was also explored. A total of 201 older rural community residents participated in the study. Findings showed that rural elders experienced a number of stressors related to health and family issues. Differences in the degree of stressfulness of individuals differed by gender, educational level, living arrangement, and socioeconomic status (SES). Findings in this study also showed that there was a high association among stress level, depressive symptoms, and mood status. The findings of this study will assist community health policy-makers in determining the need for health-related services for rural elders experiencing these problems.

Optimizing inhaler use by pharmacist-provided education to community-dwelling elderly.

PubMed

Bouwmeester, Carla; Kraft, Jacqueline; Bungay, Kathleen M

2015-10-01

To assess, using a standard observational tool, the ability of patients to demonstrate and maintain proper inhaled medication administration techniques following pharmacist education. Six-month observational study. Patients' homes or adult day health center. Patients in a Program for All-inclusive Care for the Elderly (PACE) prescribed one or more inhaled medications used at least once daily. Instruction by on-site clinical pharmacist. Hickey's Pharmacies Inhaler Technique assessment (score range: 0-20, higher better). Forty-two patients were evaluated at baseline, taught proper techniques for using inhaled medications, assessed immediately following the education, and re-assessed 4-6 weeks later. The mean pre-assessment score was 14 (SD 4.5, range 0-20), the initial post-assessment score increased to 18 (SD 3, range 10-20). The second post-assessment (4-6 weeks later) score mean was 17.7 (SD 3, range 10-20). Both follow-up scores were significantly improved from baseline (p < 0.05). Multivariable analysis indicated the strongest predictors of second post-training score were: score after initial pharmacist training and being subscribed to auto-refill. These characteristics predicted ∼70% of the variance in the second score (p < 0.001). These results indicate that education by a pharmacist combined with an auto-refill program can improve and sustain appropriate inhaler use by community-dwelling elders in a PACE program. The improved score was maintained 4-6 weeks later indicating a sustained benefit of medication administration education. Optimal inhaler use ensures optimal dosing and supports appropriate inhaler treatment in lieu of oral agents. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Effects of home-visit nutrition education on nutritional status improvement of an urban community-dwelling elderly women in Korea].

PubMed

Kwon, Jinhee; Suzuki, Takao; Kim, Hunkyung; Yoon, Heejung; Lee, Sungkook

2004-06-01

This study was conducted to evaluate the effects on home-visit nutrition education by a dietitian on nutritional status improvement of an urban community-dwelling elderly women in Korea. In the baseline survey, information on general characteristics, health-related characteristics, anthropometric measurements, biochemical measurements, nutritional knowledge. nutritional attitude, dietary habits, and food and nutrient intakes of 183 elderly people were obtained. The intervention group received weekly home-visit nutrition education over 4 months. After home-visiting nutrition education, nutritional knowledge, nutritional attitude and dietary habit were increased significantly by 1.8, 2.1 and 6.9 in the intervention group (P<0.01), respectively, who also appeared to consume more cereals and their products, legumes and their products, vegetables, seasonings, milk and dairy products than the control group. It was found that the nutrient intake increased significantly regarding energy, protein, calcium, iron, phosphorus, thiamin and riboflavin (P<0.05). The MAR (mean nutrient adequacy ratio) increased by 0.22 during the period of the study in the intervention group, and 0.09 in the control group, the difference being statistically significant (P<0.01). Differences between in mean change of anthropometric and biochemical indices between the intervention and control groups were not significant. These findings suggest that home-visit nutrition education by a dietitian is effective for improvement of the nutritional status of elderly women in an urban community. In conclusion, home-visit nutrition education should be recommended for nutritional status improvement and health promotion in the community elderly.

[Prevalence and associated factors of falls in community-dwelling elderly].

PubMed

Lavedán Santamaría, Ana; Jürschik Giménez, Pilar; Botigué Satorra, Teresa; Nuin Orrio, Carmen; Viladrosa Montoy, Maria

2015-01-01

To estimate the prevalence of falls and to identify their associated factors in community-dwelling elderly. A descriptive, cross-sectional study. Primary Health Care, Lleida. Six hundred and forty people aged 75 and older were included, in possession of a health card and living in single-family houses, through random sampling. Main measurements Data source comes from the survey of frailty in Lleida (FRALLE Survey). The variables used were the occurrence of falls, sociodemographic factors, health status, quality of life related to health and fear of falling. The prevalence of falls was 25.0% (95% CI 24.8-25.1). After multivariate analysis, basic disability (OR=2.17; 95% CI 1.32-3.58), depressive symptoms (OR=1.67; 95% CI 1.07-2.59) and fear of falling (OR=2.53; 95% CI 1.63-3.94) were the only factors independently associated with falls in the last year. One out of 4 older people reported at least a fall in the last year. This study demonstrates that fear of falling, depressive symptoms and basic disability are independent variables associated with previous falls. These 3 factors can lead to a flattering spiral of falling and may be potential targets for effective functioning in the context of falls. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Nutritional and biochemical parameters associated with 6-year change in bone mineral density in community-dwelling Japanese women aged 69 years and older: The Muramatsu Study.

PubMed

Nakamura, Kazutoshi; Oyama, Mari; Saito, Toshiko; Oshiki, Rieko; Kobayashi, Ryosaku; Nishiwaki, Tomoko; Nashimoto, Mitsue; Tsuchiya, Yasuo

2012-04-01

Predictors of bone loss in elderly Asian women have been unclear. This cohort study aimed to assess lifestyle, nutritional, and biochemical predictors of bone loss in elderly Japanese women. Subjects included 389 community-dwelling women aged 69 y and older from the Muramatsu cohort initiated in 2003; follow-up ended in 2009. We obtained data on physical characteristics, osteoporosis treatment (with bisphosphonates or selective estrogen receptor modulators), physical activity, calcium intake, serum 25-hydroxyvitamin D, undercarboxylated osteocalcin, serum albumin, and bone turnover markers as predictors. The outcome was a 6-y change in forearm BMD (ΔBMD). Osteoporosis treatment was coded as 0 for none, 1 for sometimes, and 2 for always during the follow-up period. Stepwise multiple linear regression analysis was used to identify independent predictors of ΔBMD. Mean age of the subjects was 73.3 y. Mean values of ΔBMD and Δweight were -0.019 g/cm(2) (-5.8%) and -2.2 kg, respectively. Stepwise multiple linear regression analysis revealed baseline BMD (β = -0.137, P < 0.0001), osteoporosis treatment (β = 0.0068, P = 0.0105), serum albumin levels (β = 0.0122, P = 0.0319), and Δweight (β = 0.0015, P = 0.0009) as significant independent predictors of ΔBMD. However, none of the other nutritional or biochemical indices were found to be significant predictors of ΔBMD. Our findings indicate that adequate general nutrition and appropriate osteoporosis medication, rather than specific nutritional regimens, may be effective in preventing bone loss in elderly women. Copyright © 2012 Elsevier Inc. All rights reserved.

Incidence and predictors of sarcopenia onset in community-dwelling elderly Japanese women: 4-year follow-up study.

PubMed

Kim, Hunkyung; Suzuki, Takao; Kim, Miji; Kojima, Narumi; Yoshida, Yuko; Hirano, Hirohiko; Saito, Kyoko; Iwasa, Hajime; Shimada, Hiroyuki; Hosoi, Erika; Yoshida, Hideyo

2015-01-01

Several studies have explored the prevalence and risk factors of sarcopenia, but they have been based on cross-sectional data. The objective of this study was to determine the incidence and predictors of the onset of sarcopenia over 4 years in community-dwelling elderly women. Four-year longitudinal follow-up study. Urban community in Tokyo, Japan. A total of 538 nonsarcopenic women older than 75 years. Body composition was determined by bioelectrical impedance analysis. Functional fitness measurements, including grip strength, usual walking speed, timed up and go (TUG), and interview surveys were conducted at baseline and 4-year follow-up. Blood samples were obtained to analyze serum albumin and hemoglobin A1c, and kidney function was analyzed using serum creatinine and cystatin C. Sarcopenia was defined based on the criteria suggested by the European Working Group on Sarcopenia in Older People, and the development of all stages, that is, presarcopenia, sarcopenia, and severe sarcopenia as well as the components of sarcopenia skeletal muscle index (SMI), grip strength, and walking speed, were analyzed. The incidence of total sarcopenia was 39.6% (presarcopenia 23.8%, sarcopenia 11.2%, severe sarcopenia 4.6%). Older age was significantly predictive of the development of presarcopenia and severe sarcopenia. Body mass index (BMI) lower than 21.0 kg/m(2) was significantly predictive of the development of all stages of sarcopenia, as well as declines in SMI, grip strength, and walking speed. Slow TUG was a predictor of the development of presarcopenia and severe sarcopenia. Increased calf circumference showed protective effects from the development of all stages of sarcopenia. Greater albumin levels also showed lower risk of declines in SMI, walking speed, and development of presarcopenia. Cystatin C was positively associated with the development of severe sarcopenia (odds ratio 1.83, 95% confidence interval 1.08-3.12). Heart disease and hyperlipidemia history were

Educational program for physicians to reduce use of non-steroidal anti-inflammatory drugs among community-dwelling elderly persons: a randomized controlled trial.

PubMed

Ray, W A; Stein, C M; Byrd, V; Shorr, R; Pichert, J W; Gideon, P; Arnold, K; Brandt, K D; Pincus, T; Griffin, M R

2001-05-01

Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most frequently prescribed drugs for patients 65 years of age or older, primarily for musculoskeletal symptoms of osteoarthritis. Because NSAIDs frequently cause serious gastrointestinal (GI) and other complications among elderly patients, expert guidelines for osteoarthritis recommend acetaminophen-based regimens, which are safer and often as effective as NSAIDs. Evaluate a physician education program that communicated guidelines for management of osteoarthritis in elderly patients that emphasized avoidance of NSAIDs when possible. The program reviewed NSAID risks and benefits and recommended: re-evaluating continuous NSAID users, considering substitution of up to 4 g/d of acetaminophen for the NSAID, and trying topical agents and nonpharmacologic measures. Randomized controlled trial among community-dwelling Tennessee Medicaid enrollees. Study physicians had 5 or more patients who: were community-dwelling Medicaid enrollees 65 years of age or older; had used NSAIDs regularly for at least 180 days; had had no medical care encounters during this period suggesting an indication other than osteoarthritis; and had 1 year of baseline and follow-up data. The study thus included 209 physicians (103 intervention/106 control) with 1,566 qualifying regular NSAID users (768/798). Face-to-face visit to study physicians by another physician, and reminder placements in the charts of patients eligible to have NSAID use reevaluated. Change between baseline and follow-up years in: days of prescribed NSAIDs, acetaminophen, other drugs for musculoskeletal disorders, and GI drugs; outpatient visits and inpatient days of stay; SF36 measures of general health, physical function, and bodily pain (from 40% random patient sample); and over-the-counter NSAIDs (from the sample). Intervention-attributable reduction of 7% (95% CI, 3% to 11%) in days of prescribed NSAIDs use with concomitant increase in acetaminophen use. No

Examining the association between late-life leisure activity participation and global cognitive decline in community-dwelling elderly Chinese in Hong Kong.

PubMed

Leung, Grace Tak Yu; Fung, Ada Wai Tung; Tam, Cindy Woon Chi; Lui, Victor Wing Cheong; Chiu, Helen Fung Kum; Chan, Wai Man; Lam, Linda Chiu Wa

2011-01-01

This study examines the association between late-life leisure activity participation and global cognitive decline in community-dwelling elderly Chinese in Hong Kong. Five hundred and five participants, not clinically demented at the baseline, were analysed in the follow-up study of a population-based community survey among Hong Kong Chinese aged 60 and over. Information regarding leisure activity participation, global cognitive function and important sociodemographic variables was collected. Late life leisure activity profiles were classified into intellectual, social, physical and recreational categories, and were measured by total hours per week, total frequency and total number of subtypes. Multivariate logistic regression analyses were used to evaluate the association between leisure activity participation at the baseline and the incidence of global cognitive decline at the 22-month follow-up. The incidence of global cognitive decline was defined as a one-point drop in z-score of the Cantonese version of the mini-mental state examination (CMMSE). At the follow-up, a higher level of participation in intellectual activities was significantly associated with a lower incidence of global cognitive decline as measured by both the total hours per week (multivariate-adjusted OR 0.97 (95% CI 0.94-0.99, p=0.003)), and the total number of subtypes (multivariate-adjusted OR 0.74 (95% CI 0.58-0.95, p=0.018)). A higher level of late-life intellectual activity participation was associated with less global cognitive decline among community-dwelling elderly Chinese in Hong Kong. Copyright © 2010 John Wiley & Sons, Ltd.

Lifestyle Factors and Visible Skin Aging in a Population of Japanese Elders

PubMed Central

Asakura, Keiko; Nishiwaki, Yuji; Milojevic, Ai; Michikawa, Takehiro; Kikuchi, Yuriko; Nakano, Makiko; Iwasawa, Satoko; Hillebrand, Greg; Miyamoto, Kukizo; Ono, Masaji; Kinjo, Yoshihide; Akiba, Suminori; Takebayashi, Toru

2009-01-01

Background The number of studies that use objective and quantitative methods to evaluate facial skin aging in elderly people is extremely limited, especially in Japan. Therefore, in this cross-sectional study we attempted to characterize the condition of facial skin (hyperpigmentation, pores, texture, and wrinkling) in Japanese adults aged 65 years or older by using objective and quantitative imaging methods. In addition, we aimed to identify lifestyle factors significantly associated with these visible signs of aging. Methods The study subjects were 802 community-dwelling Japanese men and women aged at least 65 years and living in the town of Kurabuchi (Takasaki City, Gunma Prefecture, Japan), a mountain community with a population of approximately 4800. The facial skin condition of subjects was assessed quantitatively using a standardized facial imaging system and subsequent computer image analysis. Lifestyle information was collected using a structured questionnaire. The association between skin condition and lifestyle factors was examined using multivariable regression analysis. Results Among women, the mean values for facial texture, hyperpigmentation, and pores were generally lower than those among age-matched men. There was no significant difference between sexes in the severity of facial wrinkling. Older age was associated with worse skin condition among women only. After adjusting for age, smoking status and topical sun protection were significantly associated with skin condition among both men and women. Conclusions Our study revealed significant differences between sexes in the severity of hyperpigmentation, texture, and pores, but not wrinkling. Smoking status and topical sun protection were significantly associated with signs of visible skin aging in this study population. PMID:19700917

Baseline estradiol concentration in community-dwelling Japanese American men is not associated with intra-abdominal fat accumulation over 10 years.

PubMed

Kocarnik, Beverly M; Boyko, Edward J; Matsumoto, Alvin M; Fujimoto, Wilfred Y; Hayashi, Tomoshige; Leonetti, Donna L; Page, Stephanie T

The role of plasma estradiol in the accumulation of intra-abdominal fat (IAF) in men is uncertain. Cross-sectional studies using imaging of IAF have shown either a positive or no association. In contrast, a randomised controlled trial using an aromatase inhibitor to suppress estradiol production found an association between oestrogen deficiency and short-term IAF accumulation. No longitudinal study has been conducted to examine the relationship between plasma estradiol concentration and the change in IAF area measured using direct imaging. This is a longitudinal observational study in community-dwelling Japanese-American men (n=215, mean age 52 years, BMI 25.4kg/m 2 ). IAF and subcutaneous fat areas were assessed using computerized tomography (CT) at baseline, 5 and 10 years. Baseline plasma estradiol concentrations were measured using liquid chromatography-tandem mass spectrometry. Univariate analysis found no association between baseline estradiol concentration and baseline IAF, or 5- or 10-year changes in IAF area (r=-0.05 for both time points, p=0.45 and p=0.43, respectively). Multivariate linear regression analysis of the change in IAF area by baseline estradiol concentration adjusted for age, baseline IAF area, and weight change found no association with either the 5- or 10-year IAF area change (p=0.52 and p=0.55, respectively). Plasma estradiol concentration was not associated with baseline IAF nor with change in IAF area over 5 or 10 years based on serial CT scans in community-dwelling Japanese-American men. These results do not support a role for oestrogen deficiency in IAF accumulation in men. Copyright © 2015 Asia Oceania Association for the Study of Obesity. All rights reserved.

Baseline estradiol concentration in community-dwelling Japanese American men is not associated with intra-abdominal fat accumulation over 10 years

PubMed Central

Kocarnik, Beverly M.; Boyko, Edward J.; Matsumoto, Alvin M.; Fujimoto, Wilfred Y.; Hayashi, Tomoshige; Leonetti, Donna L.; Page, Stephanie T.

2016-01-01

Summary Problem The role of plasma estradiol in the accumulation of intra-abdominal fat (IAF) in men is uncertain. Cross-sectional studies using imaging of IAF have shown either a positive or no association. In contrast, a randomised controlled trial using an aromatase inhibitor to suppress estradiol production found an association between oestrogen deficiency and short-term IAF accumulation. No longitudinal study has been conducted to examine the relationship between plasma estradiol concentration and the change in IAF area measured using direct imaging. Methods This is a longitudinal observational study in community-dwelling Japanese-American men (n = 215, mean age 52 years, BMI 25.4 kg/m2). IAF and subcutaneous fat areas were assessed using computerized tomography (CT) at baseline, 5 and 10 years. Baseline plasma estradiol concentrations were measured using liquid chromatography-tandem mass spectrometry. Results Univariate analysis found no association between baseline estradiol concentration and baseline IAF, or 5- or 10-year changes in IAF area (r = −0.05 for both time points, p = 0.45 and p = 0.43, respectively). Multivariate linear regression analysis of the change in IAF area by baseline estradiol concentration adjusted for age, baseline IAF area, and weight change found no association with either the 5- or 10-year IAF area change (p = 0.52 and p = 0.55, respectively). Conclusions Plasma estradiol concentration was not associated with baseline IAF nor with change in IAF area over 5 or 10 years based on serial CT scans in community-dwelling Japanese-American men. These results do not support a role for oestrogen deficiency in IAF accumulation in men. PMID:26747209

Determinants of non-compliance with herpes zoster vaccination in the community-dwelling elderly.

PubMed

Opstelten, Wim; van Essen, Gerrit A; Hak, Eelko

2009-01-07

As part of a series of studies on vaccine acceptance, we assessed determinants of compliance of the community-dwelling elderly with herpes zoster (HZ) vaccination in an existing influenza vaccination program. General practitioners (GPs) sent out a questionnaire to 1778 patients aged > or =65 years, and offered them free HZ vaccination simultaneously with the yearly influenza vaccination. In all, 690 patients (39%) were vaccinated against HZ; 1349 patients (76%) accepted influenza vaccination. Determinants of non-compliance with HZ vaccination were perceived lack of recommendation by the GP, unwillingness to comply with the doctor's advice, perception of low risk of contracting HZ, perception of short pain duration of HZ, and the opinion that vaccinations weaken one's natural defenses. The same determinants were associated with non-compliance with both vaccinations, but objections in general towards vaccination, a high education and difficulties to visit GPs were also important. Uptake of HZ vaccination was rather low and more data on (cost-)effectiveness might encourage GPs to offer HZ vaccination to their patients.

Nutritional status of community-dwelling elderly with newly diagnosed Alzheimer's disease: prevalence of malnutrition and the relation of various factors to nutritional status.

PubMed

Droogsma, E; van Asselt, D Z B; Schölzel-Dorenbos, C J M; van Steijn, J H M; van Walderveen, P E; van der Hooft, C S

2013-07-01

To determine the prevalence of malnutrition and its relation to various factors in community-dwelling elderly with newly diagnosed Alzheimer's disease (AD). Retrospective cross-sectional study. Memory clinic in a rural part of the Netherlands. 312 Community-dwelling AD patients, aged 65 years or older, were included. At the time the diagnosis AD was made, socio-demographic characteristics and data on nutritional status (Mini Nutritional Assessment (MNA)), cognitive function (Mini Mental State Examination (MMSE), Cambridge Cognitive Examination (Camcog)), functional status (Interview for Deterioration in Daily Living Activities in Dementia (IDDD), Barthel Index (BI)) and behaviour (Revised Memory and Behaviour Problems Checklist (RMBPC)) were assessed. Characteristics of well-nourished patients (MNA score >23.5) were compared to characteristics of patients at risk of malnutrition (MNA score 17-23.5). Linear regression analysis was performed to assess the effect of various factors on nutritional status. The prevalence of malnutrition was 0% and 14.1% was at risk of malnutrition. AD patients at risk of malnutrition were more impaired in basic and complex daily functioning than well-nourished AD patients (median IDDD score 41.5 [25th -75th percentile 38.8-48.0] versus median IDDD score 40.0 [25th -75th percentile 37.0-43.0], p = 0.028). The degree of impairment in basic and complex daily functioning (IDDD) was independently related to nutritional status (MNA) (p = 0.001, B = -0.062). One in seven community-dwelling elderly with newly diagnosed AD is at risk of malnutrition. The degree of impairment in daily functioning is independently related to nutritional status. Therefore, assessment of the nutritional status should be included in the comprehensive assessment of AD patients. The relation between daily functioning, nutritional status and AD warrants further investigation.

Relationship of Having Hobbies and a Purpose in Life With Mortality, Activities of Daily Living, and Instrumental Activities of Daily Living Among Community-Dwelling Elderly Adults.

PubMed

Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

2016-07-05

This study's aim was to clarify the relationship of having hobbies and a purpose in life (PIL; in Japanese, ikigai) with mortality and a decline in the activities of daily living (ADL) and instrumental ADL (IADL) among the community-dwelling elderly. Prospective observational data from residents aged ≥65 years who were at increased risk for death (n = 1853) and developing a decline in ADL (n = 1254) and IADL (n = 1162) were analyzed. Cox proportional hazard models were used for mortality analysis of data from February 2011 to November 2014. ADL and IADL were evaluated using the Barthel Index and the Tokyo Metropolitan Institute of Gerontology Index of Competence, respectively. ADL and IADL were assessed at baseline and follow-up and were evaluated using logistic regression models. Fully adjusted models included terms for age, gender, BMI, income, alcohol intake, smoking history, number of chronic diseases, cognitive function, and depression. During the follow-up of eligible participants, 248 had died, 119 saw a decline in ADL, and 178 saw a decline in IADL. In fully adjusted models, having neither hobbies nor PIL was significantly associated with an increased risk of mortality (hazard ratio 2.08; 95% confidence interval [CI], 1.47-2.94), decline in ADL (odds ratio 2.74; 95% CI, 1.44-5.21), and decline in IADL (odds ratio 1.89; 95% CI, 1.01-3.55) compared to having both hobbies and PIL. Although effect modifications by cognitive functioning and depression cannot be ruled out, our findings suggest that having hobbies and PIL may extend not only longevity, but also healthy life expectancy among community-dwelling older adults.

Adiponectin is not associated with renal function decline in community-dwelling elderly adults.

PubMed

Kobayashi, Hiroki; Otsuka, Hiromasa; Yanai, Mitsuru; Haketa, Akira; Hara, Motohiko; Hishiki, Mikano; Abe, Masanori; Soma, Masayoshi

2018-05-01

Adiponectin secreted by adipocytes plays an important role in the regulation of glucose and fatty acid metabolism. Contrary to findings in patients with chronic kidney disease (CKD), no prospective data about the association of serum adiponectin with renal function decline in the general population have yet appeared. Our objective was to analyze the relationship of total and high molecular weight (HMW) adiponectin with renal function decline as measured by cystatin C in community-dwelling elderly adults without moderate or severe CKD.In a prospective observational analysis, a total of 216 healthy elderly volunteers with eGFRcys ≥60 mL/min/1.73 m underwent anthropometric and laboratory tests at baseline and at follow-up visits. A subgroup with serum samples collected 5 years apart was further analyzed.There were no differences in either total or HMW adiponectin level between subjects subsequently undergoing rapid renal function decline and subjects with normal physiologic renal function decline (P = .71, P = .81). On univariate linear regression, neither total nor HMW adiponectin were associated with annual renal function decline (β = -0.23; P = .71, β = -0.057; P = .90). Multivariate analysis did not show a significant contribution of either total or HMW adiponectin to annual renal function decline (β = -0.50; P = .46, β = 0.01; P = .98). In the logistic regression analysis, we did not observe any statistically significant association of serum adiponectin levels with rapid renal function decline or incidence of CKD.Contrary to findings in populations with CKD, neither total nor HMW adiponectin had a substantial association with renal function decline in an elderly population with eGFRcys ≥60 mL/min/1.73 m. Our results and conclusions should not be extrapolated to subjects with other characteristics.

Cross-sectional study on the association between frailty and violence against community-dwelling elderly people in Brazil.

PubMed

Belisário, Mariane Santos; Dias, Flavia Aparecida; Pegorari, Maycon Sousa; Paiva, Mariana Mapelli de; Ferreira, Pollyana Cristina Dos Santos; Corradini, Fabrício Anibal; Tavares, Darlene Mara Dos Santos

2018-01-01

The physical, emotional and cognitive limitations that may be present in the aging process, coupled with family unpreparedness, may lead to greater dependence among the elderly. This favors development of frailty syndrome and greater levels of violence against the elderly. The objective here was to analyze the association between violence against the elderly and frailty; and the geographic distribution of violence against the elderly according to the presence of frailty syndrome. Cross-sectional study on 705 community-dwelling elderly people in Uberaba (MG), Brazil. The Fried frailty phenotype and conflict tactics scale were used. Data were analyzed using descriptive statistics, the chi-square test and a logistic regression model. The intensity of the events and the relationship between clusters of violence and frailty status were assessed by means of kernel estimation. The adjusted analysis indicated that pre-frailty and frailty were associated with physical and verbal aggression (odds ratio, OR = 1.51; 95% confidence interval, CI: 1.04-2.19; OR = 2.12; 95% CI: 1.29-3.47), frailty was associated with physical aggression (OR = 2.48; 95% CI: 1.25-4.94) and pre-frailty and frailty were associated with verbal aggression (OR = 1.48; 95% CI: 1.03-2.15; OR = 2.15; 95% CI: 1.31-3.52), respectively. Regardless of frailty status and its relationship with violence, clusters of occurrences were larger in similar regions in the southeastern part of the municipality; but superimposition of overlays relating to aggression showed that for frail individuals the clusters were smaller than for non-frail and pre-frail individuals. The condition of frailty was associated with greater chances of violence against the elderly.

Relationship between Sensory Perception and Frailty in a Community-Dwelling Elderly Population.

PubMed

Somekawa, S; Mine, T; Ono, K; Hayashi, N; Obuchi, S; Yoshida, H; Kawai, H; Fujiwara, Y; Hirano, H; Kojima, M; Ihara, K; Kim, H

2017-01-01

Aging anorexia, defined as loss of appetite and/or reduced food intake, has been postulated as a risk factor for frailty. Impairments of taste and smell perception in elderly people can lead to reduced enjoyment of food and contribute to the anorexia of aging. To evaluate the relationship between frailty and taste and smell perception in elderly people living in urban areas. Data from the baseline evaluation of 768 residents aged ≥ 65 years who enrolled in a comprehensive geriatric health examination survey was analyzed. Fourteen out of 29-items of Appetite, Hunger, Sensory Perception questionnaire (AHSP), frailty, age, sex, BMI, chronic conditions and IADL were evaluated. AHSP was analyzed as the total score of 8 taste items (T) and 6 smell items (S). Frailty was diagnosed using a modified Fried's frailty criteria. The area under the receiver operator curves for detection of frailty demonstrated that T (0.715) had moderate accuracy, but S (0.657) had low accuracy. The cutoffs, sensitivity, specificity and Youden Index (YI) values for each perception were T: Cutoff 26.5 (YI: 0.350, sensitivity: 0.639, specificity: 0.711) and S: Cutoff 18.5 (YI: 0.246, sensitivity: 0.690, specificity: 0.556). Results from multiple logistic regression models, after adjusting for age, sex, IADL and chronic conditions showed that participants under the T cutoff were associated with exhaustion and those below the S cutoff were associated with slow walking speed. The adjusted logistic models for age, sex, IADL and chronic conditions showed significant association between T and frailty (OR 2.81, 95% CI 1.29-6.12), but not between S and frailty (OR 1.73, 95% CI 0.83-3.63). Taste and smell perception, particularly taste perception, were associated with a greater risk of frailty in community-dwelling elderly people. These results suggest that lower taste and smell perception may be an indicator of frailty in old age.

Comorbidities, polypharmacy, functionality and nutritional status in Turkish community-dwelling female elderly.

PubMed

Bahat, Gulistan; Tufan, Fatih; Bahat, Zumrut; Tufan, Asli; Aydin, Yucel; Akpinar, Timur Selcuk; Nadir, Sevilay; Erten, Nilgun; Karan, Mehmet Akif

2014-06-01

Most elderly persons live in developing countries where current geriatric epidemiological data are scarce. We aimed to study major comorbidities, polypharmacy, functional and nutritional status in a Turkish community-dwelling female elderly clinic population. Female geriatrics outpatient clinic patients were assessed cross-sectionally. Patients underwent comprehensive geriatric cassessment, including identification of chronic diseases, drugs, functionality, and nutrition. Comorbidities and drugs were defined by the review of patients' self-reports and current medications. Geriatric depression and cognition were assessed by 30-item geriatric depression scale and Folstein mini-mental-state-examination. Functional status was assessed by the evaluation of activities of daily living (ADL) and instrumental activities of daily living (IADL) scales. Nutritional assessment was performed by mini-nutritional-assessment-short form. Five-hundred and fifteen patients were included in this study over an 8-year period. Mean age was 73.4 ± 6.9 years. Mean number of chronic diseases was 2.8. 61.1 % had >3 chronic diseases. Most common 3 diagnoses were hypertension (75.3 %), depression (45.5 %) and dementia (39.4 %). Mean number of drugs was 4.8. Polypharmacy was noted as 63.2 and 47.6 % by definitions as >4 or >5 chronic drug use, respectively. Subjects with at least one dependency of ADL and IADL were 23.4 and 64.0 %. Prevalence of poor nutrition was 39.1 %. In patients with at least one ADL or IADL dependency, undernutrition (p < 0.001), dementia (p < 0.001), cerebrovascular accident, Parkinson's disease, diabetes were more prevalent (p < 0.05) and were taking higher number of drugs (p < 0.01). Polypharmacy and functional dependency seem to be prevalent among female elders in our country. Nutritional status was worse than the other reported urban area of Turkey and also than among males of same region but better than among Iranian counterparts. This study illustrates geographical

Better functional mobility in community-dwelling elderly is related to D-hormone serum levels and to daily calcium intake.

PubMed

Dukas, L; Staehelin, H B; Schacht, E; Bischoff, H A

2005-01-01

The influence of calcitropic hormones on functional mobility has been studied in vitamin D (calcidiol) deficient elderly or elderly with a history of falls, however, data in community-dwelling independent vitamin D replete elderly are missing. We therefore assessed in an observational survey the association of calcidiol (25(OH)D3) and calcitriol (D-hormone / 1,25(OH)2D3) status as well as of daily calcium intake on functional mobility in older subjects We evaluated 192 women and 188 men, aged superior 70 years and living independently. Average Timed-up and go test (TUG-test) in seconds was taken as measure of functional mobility. Calcidiol and D-hormone serum concentrations and daily calcium intake were studied in multivariate controlled linear regression models with TUG-test performance as the dependent variable and/or as dichotomous variables (deficient vs. non-deficient, above vs. below the median, respectively). Subjects with low D-hormone serum concentrations took significantly more time to perform the TUG-test (low = 7.70s +/- 2.52 SD ; high = 6.70s +/- 1.29 SD; p = 0.004). In the linear multivariate controlled regression model increased D-hormone serum concentrations predicted better TUG-test performance (estimate -0.0007, p = 0.044). Participants with a calcium intake of > or =512 mg/day were significantly faster to perform the TUG-test than participants with a daily calcium intake of <512 mg/day (estimate:-0.43, p = 0.007). Other significant predictors of better TUG-test performance in both models were: male gender, less comorbid conditions, younger age, lower BMI, iPTH serum levels and creatinine clearance. Calcidiol serum levels were not associated with TUG-test performance. Higher D-hormone status and a calcium intake of > or =512 mg/day in community-dwelling independent older persons are significant determinants of better functional mobility. Therefore, to ensure optimal functional mobility, the care of older persons should address correction of D

National outpatient medication profiling: medications associated with outpatient fractures in community-dwelling elderly veterans

PubMed Central

French, Dustin D; Campbell, Robert; Spehar, Andrea; Rubenstein, Laurence Z; Branch, Laurence G; Cunningham, Francesca

2007-01-01

What is already known about this subject Polypharmacy, to include a subissue of potentially inappropriate prescribing, in community-dwelling elderly is widespread. The objective of this study was to identify the magnitude of problematic outpatient drug prescribing and its potential association as a risk factor for injuries. What this study adds This is the first national study of outpatient injuries in elderly veterans. The results are consistent with previous published literature highlighting the risks associated with prescribing central nervous system drugs in the elderly. Aims The primary objective of this retrospective case–control study in an elderly veteran population was to assess the impact of specific medications with recognized side-effects that increase the risk of a fall and were prescribed prior to fractures treated in the outpatient setting compared with patients treated for nonspecific chest pain. Methods Two national Veterans Health Administration (VHA) databases were used to identify 17 273 unique patients, aged ≥65 years, treated in outpatient settings with a fracture in fiscal year 2005, and for whom we could link to all of their outpatient prescriptions (809 536). For comparison, we identified other elderly patients with outpatient clinic visits for nonspecific chest pain (N = 62 331) for whom we could link with their 2 987 394 outpatient prescriptions. We categorized the fall-related medications as drugs that primarily affect the cardiovascular (CVS), the central nervous (CNS) or the muscular skeletal system (MSS). Results Significant differences in the two patient groups occurred in the CNS category. Approximately 41% of the patients with fracture-coded encounters were prescribed CNS drugs compared with 31% of the patients in the comparison group (P < 0.0003). Finally, the use of muscle relaxants in the MSS category was significantly higher in the fracture group than in the nonspecific chest pain group. Conclusions Studies using

Association of hyposalivation with oral function, nutrition and oral health in community-dwelling elderly Thai.

PubMed

Samnieng, P; Ueno, M; Shinada, K; Zaitsu, T; Wright, F A C; Kawaguchi, Y

2012-03-01

This study was to analyze the association of hyposalivation with oral function, nutritional status and oral health in community-dwelling elderly Thai. The subjects were 612 elderly people (mean age = 68.8, SD 5.9 years). Oral function (tasting, speaking, swallowing and chewing) and Mini Nutritional Assessment (MNA) were evaluated. Oral examination investigated teeth and periodontal status. Both unstimulated and stimulated whole saliva were collected for 5 minutes. Among all subjects, 14.4 % were classified within the hyposalivation. Hyposalivation was associated with gender, systemic disease, medication, and smoking. Subjects within the hyposalivation group had a higher number of decayed teeth and a higher prevalence of periodontitis than the normal salivation group (p < 0.05). The hyposalivation group also had a lower number of teeth present and a lower mean MNA score than the normal salivation group (p < 0.05). Logistic regression analysis showed that hyposalivation in both dentate and edentulous subjects was significantly associated with tasting, speaking, swallowing and chewing. This study suggested that hyposalivation is a risk factor not only for dental caries and periodontal disease but also for taste disturbances, speaking problems, swallowing problems, poor chewing ability and malnutrition. Monitoring salivary flow is an important measure in the care of older people.

Sensitivity to Change and Responsiveness of Four Balance Measures for Community-Dwelling Older Adults

PubMed Central

Latham, Nancy K.; Jette, Alan M.; Wagenaar, Robert C.; Ni, Pengsheng; Slavin, Mary D.; Bean, Jonathan F.

2012-01-01

Background Impaired balance has a significant negative impact on mobility, functional independence, and fall risk in older adults. Although several, well-respected balance measures are currently in use, there is limited evidence regarding the most appropriate measure to assess change in community-dwelling older adults. Objective The aim of this study was to compare floor and ceiling effects, sensitivity to change, and responsiveness across the following balance measures in community-dwelling elderly people with functional limitations: Berg Balance Scale (BBS), Performance-Oriented Mobility Assessment total scale (POMA-T), POMA balance subscale (POMA-B), and Dynamic Gait Index (DGI). Design Retrospective data from a 16-week exercise trial were used. Secondary analyses were conducted on the total sample and by subgroups of baseline functional limitation or baseline balance scores. Methods Participants were 111 community-dwelling older adults 65 years of age or older, with functional limitations. Sensitivity to change was assessed using effect size, standardized response mean, and paired t tests. Responsiveness was assessed using minimally important difference (MID) estimates. Results No floor effects were noted. Ceiling effects were observed on all measures, including in people with moderate to severe functional limitations. The POMA-T, POMA-B, and DGI showed significantly larger ceiling effects compared with the BBS. All measures had low sensitivity to change in total sample analyses. Subgroup analyses revealed significantly better sensitivity to change in people with lower compared with higher baseline balance scores. Although both the total sample and lower baseline balance subgroups showed statistically significant improvement from baseline to 16 weeks on all measures, only the lower balance subgroup showed change scores that consistently exceeded corresponding MID estimates. Limitations This study was limited to comparing 4 measures of balance, and anchor

Cross-cultural adaptation and validation of the Arabic version of the Physical Activity Scale for the Elderly among community-dwelling older adults in Saudi Arabia.

PubMed

Alqarni, Ayidh M; Vennu, Vishal; Alshammari, Sulaiman A; Bindawas, Saad M

2018-01-01

Older adults are the fastest growing population group worldwide. Regular physical activity (PA) is reported to reduce the risk of health conditions and improve personal well-being. Few validated instruments can be used to measure the PA levels among older adults in Saudi Arabia. The Physical Activity Scale for the Elderly (PASE) is used worldwide for evaluating the PA levels of the elderly in epidemiological studies. However, this scale has not been translated into Arabic. This study aimed to cross-culturally adapt the PASE into Arabic language and evaluate its reliability and validity among community-dwelling older adults in Saudi Arabia. This study was a cross-sectional one following Beaton guidelines to translate and perform cultural adaptation, as well as test the reliability and validity of the PASE Arabic version (PASE-A). Elderly (N=74) people from both genders, who lived in a community dwelling in Riyadh city, were selected from several primary health care centers. The study used Cronbach's alpha coefficient to assess the internal consistency reliability, while intraclass correlation coefficient (ICC 2,1 ) was used for test-retest reliability and the Spearman's rank correlation coefficient ( r ) was used to evaluate the correlation among PASE-A and grip strength, Timed Up and Go test, body mass index, and fat percentage. Out of 74 older adults, 59 (79.7%) completed the PASE-A questionnaire twice. The internal consistency of the PASE-A components was good (Cronbach's alpha 0.70-0.75), and the reliability of the components was excellent (ICC 2,1 0.90-0.98). A higher PASE-A score was associated with higher grip strength ( r =0.28, p =0.05) and with shorter Timed Up and Go test times ( r =-0.45, p =0.01). The PASE-A version was easy, understandable, and relevant for Saudi older adults' culture. This scale was a reliable and valid tool for evaluating and assessing the PA level among community-dwelling older adults in Saudi Arabia.

Relationship between built environment attributes and physical function in Japanese community-dwelling older adults.

PubMed

Soma, Yuki; Tsunoda, Kenji; Kitano, Naruki; Jindo, Takashi; Tsuji, Taishi; Saghazadeh, Mahshid; Okura, Tomohiro

2017-03-01

To explore the relationships between the built environment and older adults' physical function. The present cross-sectional study carried out in 2010-2012 used data drawn from 509 community-dwelling older adults aged 65-86 years living in Kasama City, a Japanese rural region. We evaluated physical function with the following performance tests: grip strength, sit-to-stand, timed up & go and walking speed. Using geographic information systems, we measured population density and the number of destinations related to daily life, community centers, medical facilities and recreational facilities within participants' neighborhoods. After adjusting for potential confounders, we found lower population density was related to poor performance of sit-to-stand and walking speed in both sexes, and grip strength in women (trend P < 0.05). A lower number of daily life-related destinations was related to poor performance of sit-to-stand and walking speed in men, and grip strength and sit-to-stand in women. Similarly, the number of community centers was related to walking speed in both sexes. The number of medical and recreational facilities was also related to some physical performance in both sexes. A lower land use mix score, calculated by principal component analysis, was related to lower performance of sit-to-stand and walking speed in men, and grip strength and sit-to-stand in women. The present study suggests that, although there are some sex differences, low population density, land use mix, and fewer daily life-related destinations, community centers, medical facilities and recreational facilities are negative determinants of physical function. Geriatr Gerontol Int 2017; 17: 382-390. © 2016 Japan Geriatrics Society.

Randomized controlled trial of an intervention to improve drug appropriateness in community-dwelling polymedicated elderly people.

PubMed

Campins, Lluís; Serra-Prat, Mateu; Gózalo, Inés; López, David; Palomera, Elisabet; Agustí, Clara; Cabré, Mateu

2017-02-01

Polypharmacy is frequent in the elderly population and is associated with potentially drug inappropriateness and drug-related problems. To assess the effectiveness and safety of a medication evaluation programme for community-dwelling polymedicated elderly people. Randomized, open-label, multicentre, parallel-arm clinical trial with 1-year follow-up. Primary care centres. Polymedicated (≥8 drugs) elderly people (≥70 years). Pharmacist review of all medication according to the Good Palliative-Geriatric Practice algorithm and the Screening Tool of Older Person's Prescriptions-Screening Tool to Alert Doctors to the Right Treatment criteria and recommendations to the patient's physician. Routine clinical practice. Recommendations and changes implemented, number of prescribed drugs, restarted drugs, primary care and emergency department consultations, hospitalizations and death. About 503 (252 intervention and 251 control) patients were recruited and 2709 drugs were evaluated. About 26.5% of prescriptions were rated as potentially inappropriate and 21.5% were changed (9.1% discontinuation, 6.9% dose adjustment, 3.2% substitution and 2.2% new prescription). About 2.62 recommendations per patient were made and at least one recommendation was made for 95.6% of patients. The mean number of prescriptions per patient was significantly lower in the intervention group at 3- and 6-month follow-up. Discontinuations, dose adjustments and substitutions were significantly higher than in the control group at 3, 6 and 12 months. No differences were observed in the number of emergency visits, hospitalizations and deaths. The study intervention was safe, reduced potentially inappropriate medication, but did not reduce emergency visits and hospitalizations in polymedicated elderly people. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Relationship of Having Hobbies and a Purpose in Life With Mortality, Activities of Daily Living, and Instrumental Activities of Daily Living Among Community-Dwelling Elderly Adults

PubMed Central

Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

2016-01-01

Background This study’s aim was to clarify the relationship of having hobbies and a purpose in life (PIL; in Japanese, ikigai) with mortality and a decline in the activities of daily living (ADL) and instrumental ADL (IADL) among the community-dwelling elderly. Methods Prospective observational data from residents aged ≥65 years who were at increased risk for death (n = 1853) and developing a decline in ADL (n = 1254) and IADL (n = 1162) were analyzed. Cox proportional hazard models were used for mortality analysis of data from February 2011 to November 2014. ADL and IADL were evaluated using the Barthel Index and the Tokyo Metropolitan Institute of Gerontology Index of Competence, respectively. ADL and IADL were assessed at baseline and follow-up and were evaluated using logistic regression models. Fully adjusted models included terms for age, gender, BMI, income, alcohol intake, smoking history, number of chronic diseases, cognitive function, and depression. Results During the follow-up of eligible participants, 248 had died, 119 saw a decline in ADL, and 178 saw a decline in IADL. In fully adjusted models, having neither hobbies nor PIL was significantly associated with an increased risk of mortality (hazard ratio 2.08; 95% confidence interval [CI], 1.47–2.94), decline in ADL (odds ratio 2.74; 95% CI, 1.44–5.21), and decline in IADL (odds ratio 1.89; 95% CI, 1.01–3.55) compared to having both hobbies and PIL. Conclusions Although effect modifications by cognitive functioning and depression cannot be ruled out, our findings suggest that having hobbies and PIL may extend not only longevity, but also healthy life expectancy among community-dwelling older adults. PMID:26947954

Nutritional status and functional capacity of community-dwelling elderly in Southern Laos.

PubMed

Nambooze, Joweria; Fujimura, Miho; Inaoka, Tsukasa

2014-03-01

The aim of this study was to assess the nutritional status and functional capacity of 144 community-dwelling elderly in three rural ethnic groups, namely, the Oy, the Brau and the Lao, of southern Laos. The Mini nutritional assessment (MNA) questionnaire and Determine Your Nutritional Health checklist were used to assess nutritional status. The Barthel Activities of Daily Living questionnaire and Lawton and Brody's Instrumental Activities of Daily Living questionnaire were used to assess the functional capacity of the respondents. The MNA score results indicated that 92.5 % of Oy respondents, 85.4 % of Brau respondents and 60 % of Lao respondents were malnourished. Analysis of variance tests showed that the MNA scores of the Oy and Lao ethnic groups and of the Brau and Lao ethnic groups were significantly different ( both p < 0.01), but that there was no significant difference between the MNA scores of the Oy and Brau ethnic groups (p > 0.05). In terms of functional capacity, 47.2 % of Oy respondents, 43.9 % of Brau respondents and 20 % of Lao respondents had limitations in their activities of daily living, whereas 98.1 % of Oy respondents, 97.6 % of Brau respondents and 86 % of Lao respondents had limitations in their instrumental activities of daily living. Body mass index, reduced appetite, number of meals consumed daily and presence of common diseases predicted nutritional status in all three ethnic groups; the remaining factors differed by ethnicity. This result implies that ethnic differences and other factors, such as location of the village, services, resources within the village and respondents' lifestyles, can affect nutritional status. Because predictors of nutritional status varied by ethnicity, there is a need for area-specific interventions aimed at improving the quality of life of the elderly in these areas.

Physical Fitness Measures as Potential Markers of Low Cognitive Function in Japanese Community-Dwelling Older Adults without Apparent Cognitive Problems.

PubMed

Narazaki, Kenji; Matsuo, Eri; Honda, Takanori; Nofuji, Yu; Yonemoto, Koji; Kumagai, Shuzo

2014-09-01

Detecting signs of cognitive impairment as early as possible is one of the most urgent challenges in preventive care of dementia. It has still been unclear whether physical fitness measures can serve as markers of low cognitive function, a sign of cognitive impairment, in older people free from dementia. The aim of the present study was to examine an association between each of five physical fitness measures and global cognition in Japanese community-dwelling older adults without apparent cognitive problems. The baseline research of the Sasaguri Genkimon Study was conducted from May to August 2011 in Sasaguri town, Fukuoka, Japan. Of the 2,629 baseline subjects who were aged 65 years or older and not certified as individuals requiring nursing care by the town, 1,552 participants without apparent cognitive problems (Mini-Mental State Examination score ≥24) were involved in the present study (59.0% of the baseline subjects, median age: 72 years, men: 40.1%). Global cognitive function was measured by the Japanese version of the Montreal Cognitive Assessment. Handgrip strength, leg strength, sit-to-stand rate, gait speed, and one-leg stand time were examined as physical fitness measures. In multiple linear regression analyses, each of the five physical fitness measures was positively associated with the Montreal Cognitive Assessment score after adjusting for age and sex (p < 0.001). These associations were preserved after additional adjustment for years of formal education, body mass index, and other confounding factors (p < 0.001). The present study first demonstrated the associations between multiple aspects of physical fitness and global cognitive function in Japanese community-dwelling older people without apparent cognitive problems. These results suggest that each of the physical fitness measures has a potential as a single marker of low cognitive function in older populations free from dementia and thereby can be useful in community-based preventive care of

Web-Based Telepresence Exercise Program for Community-Dwelling Elderly Women With a High Risk of Falling: Randomized Controlled Trial.

PubMed

Hong, Jeeyoung; Kong, Hyoun-Joong; Yoon, Hyung-Jin

2018-05-28

While physical exercise is known to help prevent falls in the elderly, bad weather and long distance between the home and place of exercise represent substantial deterrents for the elderly to join or continue attending exercise programs outside their residence. Conventional modalities for home exercise can be helpful but do not offer direct and prompt feedback to the participant, which minimizes the benefit. We aimed to develop an elderly-friendly telepresence exercise platform and to evaluate the effects of a 12-week telepresence exercise program on fall-related risk factors in community-dwelling elderly women with a high risk of falling. In total, 34 women aged 68-91 years with Fall Risk Assessment scores >14 and no medical contraindication to physical training-based therapy were recruited in person from a senior citizen center. The telepresence exercise platform included a 15-inch tablet computer, custom-made peer-to-peer video conferencing server system, and broadband Internet connectivity. The Web-based program included supervised resistance exercises performed using elastic resistance bands and balance exercise for 20-40 minutes a day, three times a week, for 12 weeks. During the telepresence exercise session, each participant in the intervention group was supervised remotely by a specialized instructor who provided feedback in real time. The women in the control group maintained their lifestyle without any intervention. Fall-related physical factors (body composition and physical function parameters) and psychological factors (Korean Falls Efficacy Scale score, Fear of Falling Questionnaire score) before and after the 12-week interventional period were examined in person by an exercise specialist blinded to the group allocation scheme. Of the 30 women enrolled, 23 completed the study. Compared to women in the control group (n=13), those in the intervention group (n=10) showed significant improvements on the scores for the chair stand test (95% confidence

Nonimaging clinical assessment of impaired swallowing in community-dwelling older adults in Taiwan.

PubMed

Chen, Miao-Yen; Lin, Li-Chan

2012-12-01

Impaired swallowing is common in elderly patients as well as those with neurological disorders and degenerative diseases. Convenient and accurate assessments should be available to community-dwelling older adults to diagnose and provide early management and care of swallowing difficulties, an important factor of influence on elderly life quality. This study used convenient nonimaging methods to assess swallowing functions in community-dwelling older adults and estimated the prevalence of swallowing difficulties. The study adopted a survey method and recruited 216 community-dwelling older adults over 65 years old in northern Taiwan. Researchers used tools including a swallowing test, questionnaire, water test, peripheral arterial pulse oximeter, and laryngeal S-EMG to assess participant swallowing functions and the prevalence of impaired swallowing. We found a 9.5% prevalence of impaired swallowing based on swallow questionnaire and water test results. Age correlated negatively with swallowing speed. A one-way ANOVA showed a significant difference in swallowing speed among the four age groups (F = 6.478, p < .00). A post hoc Scheffe comparison showed significant differences in swallowing time between the 60- to 69- and 70- to 79-year-old groups and 60- to 69- and 80- to 89-year-old groups. Multiple regression of impaired swallowing on various independent variables showed a significant standardized coefficient of 0.163 for age (t = 2.328, p = .021). Logistic regression showed a significant Wals test value for age (p = .007). The Kappa value was 0.307 for agreement analysis between impaired swallowing and SaO(2) value reduction of more than 2%. Swallowing function deteriorates with age. Results of this study provide an assessment of the prevalence of impaired swallowing in community-dwelling older adults in Taiwan. Results can help guide clinical nurses to enhance their objective assessment of impaired swallowing to improve patient quality of life.

Individual and Area Level Socioeconomic Status and Its Association with Cognitive Function and Cognitive Impairment (Low MMSE) among Community-Dwelling Elderly in Singapore.

PubMed

Wee, Liang En; Yeo, Wei Xin; Yang, Gui Rong; Hannan, Nazirul; Lim, Kenny; Chua, Christopher; Tan, Mae Yue; Fong, Nikki; Yeap, Amelia; Chen, Lionel; Koh, Gerald Choon-Huat; Shen, Han Ming

2012-01-01

Neighborhood socioeconomic status (SES) can affect cognitive function. We assessed cognitive function and cognitive impairment among community-dwelling elderly in a multi-ethnic urban low-SES Asian neighborhood and compared them with a higher-SES neighborhood. The study population involved all residents aged ≥60 years in two housing estates comprising owner-occupied housing (higher SES) and rental flats (low SES) in Singapore in 2012. Cognitive impairment was defined as <24 on the Mini Mental State Examination. Demographic/clinical details were collected via questionnaire. Multilevel linear regression was used to evaluate factors associated with cognitive function, while multilevel logistic regression determined predictors of cognitive impairment. Participation was 61.4% (558/909). Cognitive impairment was found in 26.2% (104/397) of residents in the low-SES community and in 16.1% (26/161) of residents in the higher-SES community. After adjusting for other sociodemographic variables, living in a low-SES community was independently associated with poorer cognitive function (β = -1.41, SD = 0.58, p < 0.01) and cognitive impairment (adjusted odds ratio 5.13, 95% CI 1.98-13.34). Among cognitively impaired elderly in the low-SES community, 96.2% (100/104) were newly detected. Living in a low-SES community is independently associated with cognitive impairment in an urban Asian society.

The added value of user involvement during the development of a feedback system regarding physical functioning for community-dwelling elderly people

PubMed Central

Vermeulen, Joan; Neyens, Jacques C. L; Spreeuwenberg, Marieke D; Van Rossum, Erik; Hewson, David; De Witte, Luc P

2012-01-01

Background The number of frail elderly people is increasing. Unfortunately, the number of caregivers is not increasing at the same pace, which affects older people, caregivers and healthcare systems. Because of these developments, self-management is becoming more important in healthcare. To support community-dwelling elderly people in their self-management, a system was developed that monitors their physical functioning. This system provides feedback to elderly people and their caregivers regarding physical indicators of frailty. The feedback is provided to elderly people via the screen of a mobile phone. It is important that elderly people understand the content of the feedback and are able to use the mobile phone properly. If not, it is unlikely that the system can support self-management. Many interactive health technologies that have been developed do not fulfil their promises. An important reason for this is that human and other non-technology issues are not sufficiently taken into consideration during the development process. Objective To collaborate with elderly people during the development and evaluation of a feedback system for community-dwelling elderly people regarding physical functioning. Methods An iterative user-centered design that consists of five phases was used to develop and evaluate the feedback system. These five phases were: 1) Selection of users, 2) Analysis of users and their context, 3) Identification of user needs, 4) Development of a prototype, and 5) Evaluation of the prototype. Three representatives of a target group panel for elderly people were selected in phase 1. They shared their needs and preferences during three expert group meetings that took place during the development process. This resulted in the development of a prototype which was first evaluated in a heuristic evaluation. Once adjustments were made, 11 elderly people evaluated the adjusted prototype using a think aloud procedure. They rated the usability and

Sensory interaction on static balance: a comparison concerning the history of falls of community-dwelling elderly.

PubMed

Ricci, Natalia Aquaroni; de Faria Figueiredo Gonçalves, Daniele; Coimbra, Arlete Maria Valente; Coimbra, Ibsen Bellini

2009-06-01

To determine whether elderly subjects with distinct histories of falls presented differences concerning the influence of sensory interaction on balance. Cross-sectional research. Ninety-six community-dwelling elderly subjects were divided into three groups, according to the history of falls within the past year (group 1, no falls; group 2, one fall; and group 3, recurrent falls). The Clinical Test of Sensory Interaction and Balance was used to evaluate the influence of sensory inputs on standing balance. The test required the subject to maintain stability during 30 s, under six conditions: (i) firm surface with eyes open; (ii) firm surface with eyes closed; (iii) firm surface with visual conflict; (iv) unstable surface with eyes open; (v) unstable surface with eyes closed; and (vi) unstable surface with visual conflict. The time expended on conditions and the number of abnormal cases were compared between groups. Each group was evaluated in relation to its performance in the progression of conditions. More abnormal cases occurred in group 3 compared to group 1 for conditions (iv) and (v); and compared to group 2 for condition (iv). Group 3 remained less time than group 1 under conditions (iv), (v) and (vi). Groups 1, 2 and 3 presented relevant decrements in trial duration from conditions (iv) to (v). For group 3, a significant decay was also noted from condition (i) to (ii). Sensorial interaction in the elderly varies according to their history of falls. Thus, it is possible to correctly guide the rehabilitation process and to prevent sensorial decays according to an individual's history of falls.

Score Distributions of the Balance Outcome Measure for Elder Rehabilitation (BOOMER) in Community-Dwelling Older Adults With Vertebral Fracture.

PubMed

Brown, Zachary M; Gibbs, Jenna C; Adachi, Jonathan D; Ashe, Maureen C; Hill, Keith D; Kendler, David L; Khan, Aliya; Papaioannou, Alexandra; Prasad, Sadhana; Wark, John D; Giangregorio, Lora M

2017-11-28

We sought to evaluate the Balance Outcome Measure for Elder Rehabilitation (BOOMER) in community-dwelling women 65 years and older with vertebral fracture and to describe score distributions and potential ceiling and floor effects. This was a secondary data analysis of baseline data from the Build Better Bones with Exercise randomized controlled trial using the BOOMER. A total of 141 women with osteoporosis and radiographically confirmed vertebral fracture were included. Concurrent validity and internal consistency were assessed in comparison to the Short Physical Performance Battery (SPPB). Normality and ceiling/floor effects of total BOOMER scores and component test items were also assessed. Exploratory analyses of assistive aid use and falls history were performed. Tests for concurrent validity demonstrated moderate correlation between total BOOMER and SPPB scores. The BOOMER component tests showed modest internal consistency. Substantial ceiling effect and nonnormal score distributions were present among overall sample and those not using assistive aids for total BOOMER scores, although scores were normally distributed for those using assistive aids. The static standing with eyes closed test demonstrated the greatest ceiling effects of the component tests, with 92% of participants achieving a maximal score. While the BOOMER compares well with the SPPB in community-dwelling women with vertebral fractures, researchers or clinicians considering using the BOOMER in similar or higher-functioning populations should be aware of the potential for ceiling effects.

Association of Psychosocial Conditions, Oral Health, and Dietary Variety with Intellectual Activity in Older Community-Dwelling Japanese Adults.

PubMed

Tomioka, Kimiko; Okamoto, Nozomi; Kurumatani, Norio; Hosoi, Hiroshi

2015-01-01

This study examined the factors related to intellectual activity in community-dwelling elderly persons. Self-administered questionnaires mailed to all people aged ≥65 years in a dormitory suburb in Japan (n = 15,210). The response rate was 72.2%. Analytical subjects (n = 8,910) were those who lived independently and completely answered questions about independent and dependent variables and covariates. Independent variables included psychosocial conditions (i.e., social activities, hobbies, and a sense that life is worth living (ikigai)), oral health (i.e., dental health behaviors and oral function evaluated by chewing difficulties, swallowing difficulties, and oral dryness), and dietary variety measured using the dietary variety score (DVS). A dependent variable was intellectual activity measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Covariates included age, gender, family structure, pensions, body mass index, alcohol, smoking, medical history, self-rated health, medications, cognitive function, depression, and falling. Logistic regression was used to estimate the odds ratio (OR) for poor intellectual activity. Poor intellectual activity was reported by 28.9% of the study population. After adjustment for covariates and independent variables, poor intellectual activity was significantly associated with nonparticipation in social activities (OR = 1.90, 95%CI = 1.61-2.24), having neither hobbies nor ikigai (3.13, 2.55-3.84), having neither regular dental visits nor daily brushing (1.70, 1.35-2.14), the poorest oral function (1.61, 1.31-1.98), and the lowest DVS quartile (1.96, 1.70-2.26). These results indicate that psychosocial conditions, oral health, and dietary variety are independently associated with intellectual activity in elderly persons. The factors identified in this study may be used in community health programs for maintaining the intellectual activity ability of the elderly.

Association of Psychosocial Conditions, Oral Health, and Dietary Variety with Intellectual Activity in Older Community-Dwelling Japanese Adults

PubMed Central

Tomioka, Kimiko; Okamoto, Nozomi; Kurumatani, Norio; Hosoi, Hiroshi

2015-01-01

Background This study examined the factors related to intellectual activity in community-dwelling elderly persons. Methods Self-administered questionnaires mailed to all people aged ≥65 years in a dormitory suburb in Japan (n = 15,210). The response rate was 72.2%. Analytical subjects (n = 8,910) were those who lived independently and completely answered questions about independent and dependent variables and covariates. Independent variables included psychosocial conditions (i.e., social activities, hobbies, and a sense that life is worth living (ikigai)), oral health (i.e., dental health behaviors and oral function evaluated by chewing difficulties, swallowing difficulties, and oral dryness), and dietary variety measured using the dietary variety score (DVS). A dependent variable was intellectual activity measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Covariates included age, gender, family structure, pensions, body mass index, alcohol, smoking, medical history, self-rated health, medications, cognitive function, depression, and falling. Logistic regression was used to estimate the odds ratio (OR) for poor intellectual activity. Results Poor intellectual activity was reported by 28.9% of the study population. After adjustment for covariates and independent variables, poor intellectual activity was significantly associated with nonparticipation in social activities (OR = 1.90, 95%CI = 1.61–2.24), having neither hobbies nor ikigai (3.13, 2.55–3.84), having neither regular dental visits nor daily brushing (1.70, 1.35–2.14), the poorest oral function (1.61, 1.31–1.98), and the lowest DVS quartile (1.96, 1.70–2.26). Conclusion These results indicate that psychosocial conditions, oral health, and dietary variety are independently associated with intellectual activity in elderly persons. The factors identified in this study may be used in community health programs for maintaining the intellectual activity ability of the

Japanese version of the Montreal Cognitive Assessment cut-off score to clarify improvement of mild cognitive impairment after exercise training in community-dwelling older adults.

PubMed

Nara, Marina; Sugie, Masamitsu; Takahashi, Tetsuya; Koyama, Teruyuki; Sengoku, Renpei; Fujiwara, Yoshinori; Obuchi, Shuichi; Harada, Kazumasa; Kyo, Shunei; Ito, Hideki

2018-02-02

Physical exercise improves cognitive function in people with mild cognitive impairment (MCI). However, information about whether the degree of MCI before exercise training affects improvement in cognitive function is lacking. Therefore, we aimed to investigate the cut-off value in a MCI screening tool that predicts reversal to normal cognitive function after exercise training in older adults with MCI. Participants included 112 Japanese community-dwelling older adult outpatients (37 men, 75 women; mean age 76.3 years). We administered the Japanese version of the Montreal Cognitive Assessment (MoCA-J) before and after exercise training. MCI was defined as a MoCA-J score <26. All participants underwent exercise training 2 days per week for 6 months, according to American Heart Association guidelines. The prevalence of MCI was 65.2%. After exercise training, 46.6% of participants with MCI reversed to normal cognitive function. The MoCA-J cut-off score to predict cognitive function potentially reversible to normal was 23, with receiver operating characteristic analysis showing an area under the curve of 0.80, sensitivity of 79.4% and specificity of 69.2%. Multiple logistic regression analysis to predict non-MCI after exercise training showed that MoCA-J score ≥23 (OR 6.9, P < .001), female sex (OR 3.4, P = .04) and age (OR 0.9, P = .04) were independent determinants. The MoCA-J cut-off score of 23 might be useful to predict cognitive function that is potentially reversible to normal among community-dwelling Japanese older adults with MCI. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 The Authors Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

The relationship between seven health practices and oral health status in community-dwelling elderly Thai.

PubMed

Samnieng, Patcharaphol; Ueno, Masayuki; Zaitsu, Takashi; Shinada, Kayoko; Wright, Fredrick A C; Kawaguchi, Yoko

2013-12-01

This study aims to analyse the relationship between seven health practices, oral health behaviors, and oral health status in community dwelling elderly Thai. The subjects were 612 elderly people (mean age = 68.8 ± 5.9 years). Questionnaires survey about sociodemographics, self-reported seven health practices and oral health behaviors were conducted by trained interviewers. Oral examinations investigated the number of teeth present, decayed teeth, periodontal status and functional tooth units (FTUs). Oral malodor was assessed by Organoleptic Test, and unstimulated saliva was collected for 5 min. Five health practices (smoking, drinking, physical activity, breakfast and weight maintenance) were significantly related with oral health behaviors. ancova analysis demonstrated the following significant associations: (i) smoking behavior with number of teeth present, number of FTUs, decayed teeth, periodontal disease, oral malodor and salivary flow rate, (ii) drinking alcohol behavior with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (iii) eating breakfast behavior with periodontal disease, oral malodor and salivary flow rate, (iv) eating between-meal snack with number of teeth present, number of FTUs, decayed teeth and periodontal disease, (v) maintaining weight with number of teeth present, number of FTUs, periodontal disease and oral malodor, (vi) sleeping with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (vii) physical activity with periodontal disease and salivary flow rate. Good health practices were related with good oral health behaviors. Moreover, general health practices were associated with the clinical oral health status such as number of teeth present, decayed teeth, FTUs, periodontal disease, oral malodor and salivary flow rate. The elderly with good general health practices were considered to have good oral health status. Improving general health

Psycho-social activity factors associated with self-rated health among community-dwelling elderly people A five-year longitudinal study.

PubMed

Yamauchi, Kanako; Saito, Isao; Kato, Tadahiro; Tanigawa, Takeshi; Kobayashi, Toshio

2015-01-01

This longitudinal study examined psychological and social activity factors related to poor self-rated health (SRH) in community-dwelling elderly people. The general health of 7,413 elderly individuals aged 65 years and over in Toon City, Ehime Prefecture, Japan was surveyed. We followed 4,372 participants, over a five-year period, after excluding those who were aged 85 years and over, had a disability, had moved away, or had died. The data from 3,358 respondents (response rate: 76.8%) were analyzed. We divided the patients into two groups based on their SRH responses: healthy, including those who answered "excellent" or "good," and unhealthy, including those who answered "not good" or "poor." We examined changes in SRH for both groups between the first survey and the survey conducted after five years. Among the healthy subjects at the first survey, we analyzed the relationship between SRH, after five years, and psycho-social activity factors using a logistic regression analysis. These factors included physical and social competence, life satisfaction, and tendency towards dementia and/or depression. SRH of both men and women significantly declined over five years. The percentage of men and women, who maintained SRH as healthy, after the 5-year follow-up period, was approximately 60% in those aged 65-74 years and 40% in those aged 75-84 years. In those aged 65-74 years, the odds ratio (OR) for a SRH of unhealthy (after five years), associated with Life Satisfaction Index-K (LSI-K) scores (at the first survey), was significantly lower at 0.85 (95% confidence interval [CI]: 0.77-0.93) for men and 0.79 (95% CI: 0.72-0.87) for women. The OR of tendency toward depression was significantly higher at 1.68 (95% CI: 1.11-2.56) for women only. In those aged 75-84 years, the OR for a SRH of unhealthy (after five years), associated with LSI-K scores (at the first survey), was significantly lower at 0.87 (95% CI: 0.77-1.00) for men and 0.89 (95% CI: 0.80-0.99) for women. The OR

The association between sleep duration and physical performance in Chinese community-dwelling elderly.

PubMed

Fu, Liyuan; Jia, Liye; Zhang, Wen; Han, Peipei; Kang, Li; Ma, Yixuan; Yu, Hairui; Zhai, Tianqi; Chen, Xiaoyu; Guo, Qi

2017-01-01

Physical performance is an important healthy factor in elder people. Good living habits, which include sleep, can maintain physical strength and physical performance. The aim of the present study was to conduct a cross-sectional study to determine the association between total sleep duration and physical performance. Our study population comprised residents of the township central hospital in the suburban of Tianjin, China. We measured muscle strength, walk speed and balance function by grip, 4-m walk test and timed up and go test (TUGT). We divided sleep duration into four groups <7h, 7-8h, >8-9h, >9h. A total 898 participants had completed data (392 men and 506 women, mean age 67.71 years). In man, adjusted sleep duration was associated with lower grip in > 9 h group, the mean value (95% CI) was 0.429 (0.409, 0.448), and longer TUGT time was also associated with long sleep duration, 10.46s (9.97 s, 10.95 s). In women, adjusted slower 4-m walk speed present an inverse U-shaped relation with sleep duration, by 0.93 m/s (0.86 m/s, 0.98 m/s), 0.97 m/s (0.96 m/s, 1.00 m/s), 0.97 m/s (0.95 m/s, 0.99 m/s) and 0.92 m/s (0.89 m/s, 0.96 m/s); longer TUGT time were associated with long sleep duration (> 9 h), by 11.23 s (10.70 s, 11.77 s). In Chinese community-dwelling elderly, lower muscle strength and lower balance function were associated with long sleep duration in men. Slower walk speed and lower balance function were associated with long sleep duration in women.

Social Isolation in Community-Dwelling Seniors

PubMed Central

2008-01-01

Executive Summary In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry’s newly released Aging at Home Strategy. After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person’s transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report. Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series. Aging in the Community: Summary of Evidence-Based Analyses Prevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based Analysis Behavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based Analysis Caregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based Analysis Social Isolation in Community-Dwelling Seniors: An Evidence-Based Analysis The Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) Objective of the Evidence-Based Analysis The objective was to systematically review interventions aimed at preventing or reducing social isolation and loneliness in community-dwelling seniors, that is, persons ≥ 65 years of age who are not living in long-term care institutions. The analyses focused on the following questions: Are interventions to reduce social isolation and

Predictors of computer use in community-dwelling, ethnically diverse older adults.

PubMed

Werner, Julie M; Carlson, Mike; Jordan-Marsh, Maryalice; Clark, Florence

2011-10-01

In this study, we analyzed self-reported computer use, demographic variables, psychosocial variables, and health and well-being variables collected from 460 ethnically diverse, community-dwelling elders to investigate the relationship computer use has with demographics, well-being, and other key psychosocial variables in older adults. Although younger elders with more education, those who employ active coping strategies, or those who are low in anxiety levels are thought to use computers at higher rates than do others, previous research has produced mixed or inconclusive results regarding ethnic, gender, and psychological factors or has concentrated on computer-specific psychological factors only (e.g., computer anxiety). Few such studies have employed large sample sizes or have focused on ethnically diverse populations of community-dwelling elders. With a large number of overlapping predictors, zero-order analysis alone is poorly equipped to identify variables that are independently associated with computer use. Accordingly, both zero-order and stepwise logistic regression analyses were conducted to determine the correlates of two types of computer use: e-mail and general computer use. Results indicate that younger age, greater level of education, non-Hispanic ethnicity, behaviorally active coping style, general physical health, and role-related emotional health each independently predicted computer usage. Study findings highlight differences in computer usage, especially in regard to Hispanic ethnicity and specific health and well-being factors. Potential applications of this research include future intervention studies, individualized computer-based activity programming, or customizable software and user interface design for older adults responsive to a variety of personal characteristics and capabilities.

Orofacial pain conditions and impact on quality of life in community-dwelling elderly people in Hong Kong.

PubMed

Luo, Yan; McMillan, Anne S; Wong, May C M; Zheng, Jun; Lam, Cindy L K

2007-01-01

To determine orofacial pain (OFP) characteristics, associated disability, and effect on quality of life in elderly community-dwelling Chinese people. A cross-sectional survey involving elderly people registered with the Family Medicine Unit of the University of Hong Kong served as the sampling frame. Elderly people with recent OFP symptoms and a comparison control group without OFP participated. Standard questions were asked about OFP conditions in the previous month and the Oral Health Impact Profile (OHIP-14), General Health Questionnaire (GHQ-12), and pain-related disability questions were administered prior to a standard clinical examination. Ninety-five people with OFP and 100 people without OFP participated. The median number of pain symptoms per subject was 2.0. Toothache was the most common symptom (58.9%); shooting pain across the face and muscle tenderness were the least common (6.3%). More than half of the pain participants described moderate to severe OFP. The prevalences of patients with neurological/vascular (NV), musculoligamentous/soft tissue (MST), or dentoalveolar (DA) OFP were 35.8%, 33.7%, and 30.5%, respectively. Chronic OFP was common (80%). The mean OHIP-14 summary score was significantly higher in OFP subjects than controls (P < .001) and significantly higher in the MST and DA subgroups than in the NV subgroup (P < .001). GHQ scores of > or = 4, indicating greater psychological distress, were more common in OFP subjects than controls (P < .01). Twenty percent of OFP subjects indicated that their conditions interfered with daily life activities, and in 9.9% it affected ability to work. OFP had a substantial detrimental impact on daily life activities, psychological distress level, and quality of life in Chinese elders. MST and DA conditions had the greatest adverse impact on quality of life.

Association of Physical Performance and Pain With Fear of Falling Among Community—Dwelling Japanese Women Aged 65 Years and Older

PubMed Central

Tomita, Yoshihito; Arima, Kazuhiko; Kanagae, Mitsuo; Okabe, Takuhiro; Mizukami, Satoshi; Nishimura, Takayuki; Abe, Yasuyo; Goto, Hisashi; Horiguchi, Itsuko; Aoyagi, Kiyoshi

2015-01-01

Abstract Our aim was to explore the association of physical performance and pain with fear of falling among community-dwelling Japanese women. The subjects were 278 women aged 65 years and over. We collected information on fear of falling, painful joints, comorbidities, falls in the previous year, and cataracts. Walking time (distance of 6 m), chair stand time (5 times), grip strength, the timed up and go test (TUG), and functional reach were measured. The prevalence of fear of falling was 36.3%, and it increased with age, but it was not significant (P = 0.081). Multivariate logistic regression analysis showed that poor physical performance (longer walking time, longer chair stand time, weaker grip strength, and longer TUG) and pain (low back, and upper and lower extremity pain) were significantly associated with fear of falling after adjusting for age, body mass index, comorbidities, falls in the previous year, and cataracts. Maintaining physical functioning and managing pain may be important for elderly women with fear of falling. PMID:26334906

An analysis of structural relationship among achievement motive on social participation, purpose in life, and role expectations among community dwelling elderly attending day services

PubMed Central

Kyougoku, Makoto

2016-01-01

Background. Achievement motive is defined as the intention to achieve one’s goals. Achievement motive is assumed to promote clients to choices and actions toward their valuable goal, so it is an important consideration in rehabilitation. Purpose. The purpose of this study is to demonstrate the structural relationship among achievement motive on purpose in life, social participation, and role expectation of community-dwelling elderly people. Methods. Participants were community-dwelling elderly people in day-service centers. A total of 281 participants (male: 127, female: 154) answered the self-administered questionnaire in cross-sectional research. The questionnaire was comprised of demographic data and scales that evaluated achievement motive, social participation, purpose in life, and role expectation. We studied the structural relationship established by our hypothesized model via a structural equation modeling approach. Results. We checked the standardized path coefficients and the modification indices; the modified model’s statistics were a good fit: CFI = 0.984, TLI = 0.983, RMSEA = 0.050, 90% CI [0.044–0.055]. Achievement motive had a significantly direct effect on purpose in life (direct effect = 0.445, p value < 0.001), a significantly indirect effect on purpose in life via social participation or role expectation (indirect effect = 0.170, p value < 0.001) and a total effect on purpose in life (total effect = 0.615). Discussion. This result suggests that enhancing the intention to achieve one’s goals enables participants to feel a spirit of challenge with a purpose and a sense of fulfillment in their daily lives. PMID:26835188

An analysis of structural relationship among achievement motive on social participation, purpose in life, and role expectations among community dwelling elderly attending day services.

PubMed

Sano, Nobuyuki; Kyougoku, Makoto

2016-01-01

Background. Achievement motive is defined as the intention to achieve one's goals. Achievement motive is assumed to promote clients to choices and actions toward their valuable goal, so it is an important consideration in rehabilitation. Purpose. The purpose of this study is to demonstrate the structural relationship among achievement motive on purpose in life, social participation, and role expectation of community-dwelling elderly people. Methods. Participants were community-dwelling elderly people in day-service centers. A total of 281 participants (male: 127, female: 154) answered the self-administered questionnaire in cross-sectional research. The questionnaire was comprised of demographic data and scales that evaluated achievement motive, social participation, purpose in life, and role expectation. We studied the structural relationship established by our hypothesized model via a structural equation modeling approach. Results. We checked the standardized path coefficients and the modification indices; the modified model's statistics were a good fit: CFI = 0.984, TLI = 0.983, RMSEA = 0.050, 90% CI [0.044-0.055]. Achievement motive had a significantly direct effect on purpose in life (direct effect = 0.445, p value < 0.001), a significantly indirect effect on purpose in life via social participation or role expectation (indirect effect = 0.170, p value < 0.001) and a total effect on purpose in life (total effect = 0.615). Discussion. This result suggests that enhancing the intention to achieve one's goals enables participants to feel a spirit of challenge with a purpose and a sense of fulfillment in their daily lives.

Global cognition and 8-year survival among Japanese community-dwelling older adults.

PubMed

Iwasa, Hajime; Kai, Ichiro; Yoshida, Yuko; Suzuki, Takao; Kim, Hunkyung; Yoshida, Hideyo

2013-08-01

We sought to examine the longitudinal relationship between cognitive function and all-cause mortality among Japanese community-dwelling older adults, using an 8-year prospective cohort study design with mortality surveillance. A total of 454 men and 386 women, aged 70 years and older, participated in the study. The Mini Mental State Examination (MMSE) was administered to assess global cognition. The total MMSE score and subscale scores were used as independent variables, and age, gender, education level, chronic disease, sensory deficit, depressive symptoms, and instrumental activities of daily living were used as covariates. During the follow-up period, 191 subjects (139 men and 52 women) died, and 64 subjects (31 men and 33 women) moved to a different region of Japan and were lost to follow-up. Use of the multivariate Cox proportional hazards model, adjusted for potential confounders, showed that global cognition was significantly and independently associated with mortality (hazard ratio [HR] = 1.59, 95% confidence interval [CI]: 1.14-2.23 and HR = 2.81, 95% CI: 1.77-4.36 for the middle [24-27 points] and lowest [0-23 points] categories, respectively). Among the MMSE subscales, place orientation (HR = 1.57, 95% CI: 1.09-2.25), calculation (HR = 1.67, 95% CI: 1.18-2.35), and delayed recall (HR = 1.42, 95% CI: 1.03-1.96), were also significantly and independently associated with mortality. Our study suggests that among older individuals, those with lower levels of cognitive function are more likely to have a shorter lifespan compared with those with higher cognitive functioning. Copyright © 2012 John Wiley & Sons, Ltd.

Age and gender differences in the association between social participation and instrumental activities of daily living among community-dwelling elderly.

PubMed

Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

2017-04-28

Although many studies have suggested social participation (SP) has beneficial effects on elderly people's health, most of them failed to deal with paid work. Additionally, few studies have focused on the age effect between SP and older people's health. To investigate whether the association between SP, including paid work, and instrumental activities of daily living (IADL), exhibits not only in gender, but also in age among community-dwelling older adults. In 2014, we distributed self-administered questionnaires to all community-dwelling elderly aged ≥65 in two medium-sized cities in Nara Prefecture, Japan (n = 32,825). 22,845 residents submitted the questionnaire (response rate, 69.6%). Analyzed subjects were limited to 17,680 persons who had neither dependency in basic ADL nor missing data for required items. SP was assessed based on participation frequency in seven types of social activities: volunteer groups, sports groups, hobby groups, cultural groups, senior citizens' clubs, neighborhood community associations, and paid work. Using Poisson regression models, prevalence ratio for poor IADL was calculated. To examine age and gender differences in the association between SP and IADL, we performed stratified analyses by age and gender group; male young-old (aged 65-74), male old-old (aged ≥75), female young-old, and female old-old. Prevalence of those with poor IADL was 17.1% in males and 4.5% in females, showing a significant gender difference. After adjustment for relevant covariates, volunteer groups were inversely associated with poor IADL only in males and the relationship was stronger in the old-old group than in the young-old group. Conversely, only females had a significant inverse association between paid work and poor IADL, and the association was not reliant on their ages but only those who participated infrequently had a favorable effect. Influence of age in the beneficial association between SP and IADL was generally larger in the old

[Correlates of change in cognitive function during a two-year follow-up period in a comprehensive health examination for the community-dwelling elderly for the prevention of geriatric syndromes and bed-ridden state].

PubMed

Iwasa, Hajime; Suzuki, Takao; Yoshida, Yuko; Kwon, Jinhee; Yoshida, Hideyo; Kim, Hunkyung; Sugiura, Miho; Furuna, Taketo

2006-11-01

We explored correlates of change in cognitive function during a two-year follow-up period among the community-dwelling elderly in Japan, using a population-based prospective approach. The participants analyzed in the present study were 260 men and 222 women aged 70 to 84 years at baseline, living in an urban Japanese community. Data such as change in cognitive function during two years (calculated by subtracting baseline Mini-Mental State Examination [MMSE] score from follow-up MMSE score: a negative value means a decrease in MMSE scores during the two-year period) as an outcome variable, age, education, hearing and vision problems, IADL deficit (measured by the Tokyo Metropolitan Institute of Gerontology of Index of Competence), problems related to memory complaint, living alone, hemoglobin level, as explanatory variables, and the baseline MMSE score, depressive status (measured by the Mini-International Neuropsychiatric Interview), chronic conditions (hypertension, stroke, and diabetes mellitus) as covariates, were collected during a comprehensive health examination survey for the elderly. We conducted multivariate regression analysis by genders to explore correlates of change in cognitive function. The results showed that higher age (beta = -0.18), presence of hearing problem (beta = -0.21), presence of IADL deficit (beta = -0.15), and memory complaint (beta = -0.20) in men, and higher age (beta = -0.27), low education level (beta = -0.25) and lower hemoglobin level (beta = 0.16) in women, were significantly associated with change in cognitive function when adjusting for the potential confounders. These factors may be reliable predictors for cognitive decline.

Effects of gum chewing exercises on saliva secretion and occlusal force in community-dwelling elderly individuals: A pilot study.

PubMed

Nakagawa, Kazuharu; Matsuo, Koichiro; Takagi, Daisuke; Morita, Yu; Ooka, Takafumi; Hironaka, Shouji; Mukai, Yoshiharu

2017-01-01

Elderly individuals face the risk of reductions in saliva secretion and occlusal force caused by systemic diseases or medications that can eventually result in malnutrition and systemic complications. We tested the hypothesis that regular gum chewing exercises (GCE) would enhance saliva secretion and occlusal force in an elderly population. A total of 12 community-dwelling elderly individuals (3 men and 9 women) participated in this study after providing informed consent. Participants carried out GCE regimens using a soft gum (GCE-S) or hard gum (GCE-H) for 2 weeks each, with a 2-week rest period between trials. Mucosal moisture on the tongue surface, resting saliva, and occlusal force were measured before and after each test gum, and changes in parameters at relevant time-points were statistically analyzed. Differences in each measurement item were assessed using the Friedman test for before and after the GCE. We used the Holm's correction for multiple comparisons if the Friedman test results were significant. The critical value for rejecting the null hypothesis was set at P < 0.05. Resting saliva secretion significantly increased after GCE-S, returned to baseline levels during the rest period and significantly increased again after GCE-H. Mucosal moisture and occlusal force followed a similar trend, with a significant rise after GCE-H. The results of the present study suggest that GCE can increase resting saliva secretion and occlusal force in elderly individuals. Further investigations are required on the appropriate use of soft and hard gums to address oral frailty in elderly individuals. Geriatr Gerontol Int 2017; 17: 48-53. © 2015 The Authors. Geriatrics & Gerontology International published by Wiley Publishing Asia Pty Ltd on behalf of Japan Geriatrics Society.

Prevalence of sarcopenia among older community-dwelling people with normal health and nutritional state.

PubMed

Hedayati, Kerstin Khalaj; Dittmar, Manuela

2010-01-01

This study analyzed whether sarcopenia, a risk factor for disability in the aged, also occurs in healthy community-dwelling elders with normal nutritional state. As indicators, body cell mass (BCM) and lean body mass (LBM) were determined in 110 Germans (ages 60-83) using bioimpedance analysis. Nutritional status, muscle function, anthropometry, and physical activity level were investigated. Sarcopenia was already present in well nourished healthy elders. Its prevalence depended on the measure of muscle mass used (BCM percent, 22 percent males, 20 percent females; LBM percent, 4 percent males, 11 percent females). In conclusion, screening for presence of sarcopenia is needed in healthy, well-nourished elderly populations requiring an international standardization. Copyright © Taylor & Francis Group, LLC

PREDICTORS OF COMPUTER USE IN COMMUNITY-DWELLING ETHNICALLY DIVERSE OLDER ADULTS

PubMed Central

Werner, Julie M.; Carlson, Mike; Jordan-Marsh, Maryalice; Clark, Florence

2011-01-01

Objective In this study we analyzed self-reported computer use, demographic variables, psychosocial variables, and health and well-being variables collected from 460 ethnically diverse, community-dwelling elders in order to investigate the relationship computer use has with demographics, well-being and other key psychosocial variables in older adults. Background Although younger elders with more education, those who employ active coping strategies, or those who are low in anxiety levels are thought to use computers at higher rates than others, previous research has produced mixed or inconclusive results regarding ethnic, gender, and psychological factors, or has concentrated on computer-specific psychological factors only (e.g., computer anxiety). Few such studies have employed large sample sizes or have focused on ethnically diverse populations of community-dwelling elders. Method With a large number of overlapping predictors, zero-order analysis alone is poorly equipped to identify variables that are independently associated with computer use. Accordingly, both zero-order and stepwise logistic regression analyses were conducted to determine the correlates of two types of computer use: email and general computer use. Results Results indicate that younger age, greater level of education, non-Hispanic ethnicity, behaviorally active coping style, general physical health, and role-related emotional health each independently predicted computer usage. Conclusion Study findings highlight differences in computer usage, especially in regard to Hispanic ethnicity and specific health and well-being factors. Application Potential applications of this research include future intervention studies, individualized computer-based activity programming, or customizable software and user interface design for older adults responsive to a variety of personal characteristics and capabilities. PMID:22046718

Elder mistreatment in a community dwelling population: the Malaysian Elder Mistreatment Project (MAESTRO) cohort study protocol

PubMed Central

Choo, Wan Yuen; Hairi, Noran Naqiah; Sooryanarayana, Rajini; Yunus, Raudah Mohd; Hairi, Farizah Mohd; Ismail, Norliana; Kandiben, Shathanapriya; Mohd Ali, Zainudin; Ahmad, Sharifah Nor; Abdul Razak, Inayah; Othman, Sajaratulnisah; Tan, Maw Pin; Mydin, Fadzilah Hanum Mohd; Peramalah, Devi; Brownell, Patricia; Bulgiba, Awang

2016-01-01

Introduction Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences. Methods and analysis This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression. Ethics and dissemination The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments

Frailty among Mexican community-dwelling elderly: a story told 11 years later. The Mexican Health and Aging Study

PubMed Central

Aguilar-Navarro, Sara G; Amieva, Hélène; Gutiérrez-Robledo, Luis Miguel; Avila-Funes, José Alberto

2015-01-01

Objective To describe the characteristics and prognosis of subjects classified as frail in a large sample of Mexican community-dwelling elderly. Materials and methods An eleven-year longitudinal study of 5 644 old adults participating in the Mexican Health and Aging Study (MHAS). Frailty was defined loss, weakness, exhaustion, slow walking speed and low physical activity. The main outcomes were incident disability and death. Multiple covariates were used to test the prognostic value of frailty. Results Thirty-seven percent of participants (n = 2 102) met the frailty criteria. Frail participants were significantly older, female, less disease, lower income, and poorer self-reported health status, in comparison with their non-frail counterparts. Frailty was a predictor both for disability activities of daily living and for mortality. Conclusion After a follow-up of more than ten years, the phenotype of frailty was a predictor for adverse health-related outcomes, including ADL disability and death. PMID:26172236

[Homebound elderly in a Japanese community: related factors and change of mobility].

PubMed

Imuta, H; Yasumura, S; Fujita, M; Arai, H; Fukao, A

1998-09-01

The aim of this study was to identify the prevalence of homebound elderly (defined as people whose daily activities were limited to their home) and factors related to it among 300 community elderly residents aged 60 and over in Yamagata city. In 1995, the baseline survey was performed and the follow-up survey was conducted one year later. Subjects were divided into two groups according to the extent of their daily activities: the non-homebound group (defined as people whose daily activities extended into their community) and the homebound group. The main results were as follows; 1. The prevalence of homebound elderly was 7.7% in 1995. 2. Chi-square test or t test was performed to examine the relationship between homebound and various factors. Significant factors were age, history of hypertension, history of mental disease, incompetence of ADLs (walking, eating, toileting, bathing, dressing), interpersonal dependency, subjective health, 'ikigai' (meaningfulness of life), life style (cooking, cleaning, reading newspaper or magazine, watching TV, exercise, associate with friend) and TMIG (Tokyo Metropolitan Institute of Gerontology) index of competence. The present study reveals that daily activities in community elderly residents is related to not only physical factors but also psychosocial factors. Using the significant variables in univariate analysis, multiple logistic regression analysis controlling for age was performed. Significant factors for homebound were incompetence of ADLs (walking, toileting), subjective health and TMIG index of competence. 3. Three out of 214 non-homebound elderly persons in 1995 changed to homebound in 1996.

Characteristics of walking, activity, fear of falling, and falls in community-dwelling older adults by residence.

PubMed

Wert, David M; Talkowski, Jaime B; Brach, Jennifer; VanSwearingen, Jessie

2010-01-01

Research focusing on community-dwelling older adults includes adults living in senior living residences (SLR) and independent community residences (ICR). Walking, physical activity, fear of falling, and fall history may differ on the basis of residence. We describe characteristics of walking, physical activity, fear of falling, and fall history between community-dwelling older adults by residence. Participants of this secondary analysis included community-dwelling older adults from independent living units within a senior life care community (SLR) and older adults recruited from the Pittsburgh community (ICR). Demographic information and physical (gait speed and physical activity), psychosocial (fear of falling and confidence in walking), and fall history measures were collected. Adults living in SLR compared with those in ICR were older, were more likely to live alone, and had greater disease burden. Compared with individuals in ICR, individuals in SLR reported less fear of falling (Survey of Activity and Fear of Falling in the Elderly tool fear results 0.24 and 0.50, respectively). Fewer older adults in SLR compared with those in ICR reported falling in the past year. Older adults living in SLR compared with those in ICR had similar physical function but differed in report of fear of falling and fall history. Recognizing the possible differences in psychosocial function by place of residence is important for health care providers and researchers conducting interventions and studies for community-dwelling older adults.

Prevalence and incidence of dementia among 75-80-year-old community-dwelling elderly in different districts of Antwerp, Belgium: the Antwerp Cognition (ANCOG) Study.

PubMed

De Deyn, P P; Goeman, J; Vervaet, A; Dourcy-Belle-Rose, B; Van Dam, D; Geerts, E

2011-11-01

To analyse the prevalence and incidence of dementia in a population of community-dwelling elderly (aged 75-80), living in socio-economically differing districts of Antwerp (Belgium), taking into account possible gender and educational differences. A longitudinal cohort study (N=825) with a 3-year follow-up period (N=363). The Mini Mental State Examination (MMSE) was used as a primary screen of cognitive functioning. Scoring 21 or below led to a second phase examination by a neurologist, including the CAMDEX-R-N and a neurological examination, to provide a tentative aetiological diagnosis of dementia. These procedures were conducted annually during a 3-year follow-up period. In accordance with international literature, the overall prevalence rate of dementia was 8.7%. The cumulative incidence rate (IR) of dementia was 36.60 per 1000Py with annual IRs ranging from 34.39 over 35.16 to 49.04 per 1000Py. Dementia of the Alzheimer type (DAT) was the most occurring prevalent and incident cause. Women appeared to be at higher risk and the occurrence of cognitive deterioration was more prominent in districts with lower socio-economic status, possibly related to a lower education level. We demonstrate dementia is a considerable health problem in an urban Belgian population of community-dwelling elderly aged between 75 and 80 years old. In order to prepare health care and social security systems for the future management of dementia, proper epidemiological insight into the current and future magnitude of the burden of dementia, taking into account socio-economic differences, to which this study contributes, are required. Copyright © 2011 Elsevier B.V. All rights reserved.

Comparison of seven fall risk assessment tools in community-dwelling Korean older women.

PubMed

Kim, Taekyoung; Xiong, Shuping

2017-03-01

This study aimed to compare seven widely used fall risk assessment tools in terms of validity and practicality, and to provide a guideline for choosing appropriate fall risk assessment tools for elderly Koreans. Sixty community-dwelling Korean older women (30 fallers and 30 matched non-fallers) were evaluated. Performance measures of all tools were compared between the faller and non-faller groups through two sample t-tests. Receiver Operating Characteristic curves were generated with odds ratios for discriminant analysis. Results showed that four tools had significant discriminative power, and the shortened version of Falls Efficacy Scale (SFES) showed excellent discriminant validity, followed by Berg Balance Scale (BBS) with acceptable discriminant validity. The Mini Balance Evaluation System Test and Timed Up and Go, however, had limited discriminant validities. In terms of practicality, SFES was also excellent. These findings suggest that SFES is the most suitable tool for assessing the fall risks of community-dwelling Korean older women, followed by BBS. Practitioner Summary: There is no general guideline on which fall risk assessment tools are suitable for community-dwelling Korean older women. This study compared seven widely used assessment tools in terms of validity and practicality. Results suggested that the short Falls Efficacy Scale is the most suitable tool, followed by Berg Balance Scale.

Bacterial Pneumonia in Elderly Japanese Populations

PubMed Central

Miyashita, Naoya; Yamauchi, Yasuhiro

2018-01-01

Bacterial pneumonia is one of the most important infectious diseases in terms of incidence, effect on quality of life, mortality, and impact on society. Pneumonia was the third leading cause of death in Japan in 2011. In 2016, 119 650 Japanese people died of pneumonia, 96% of whom were aged 65 years and above. The symptoms of pneumonia in elderly people are often atypical. Aspiration pneumonia is seen more frequently than in young people because of swallowing dysfunction in the elderly. The mortality rate is also higher in the elderly than in young people. In Japan, the population is aging at an unprecedented rate, and pneumonia in the elderly will be increasingly important in medicine and medical economics in the future. To manage pneumonia in the elderly, it is important to accurately evaluate its severity, administer appropriate antibiotic treatment, and implement effective preventive measures. PMID:29434484

[Effect of cognitive stimulation in elderly community].

PubMed

Apóstolo, João Luís Alves; Cardoso, Daniela Filipa Batista; Paúl, Constança; Rodrigues, Manuel Alves; Macedo, Marinha Sofia

2016-01-01

To demonstrate that the implementation of the Cognitive Stimulation (CS) program 'Making a Difference' (MD) improves cognition and depressive symptoms in retired community elders. This was a multicenter quasi-experimental study of 45 community dwelling elders (38 women and 7 men), with a mean age of 75.29, from 3 day-care centers in rural, semi-rural and urban environments in the central region of Portugal. Participants attended 14 sessions twice a week over seven weeks. The Montreal Cognitive Assessment (MoCA) and the Geriatric Depression Scale (GDS-15) were administered at the following three time points: baseline, post-test, and follow-up. From baseline to post-test, there is a statistically significant difference in depressive symptoms (F=7.494; P=.010) explaining 21% of the variance (partial eta squared [ηp(2)]=.21), power=.75, but there is no statistically significant difference in cognition. From post-test to follow-up, there is no difference in both cognition and depression outcomes. Our results showed improvement in elders' depressive symptoms after a seven weeks intervention program but it did not have a protective effect after the three months follow-up. No evidence was found for its efficacy in improving cognition. Cognitive stimulation may be a useful in preventing elder's depressive symptoms when included in their health promotion care plan. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Physical activity, quality of life and symptoms of depression in community-dwelling and institutionalized older adults.

PubMed

Salguero, Alfonso; Martínez-García, Raquel; Molinero, Olga; Márquez, Sara

2011-01-01

This study was aimed to investigate in a sample of Spanish elderly whether measures of physical activity are related to health-related quality of life (HRQoL) and symptoms of depression in community dwelling and institutionalized elderly. The sample was a cohort of 436 elderly (234 women and 202 men, aged 60-98 years) from the North of Spain. 58% were community-dwellers and 42% were institutionalized in senior residences. Participants completed measures of physical activity (Yale Physical Activity Survey, YPAS), HRQoL (Medical Outcomes Study 36-item Short Form Health Survey, SF-36) and symptoms of depression (Geriatric Depression Scale, GDS). All SF-36 domains, except role-emotional, were significantly correlated with the YPAS activity dimension summary index. Physical function, role-physical, general health and vitality correlated with total time activity, and correlations were observed between weekly energy expenditure and physical function, role physical, vitality and mental health. Depressive symptom scores correlated significantly with the YPAS activity dimension summary index and the weekly energy expenditure. Scores for various domains of the SF-36 and for depressive symptoms significantly differed among less and more active individuals of the same sex and institutionalization category. Differences generally reached a higher extent in institutionalized subjects in comparison to community dwellers. In conclusion, physical activity was related to different domains of both the physical and mental components of HRQoL and to decreased depressive symptoms. Results emphasize the positive effects of physical activity in both community-dwelling and institutionalized older adults. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

The budget impact of oral nutritional supplements for disease related malnutrition in elderly in the community setting.

PubMed

Freijer, Karen; Nuijten, Mark J C; Schols, Jos M G A

2012-01-01

A health economic analysis was performed to assess the economic impact on the national health care budget of using oral nutritional supplements (ONS), being a food for special medical purposes also known as medical nutrition, for the treatment of disease related malnutrition (DRM) in the community in the Netherlands. An economic model was developed to calculate the budget impact of using ONS in community dwelling elderly (>5 years) with DRM in the Netherlands. The model reflects the costs of DRM and the cost reductions resulting from improvement in DRM due to treatment with ONS. Using ONS for the treatment of DRM in community dwelling elderly, leads to a total annual cost savings of € 13 million (18.9% savings), when all eligible patients are treated. The additional costs of ONS (€ 57 million) are more than balanced by a reduction of other health care costs, e.g., re-/hospitalization (€ 70 million). Sensitivity analyses were performed on all parameters, including duration of treatment with ONS and the prevalence of DRM. This budget impact analysis shows that the use of ONS for treatment of DRM in elderly patients in the community may lead to cost savings in the Netherlands.

Elder mistreatment in a community dwelling population: the Malaysian Elder Mistreatment Project (MAESTRO) cohort study protocol.

PubMed

Choo, Wan Yuen; Hairi, Noran Naqiah; Sooryanarayana, Rajini; Yunus, Raudah Mohd; Hairi, Farizah Mohd; Ismail, Norliana; Kandiben, Shathanapriya; Mohd Ali, Zainudin; Ahmad, Sharifah Nor; Abdul Razak, Inayah; Othman, Sajaratulnisah; Tan, Maw Pin; Mydin, Fadzilah Hanum Mohd; Peramalah, Devi; Brownell, Patricia; Bulgiba, Awang

2016-05-25

Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences. This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression. The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments, and published in appropriate scientific journals and

Social isolation in community-dwelling seniors: an evidence-based analysis.

PubMed

2008-01-01

In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE OF THE EVIDENCE-BASED ANALYSIS: The objective was to systematically review interventions aimed at preventing or reducing social isolation and loneliness in community-dwelling seniors, that is, persons ≥ 65 years of age who are not living in long-term care institutions. The analyses focused on the following questions: Are interventions to reduce social isolation and/or loneliness effective?Do these

Exercise for Fall Risk Reduction in Community-Dwelling Older Adults: A Systematic Review

PubMed Central

Arnold, Catherine M.; Sran, Meena M.; Harrison, Elizabeth L.

2008-01-01

Purpose: To evaluate the influence of exercise on falls and fall risk reduction in community-dwelling older adults and to present an updated synthesis of outcome measures for the assessment of fall risk in community-dwelling older adults. Method: A systematic review was performed, considering English-language articles published from 2000 to 2006 and accessible through MEDLINE, CINAHL, PEDro, EMBASE, and/or AMED. Included were randomized controlled clinical trials (RCTs) that used an exercise or physical activity intervention and involved participants over age 50. Screening and methodological quality for internal validity were conducted by two independent reviewers. Results: The search retrieved 156 abstracts; 22 articles met the internal validity criteria. Both individualized and group exercise programmes were found to be effective in reducing falls and fall risk. The optimal type, frequency, and dose of exercise to achieve a positive effect have not been determined. A variety of outcome measures have been used to measure fall risk, especially for balance. Conclusions: Falls and fall risk can be reduced with exercise interventions in the community-dwelling elderly, although the most effective exercise variables are unknown. Future studies in populations with comorbidities known to increase fall risk will help determine optimal, condition-specific fall-prevention programmes. Poor balance is a key risk factor for falls; therefore, the best measure of this variable should be selected when evaluating patients at risk of falling. PMID:20145768

Cardiac function and cognition in older community-dwelling cardiac patients.

PubMed

Eggermont, Laura H P; Aly, Mohamed F A; Vuijk, Pieter J; de Boer, Karin; Kamp, Otto; van Rossum, Albert C; Scherder, Erik J A

2017-11-01

Cognitive deficits have been reported in older cardiac patients. An underlying mechanism for these findings may be reduced cardiac function. The relationship between cardiac function as represented by different echocardiographic measures and different cognitive function domains in older cardiac patients remains unknown. An older (≥70 years) heterogeneous group of 117 community-dwelling cardiac patients under medical supervision by a cardiologist underwent thorough echocardiographic assessment including left ventricular ejection fraction, cardiac index, left atrial volume index, left ventricular mass index, left ventricular diastolic function, and valvular calcification. During a home visit, a neuropsychological assessment was performed within 7.1 ± 3.8 months after echocardiographic assessment; the neuropsychological assessment included three subtests of a word-learning test (encoding, recall, recognition) to examine one memory function domain and three executive function tests, including digit span backwards, Trail Making Test B minus A, and the Stroop colour-word test. Regression analyses showed no significant linear or quadratic associations between any of the echocardiographic functions and the cognitive function measures. None of the echocardiographic measures as representative of cardiac function was correlated with memory or executive function in this group of community-dwelling older cardiac patients. These findings contrast with those of previous studies. © 2017 Japanese Psychogeriatric Society.

Frailty Is a Major Related Factor for at Risk of Malnutrition in Community-Dwelling Older Adults.

PubMed

Chang, Shu-Fang

2017-01-01

who were frail exhibited a particularly high risk of malnutrition. The results revealed that the evaluation of malnutrition risk should be conducted in older persons living in the community. Frailty in particular was identified as a major risk factor for malnutrition in community-dwelling elderly persons. Community nurses should pay attention to the nutritional conditions of community-dwelling elderly persons. Community nurses should assess the at-risk population and provide effective preventive strategies and programs to reduce the prevalence of malnutrition and frailty. © 2016 Sigma Theta Tau International.

Vitamin D receptor variability and physical activity are jointly associated with low handgrip strength and osteoporosis in community-dwelling elderly people in Taiwan: the Taichung Community Health Study for Elders (TCHS-E).

PubMed

Wu, F-Y; Liu, C-S; Liao, L-N; Li, C-I; Lin, C-H; Yang, C-W; Meng, N-H; Lin, W-Y; Chang, C-K; Hsiao, J-H; Li, T-C; Lin, C-C

2014-07-01

We studied 472 elders to assess joint association of vitamin D receptor (VDR) variability and physical activity on low handgrip strength (LHS) and osteoporosis (OST). Our findings showed that higher risks of OST were associated with physically inactive elders with some specific VDR variations, highlighting the importance of promotion program for physical activity. The aim of this study was to determine the joint association between VDR variability and physical activity on LHS and OST in community-dwelling elders. Bone mineral density of the lumbar spine (LS), the femoral neck (FN), and the total hip were measured by dual-energy X-ray absorptiometry. Four single-nucleotide polymorphisms (SNPs) (rs7975232, rs1544410, rs2239185, and rs3782905) of the VDR gene were examined in 472 participants. Physical inactivity and each of the four SNPs were jointly associated with a significantly greater risk of LHS in people than that associated with each of the VDR SNPs or low physical activity alone. Physically inactive men with the AG or AA genotype of rs2239185 had a significantly greater risk of overall, LS, and FN OST than those of physically active men with the GG genotype [odds ratio (OR) 3.57, 95 % confidence interval (CI) 1.10-11.65; OR 4.74, 95 % CI 1.43-15.70; and OR 5.06, 95 % CI 1.08-23.71, respectively]. Similarly, physically inactive women with the CG or CC genotype of rs3782905 and the AG or AA genotype of rs1544410 had a significantly greater risk of FN OST than physically active women with the GG genotype (OR 5.33, 95 % CI 1.23-23.06 and OR 5.36, 95 % CI 1.11-25.94, respectively). VDR polymorphisms and physical activity are jointly associated with LHS and OST in elders. Health care programs should promote physical activity among elders as a cost-effective way to prevent LHS and OST, especially in those who may be genetically predisposed.

Functional mobility and balance in community-dwelling elderly submitted to multisensory versus strength exercises

PubMed Central

Alfieri, Fábio Marcon; Riberto, Marcelo; Gatz, Lucila Silveira; Ribeiro, Carla Paschoal Corsi; Lopes, José Augusto Fernandes; Santarém, José Maria; Battistella, Linamara Rizzo

2010-01-01

It is well documented that aging impairs balance and functional mobility. The objective of this study was to compare the efficacy of multisensory versus strength exercises on these parameters. We performed a simple blinded randomized controlled trial with 46 community-dwelling elderly allocated to strength ([GST], N = 23, 70.2-years-old ± 4.8 years) or multisensory ([GMS], N = 23, 68.8-years-old ± 5.9 years) exercises twice a week for 12 weeks. Subjects were evaluated by blinded raters using the timed ‘up and go’ test (TUG), the Guralnik test battery, and a force platform. By the end of the treatment, the GMS group showed a significant improvement in TUG (9.1 ± 1.9 seconds (s) to 8.0 ± 1.0 s, P = 0.002); Guralnik test battery (10.6 ± 1.2 to 11.3 ± 0.8 P = 0.009); lateromedial (6.1 ± 11.7 cm to 3.1 ± 1.6 cm, P = 0.02) and anteroposterior displacement (4.7 ± 4.2 cm to 3.4 ± 1.0 cm, P = 0.03), which were not observed in the GST group. These results reproduce previous findings in the literature and mean that the stimulus to sensibility results in better achievements for the control of balance and dynamic activities. Multisensory exercises were shown to be more efficacious than strength exercises to improve functional mobility. PMID:20711437

Frailty and cardiovascular risk in community-dwelling elderly: a population-based study.

PubMed

Ricci, Natalia Aquaroni; Pessoa, Germane Silva; Ferriolli, Eduardo; Dias, Rosangela Correa; Perracini, Monica Rodrigues

2014-01-01

Evidence suggests a possible bidirectional connection between cardiovascular disease (CVD) and the frailty syndrome in older people. To verify the relationship between CVD risk factors and the frailty syndrome in community-dwelling elderly. This population-based study used data from the Fragilidade em Idosos Brasileiros (FIBRA) Network Study, a cross-sectional study designed to investigate frailty profiles among Brazilian older adults. Frailty status was defined as the presence of three or more out of five of the following criteria: unintentional weight loss, weakness, self-reported fatigue, slow walking speed, and low physical activity level. The ascertained CVD risk factors were self-reported and/or directly measured hypertension, diabetes mellitus, obesity, waist circumference measurement, and smoking. Of the 761 participants, 9.7% were characterized as frail, 48.0% as pre-frail, and 42.3% as non-frail. The most prevalent CVD risk factor was hypertension (84.4%) and the lowest one was smoking (10.4%). It was observed that among those participants with four or five risk factors there was a higher proportion of frail and pre-frail compared with non-frail (Fisher's exact test: P=0.005; P=0.021). Self-reported diabetes mellitus was more prevalent among frail and pre-frail participants when compared with non-frail participants (Fisher's exact test: P≤0.001; P≤0.001). There was little agreement between self-reported hypertension and hypertension identified by blood pressure measurement. Hypertension was highly prevalent among the total sample. In addition, frail and pre-frail older people corresponded to a substantial proportion of those with more CVD risk factors, especially diabetes mellitus, highlighting the need for preventive strategies in order to avoid the co-occurrence of CVD and frailty.

Frailty and cardiovascular risk in community-dwelling elderly: a population-based study

PubMed Central

Ricci, Natalia Aquaroni; Pessoa, Germane Silva; Ferriolli, Eduardo; Dias, Rosangela Correa; Perracini, Monica Rodrigues

2014-01-01

Background Evidence suggests a possible bidirectional connection between cardiovascular disease (CVD) and the frailty syndrome in older people. Purpose To verify the relationship between CVD risk factors and the frailty syndrome in community-dwelling elderly. Methods This population-based study used data from the Fragilidade em Idosos Brasileiros (FIBRA) Network Study, a cross-sectional study designed to investigate frailty profiles among Brazilian older adults. Frailty status was defined as the presence of three or more out of five of the following criteria: unintentional weight loss, weakness, self-reported fatigue, slow walking speed, and low physical activity level. The ascertained CVD risk factors were self-reported and/or directly measured hypertension, diabetes mellitus, obesity, waist circumference measurement, and smoking. Results Of the 761 participants, 9.7% were characterized as frail, 48.0% as pre-frail, and 42.3% as non-frail. The most prevalent CVD risk factor was hypertension (84.4%) and the lowest one was smoking (10.4%). It was observed that among those participants with four or five risk factors there was a higher proportion of frail and pre-frail compared with non-frail (Fisher’s exact test: P=0.005; P=0.021). Self-reported diabetes mellitus was more prevalent among frail and pre-frail participants when compared with non-frail participants (Fisher’s exact test: P≤0.001; P≤0.001). There was little agreement between self-reported hypertension and hypertension identified by blood pressure measurement. Conclusion Hypertension was highly prevalent among the total sample. In addition, frail and pre-frail older people corresponded to a substantial proportion of those with more CVD risk factors, especially diabetes mellitus, highlighting the need for preventive strategies in order to avoid the co-occurrence of CVD and frailty. PMID:25336932

The relationship of community activities with cognitive impairment and depressive mood independent of mobility disorder in Japanese older adults.

PubMed

Okura, Mika; Ogita, Mihoko; Yamamoto, Miki; Nakai, Toshimi; Numata, Tomoko; Arai, Hidenori

This study aimed to examine the relationship of participating in community activities (CA) with cognitive impairment and depressive mood independent of mobility disorder (MD) among older Japanese people. Elderly residents in institutions or those requiring long-term care insurance services were excluded; questionnaires were mailed to 5401 older adults in 2013. The response rate was 94.3% (n=5094). We used multiple imputation to manage missing data. The questionnaire addressed physical fitness, memory, mood, and CA. Participants were divided into two groups (good and bad) based on the median scores for physical fitness, memory, and mood. We identified items related to periodically performed CA, cognitive impairment, and depressive mood, and examined correlations between scores on these sets of items. The mean age was 75.9 years; 58.4% of participants were women. The following CA significantly predicted reduced cognitive impairment and depressive mood independent of MD: volunteer activity, community activity, visiting friends at home, pursuing hobbies, paid work, farm work, and daily shopping. These results were corrected for age, sex, and response method (mail or home-visit). Higher CA scores were associated with lower cognitive impairment and lower depressive mood independent of MD. CA is negatively associated with cognitive impairment and depressive mood among community-dwelling elderly independent of MD; promoting CA may protect against cognitive impairment and depressive mood in this population. However, MD, cognitive impairment, and depressive mood may lead to reduced CA. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Normative scores on the Berg Balance Scale decline after age 70 years in healthy community-dwelling people: a systematic review.

PubMed

Downs, Stephen; Marquez, Jodie; Chiarelli, Pauline

2014-06-01

What is the mean Berg Balance Scale score of healthy elderly people living in the community and how does it vary with age? How much variability in Berg Balance Scale scores is present in groups of healthy elderly people and how does this vary with age? Systematic review with meta-analysis. Any group of healthy community-dwelling people with a mean age of 70 years or greater that has undergone assessment using the Berg Balance Scale. Mean and standard deviations of Berg Balance Scale scores within cohorts of elderly people of known mean age. The search yielded 17 relevant studies contributing data from a total of 1363 participants. The mean Berg Balance Scale scores ranged from 37 to 55 out of a possible maximum score of 56. The standard deviation of Berg Balance Scale scores varied from 1.0 to 9.2. Although participants aged around 70 years had very close to normal Berg Balance Scale scores, there was a significant decline in balance with age at a rate of 0.7 points on the 56-point Berg Balance Scale per year. There was also a strong association between increasing age and increasing variability in balance (R(2) = 0.56, p < 0.001). Healthy community-dwelling elderly people have modest balance deficits, as measured by the Berg Balance Scale, although balance scores deteriorate and become more variable with age. Copyright © 2014. Published by Elsevier B.V.

Low peak jump power is associated with elevated odds of dysmobility syndrome in community-dwelling elderly individuals: the Korean Urban Rural Elderly (KURE) study.

PubMed

Hong, Namki; Kim, Chang Oh; Youm, Yoosik; Kim, Hyeon Chang; Rhee, Yumie

2018-06-01

In a community-dwelling elderly cohort (Korean Urban Rural Elderly), low peak jump power was associated with elevated odds of dysmobility syndrome and its components, independent of age and comorbidities. Jump power measurement improved discrimination of individuals with dysmobility syndrome when added to conventional risk factors. Dysmobility syndrome was proposed to encompass the risks affecting musculoskeletal outcomes. Jump power measurement is a safe, reproducible high-intensity test for physical function in elderly. However, the relationship between jump power and dysmobility syndrome remains unknown. A total of 1369 subjects (mean 71.6 years; women, 66%) were analyzed from a community-based cohort. Dysmobility syndrome was defined as the presence of ≥ 3 factors among falls in the preceding year, low lean mass, high fat mass, osteoporosis, low grip strength, and low timed get-up-and-go (TUG) performance. Subjects were grouped into tertiles of jump power relative to weight based on sex-stratified cutoffs (32.4 and 27.6 W/kg in men; 23.9 and 19.9 W/kg in women) or into the failed-to-jump group. The prevalence of dysmobility syndrome was 20% overall, increasing from the highest (T1) to lowest (T3) jump power tertile (1, 11, 15% in men; 11, 16, 39% in women) and the failed-to-jump group (39% in men; 48% in women). Low jump power or failed-to-jump was associated with elevated odds of dysmobility syndrome (T3 vs. T1, adjusted odds ratio [aOR] 4.35, p < 0.001; failed-to-jump vs. T1, aOR 7.60, p < 0.001) and its components including falls, low lean mass, high fat mass, and poor TUG performance but not osteoporosis after adjustment for covariates. Jump power modestly discriminated dysmobility syndrome (area under the curve [AUC], 0.71, p < 0.001), which improved discriminatory performance when added to conventional risk factors (AUC, from 0.75 to 0.79, p < 0.001). Low peak jump power was associated with elevated odds of dysmobility syndrome and

A study on the relationship between muscle function, functional mobility and level of physical activity in community-dwelling elderly.

PubMed

Garcia, Patrícia A; Dias, João M D; Dias, Rosângela C; Santos, Priscilla; Zampa, Camila C

2011-01-01

to evaluate the relationship between lower extremity muscle function, calf circumference (CC), handgrip strength (HG), functional mobility and level of physical activity among age groups (65-69, 70-79, 80+) of older adults (men and women) and to identify the best parameter for screening muscle function loss in the elderly. 81 community-dwelling elderly (42 women and 39 men) participated. Walking speed (Multisprint Kit), HG (Jamar dynamometer), hip, knee and ankle muscle function (Biodex isokinetic dynamometer), level of physical activity (Human Activity Profile) and CC (tape measure) were evaluated. ANOVA, Pearson correlation and ROC curves were used for statistical analysis. Dominant CC (34.9±3 vs 37.7±3.6), habitual (1.1±0.2 vs 1.2±0.2) and fast (1.4±0.3 vs 1.7±0.3) walking speed, HG (23.8±7.5 vs 31.8±10.3), average peak torque and average hip, knee and ankle power (p<0.05) were lower for the 80+ group than for the 65-69 year-olds. There were no differences in physical activity level among age groups. Moderate significant correlations were found between muscle function parameters, walking speed and HG; a fair degree of relationship was found between muscle function parameters, CC and level of physical activity (p<0.05). The ROC curve analysis suggested a cutoff point of 14.51 Kgf for screening muscle function loss in elderly women (p=0.03). This study demonstrated an association between muscle function, HG and fast walking speed, a decrease in these parameters with age and the possibility of using HG to screen for muscle function of the lower extremities.

Non-steroidal anti-inflammatory drug (NSAID) use and Alzheimer disease in community-dwelling elderly patients.

PubMed

Landi, Francesco; Cesari, Matteo; Onder, Graziano; Russo, Andrea; Torre, Sergio; Bernabei, Roberto

2003-01-01

Recently, greater attention has been paid to the role of inflammatory processes in the pathophysiology of Alzheimer disease (AD). However, the mechanism by which anti-inflammatory agents (NSAIDs) might slow the progression of AD is not completely known. The aim of the present study was to examine the relationship between NSAIDs use and AD in a large sample of community-dwelling elderly people. In a cross-sectional retrospective study, the authors analyzed data on patients admitted to home care programs. A total of 12 home health agencies participated in the project, with a total of 2,708 patients enrolled in the present study. The main outcome measures were the prevalence of AD and use of NSAIDs treatment. Compared with all non-users, NSAID users had a nearly 50% lower risk of being affected by AD. Separate multivariate analyses of subjects receiving different types of NSAIDs found a significantly decreased risk of cognitive impairment associated with non-aspirin NSAID use, whereas, among subjects taking aspirin, the difference in estimated risk did not reach statistical significance. The results of this population-based cross-sectional study are consistent with the notion that long-term NSAIDs use has a protective effect against AD. However, after possible confounding effects of age and several other variables potentially associated with cognitive impairment were controlled, this association was statistically significant only for non-aspirin NSAIDs use.

Comparison of body composition and physical and cognitive function between older Japanese adults with no diabetes, prediabetes and diabetes: A cross-sectional study in community-dwelling Japanese older people.

PubMed

Kera, Takeshi; Kawai, Hisashi; Hirano, Hirohiko; Kojima, Motonaga; Watanabe, Yutaka; Fujiwara, Yoshinori; Ihara, Kazushige; Obuchi, Shuichi

2018-03-26

Diabetes is associated with not only cardiovascular and cerebrovascular disease, but also reductions in physical and cognitive function. The purpose of the present study was to determine whether muscle strength, walking ability and balance declined in Japanese community-dwelling older adults with diabetes or prediabetes. We analyzed data from comprehensive health checkups carried out for 1689 individuals (710 men, 979 women; mean age 71.4 ± 5.6 years) between 2011 and 2016. Participants were divided into three groups: no diabetes (non-history of diabetes and glycated hemoglobin level <5.7%), prediabetes (non-history of diabetes, but glycated hemoglobin level was 5.7-6.4%) and diabetes (history of diabetes or glycated hemoglobin level >6.4%). Physical and cognitive function were compared between groups after adjusting for covariates. Participants with diabetes showed higher levels of obesity, comorbidity, gonarthrosis, and body fat, and lower levels of physical function relative to those observed in participants with prediabetes or no diabetes. After adjusting covariates, participants with diabetes showed significantly lower grip strength (P < 0.010), slower walking speed (P < 0.005), longer Timed Up and Go test time (P < 0.007) and less time spent standing on one foot (P < 0.001) relative to those with no diabetes, but not those with prediabetes. Significant functional decline was observed in community-dwelling older adults with diabetes, but not in those with prediabetes. Prevention of the progression of prediabetes to diabetes is important in avoiding reductions in physical function. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 Japan Geriatrics Society.

Prevalence of fear of falling and associated factors among Japanese community-dwelling older adults.

PubMed

Tomita, Yoshihito; Arima, Kazuhiko; Tsujimoto, Ritsu; Kawashiri, Shin-Ya; Nishimura, Takayuki; Mizukami, Satoshi; Okabe, Takuhiro; Tanaka, Natsumi; Honda, Yuzo; Izutsu, Kazumi; Yamamoto, Naoko; Ohmachi, Izumi; Kanagae, Mitsuo; Abe, Yasuyo; Aoyagi, Kiyoshi

2018-01-01

To determine the prevalence of fear of falling and associated factors among Japanese community-dwelling older adults.Cross-sectional study between 2011 and 2013.Community in which residents voluntarily attended a health examination.We recruited 844 older adults (male, n = 350; female, n = 494) aged 60 to 92 years from among those who presented at the health examination.We assessed fear of falling, falls in the previous year, pain, comorbidity, and cataracts. Five times chair stand time was applied as an indicator of physical performance.The prevalence of fear of falling was 26.9% and 43.3% among the men and women, respectively. Men and women who feared falling were older (P < .01), had longer 5 times chair stand time (P < .01), and more falls in the previous year (P < .05), pain (P < .01), and comorbidity (P < .05). Multivariate logistic regression analysis identified advanced age (odds ratios [OR], 1.57; 95% confidence interval [CI], 1.03-2.39), falls in the previous year (OR, 2.44; 95%CI, 1.29-4.64), and pain (OR, 1.82; 95%CI, 1.03-3.22) in men, and advanced age (OR, 1.59; 95%CI, 1.13-2.24), longer 5 times chair stand times (OR, 1.28; 95%CI, 1.04-1.59), falls in the previous year (OR, 2.59; 95%CI, 1.54-4.34), and pain (OR, 1.65; 95%CI, 1.06-2.55) in women as being independently associated with fear of falling.The prevalence of fear of falling was similar to previous reports. Advanced age, falls in previous year, and pain were associated with fear of falling in men. A longer 5 times chair stand time was also associated with fear of falling among older adult women. Maintenance of physical function and pain management might be important for older adults with fear of falling.

Prevalence of fear of falling and associated factors among Japanese community-dwelling older adults

PubMed Central

Tomita, Yoshihito; Arima, Kazuhiko; Tsujimoto, Ritsu; Kawashiri, Shin-ya; Nishimura, Takayuki; Mizukami, Satoshi; Okabe, Takuhiro; Tanaka, Natsumi; Honda, Yuzo; Izutsu, Kazumi; Yamamoto, Naoko; Ohmachi, Izumi; Kanagae, Mitsuo; Abe, Yasuyo; Aoyagi, Kiyoshi

2018-01-01

Abstract To determine the prevalence of fear of falling and associated factors among Japanese community-dwelling older adults. Cross-sectional study between 2011 and 2013. Community in which residents voluntarily attended a health examination. We recruited 844 older adults (male, n = 350; female, n = 494) aged 60 to 92 years from among those who presented at the health examination. We assessed fear of falling, falls in the previous year, pain, comorbidity, and cataracts. Five times chair stand time was applied as an indicator of physical performance. The prevalence of fear of falling was 26.9% and 43.3% among the men and women, respectively. Men and women who feared falling were older (P < .01), had longer 5 times chair stand time (P < .01), and more falls in the previous year (P < .05), pain (P < .01), and comorbidity (P < .05). Multivariate logistic regression analysis identified advanced age (odds ratios [OR], 1.57; 95% confidence interval [CI], 1.03–2.39), falls in the previous year (OR, 2.44; 95%CI, 1.29–4.64), and pain (OR, 1.82; 95%CI, 1.03–3.22) in men, and advanced age (OR, 1.59; 95%CI, 1.13–2.24), longer 5 times chair stand times (OR, 1.28; 95%CI, 1.04–1.59), falls in the previous year (OR, 2.59; 95%CI, 1.54–4.34), and pain (OR, 1.65; 95%CI, 1.06–2.55) in women as being independently associated with fear of falling. The prevalence of fear of falling was similar to previous reports. Advanced age, falls in previous year, and pain were associated with fear of falling in men. A longer 5 times chair stand time was also associated with fear of falling among older adult women. Maintenance of physical function and pain management might be important for older adults with fear of falling. PMID:29369207

Association Between Daily Sleep Duration and Risk of Dementia and Mortality in a Japanese Community.

PubMed

Ohara, Tomoyuki; Honda, Takanori; Hata, Jun; Yoshida, Daigo; Mukai, Naoko; Hirakawa, Yoichiro; Shibata, Mao; Kishimoto, Hiro; Kitazono, Takanari; Kanba, Shigenobu; Ninomiya, Toshiharu

2018-06-06

To investigate the association between daily sleep duration and risk of dementia and death in a Japanese elderly population. Prospective cohort study. The Hisayama Study, Japan. Community-dwelling Japanese individuals aged 60 and older without dementia. Self-reported daily sleep duration was grouped into 5 categories (<5.0, 5.0-6.9, 7.0-7.9, 8.0-9.9, ≥10.0 hours). The association between daily sleep duration and risk of dementia and death was determined using a Cox proportional hazards models. During follow-up, 294 participants developed dementia, and 282 died. Age- and sex-adjusted incidence rates of dementia and all-cause mortality were significantly greater in subjects with daily sleep duration of less than 5.0 hours and 10.0 hours and more than in those with daily sleep duration of 5.0 to 6.9 hours. These associations remained unchanged after adjustment for potential confounding factors (<5.0 hours: hazard ratio (HR)=2.64, 95% confidence interval (CI)=1.38-5.05 for dementia; HR=2.29, 95% CI=1.15-4.56 for death; ≥10.0 hours: HR=2.23, 95% CI=1.42-3.49 for dementia; HR=1.67, 95% CI=1.07-2.60 for death). Similar U-shaped associations were observed for Alzheimer's disease and vascular dementia. With regard to the influence of hypnotic use on risk of dementia and death, subjects who used hypnotics and had any sleep duration had a risk of dementia that was 1.66 times as great and a risk of death that was 1.83 times as great as those who did not use hypnotics and had a daily sleep duration of 5.0 to 6.9 hours. Short and long daily sleep duration and hypnotic use are risk factors for dementia and death in Japanese elderly adults. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Albumin, Hemoglobin, and the Trajectory of Cognitive Function in Community-Dwelling Older Japanese: A 13-Year Longitudinal Study.

PubMed

Murayama, H; Shinkai, S; Nishi, M; Taniguchi, Y; Amano, H; Seino, S; Yokoyama, Y; Yoshida, H; Fujiwara, Y; Ito, H

2017-01-01

Cognitive function can substantially decline over a long period, and understanding the trajectory of cognitive function is important. However, little is known about the linkage between nutritional biomarkers and long-term cognitive change. We analyzed 13-year longitudinal data for older Japanese to examine the associations of serum albumin and hemoglobin levels with the trajectory of cognitive function. Longitudinal study. Community-based. A total of 1,744 community-dwelling adults aged 65 years or older who participated in annual health examinations in Kusatsu town, Gunma Prefecture, Japan, from 2002-2014. Cognitive function was assessed annually by the Mini-Mental State Examination (MMSE). Albumin and hemoglobin levels at baseline (the year when a respondent first participated in the health examination) were divided into quartiles. Hierarchical linear modeling was used to analyze intrapersonal and interpersonal differences in cognitive function. Participants' MMSE scores decreased at an accelerated rate over the 13-year period. Participants with the lowest baseline albumin level (below the first quartile line) showed a greater accelerated decline in MMSE scores over time, compared with those with the highest level (above the third quartile line). Moreover, MMSE scores in participants with a lower hemoglobin level and lower MMSE score at baseline tended to decline faster over time at an accelerated rate. These findings yield new insights about the complex and diverse roles of these nutritional biomarkers on the trajectory of cognitive function in old age.

Risk of stroke and heart failure attributable to atrial fibrillation in middle-aged and elderly people: Results from a five-year prospective cohort study of Japanese community dwellers.

PubMed

Ohsawa, Masaki; Okamura, Tomonori; Tanno, Kozo; Ogasawara, Kuniaki; Itai, Kazuyoshi; Yonekura, Yuki; Konishi, Kazuki; Omama, Shinichi; Miyamatsu, Naomi; Turin, Tanvir Chowdhury; Morino, Yoshihiro; Itoh, Tomonori; Onoda, Toshiyuki; Sakata, Kiyomi; Ishibashi, Yasuhiro; Makita, Shinji; Nakamura, Motoyuki; Tanaka, Fumitaka; Kuribayashi, Toru; Ohta, Mutsuko; Okayama, Akira

2017-08-01

The relative and absolute risks of stroke and heart failure attributable to atrial fibrillation (AF) have not been sufficiently examined. A prospective study of 23,731 community-dwelling Japanese individuals was conducted. Participants were divided into two groups based on the presence or absence of prevalent AF (n = 338 and n = 23,393, respectively). Excess events (EE) due to AF and relative risks (RRs) determined using the non-AF group as the reference for incident stroke and heart failure were estimated using Poisson regression stratified by age groups (middle-aged: 40-69 years old; elderly: 70 years of age or older) after adjustment for sex and age. There were 611 cases of stroke and 98 cases of heart failure during the observation period (131,088 person-years). AF contributed to a higher risk of stroke both in middle-aged individuals (EE 10.4 per 1000 person-years; RR 4.88; 95% confidence interval [CI], 2.88-8.29) and elderly individuals (EE 18.3 per 1000 person-years; RR 3.05; 95% CI, 2.05-4.54). AF also contributed to a higher risk of heart failure in middle-aged individuals (EE 3.7 per 1000 person-years; RR 8.18; 95% CI, 2.41-27.8) and elderly individuals (EE 15.4 per 1000 person-years; RR 7.82; 95% CI, 4.11-14.9). Results obtained from multivariate-adjusted analysis were similar (stroke: EE 8.9 per 1000 person-years; RR 4.40; 95% CI, 2.57-7.55 in middle-aged and EE 17.4 per 1000 person-years; RR 2.97; 95% CI, 1.99-4.43 in elderly individuals; heart failure: EE 3.1 per 1000 person-years; RR 7.22; 95% CI, 2.06-25.3 in middle-aged and EE 14.1 per 1000 person-years; RR 7.41; 95% CI, 3.86-14.2 in elderly individuals). AF increased the risk of stroke by the same magnitude as that reported previously in Western countries. AF increased the RR of heart failure more than that in Western populations. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

[Prevalence and characteristics of urinary incontinence in community-dwelling-elderly as determined by comprehensive health examination and interview for the prevention of geriatric syndrome and bed-ridden state].

PubMed

Yoshida, Yuko; Kim, Hunkyung; Iwasa, Hajime; Kwon, Jinhee; Sugiura, Miho; Furuna, Taketo; Yoshida, Hideyo; Suzuki, Takao

2007-01-01

We examined the prevalence and characteristics of urinary incontinence in community-dwelling elderly individuals. The participants were 1,783 individuals (768 men and 1,015 women) aged over 70 years who participated in a comprehensive health examination involving a medical examination and interview, plus physical performance tests. Differences in characteristics between individuals with and without urinary incontinence were examined, and multivariate logistic regression models were used to describe the characteristics associated with urinary incontinence. The prevalence of urinary incontinence was 13.4% in men and 23.3% in women. Urinary incontinence was significantly associated with a lower level of physical fitness. Multivariate logistic regression showed that urinary incontinence was significantly associated with a slower walking speed (Odds Ratio (OR) = 0.19, 95% Confidence Intervals (CI) 0.08-0.48) and lower serum albumin level (OR = 0.40, 95% CI 0.16-0.99) in men, and with a slower walking speed (OR = 0.29, 95% CI 0.15-0.56), a higher BMI (OR = 1.09, 95% CI 1.04-1.14), depression (OR = 3.06, 95% CI 1.40-6.69), and lack of physical activity (OR = 0.70, 95% CI 0.50-0.98) in women. The characteristics of urinary incontinence in this cohort of community-dwelling elderly individuals were a low level of physical fitness and poor nutritional state in men, and a low level of physical fitness, a tendency to be obese, a poor mental health state, and lack of physical activity in women.

Influence of xerostomia on oral health-related quality of life in the elderly: a 5-year longitudinal study.

PubMed

Enoki, Kaori; Matsuda, Ken-Ich; Ikebe, Kazunori; Murai, Shunsuke; Yoshida, Minoru; Maeda, Yoshinobu; Thomson, William Murray

2014-06-01

Xerostomia and tooth loss are major oral health problems in the elderly. The aim of this longitudinal study was to characterize the influence of xerostomia on oral health-related quality of life (OHRQoL) among elderly Japanese people. A total of 99 community-dwelling, independently living individuals aged 60 years and older were interviewed and underwent dental examination at baseline and at a 5-year follow-up. The Oral Health Impact Profile-14 and the Xerostomia Inventory were used to assess OHRQoL and xerostomia severity, respectively. Participants whose xerostomia worsened over the 5-year period had a significantly poorer follow-up OHRQoL. Linear regression models showed that tooth loss and worsening xerostomia were significant predictors of poorer follow-up OHRQoL. Tooth loss and worsening xerostomia result in poorer OHRQoL among older Japanese people. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparison of the effects of water- and land-based exercises on the physical function and quality of life in community-dwelling elderly people with history of falling: a single-blind, randomized controlled trial.

PubMed

Oh, SeJun; Lim, Jong-Min; Kim, Yushin; Kim, MinSeock; Song, WoonGang; Yoon, BumChul

2015-01-01

The purpose of this study was to identify the effects of water-based exercises on the physical functions and quality of life (QOL) in community-dwelling elderly people with history of falling. Participants were randomly assigned to the water-based exercise group (n=34) or land-based exercise groups (n=32). To identify the effects on physical functions, muscle strength, flexibility, and mobility were measured. QOL and fear of falling were evaluated using the Short Form 36-item questionnaire and the modified falls efficacy scale (M-FES). The measurements were performed before and after the 10-week training period. Within-group analysis indicated that hip abduction and adduction strength improved significantly in both groups (p=0.005; p=0.007). However, no statistically significant within-group differences were found in the back scratch test (p=0.766) and chair sit-and-reach test (p=0.870). QOL was significantly different in both groups (health transition: p=0.014, physical functioning: p<0.001, role physical: p<0.001, role emotional: p=0.002, bodily pain: p<0.001, vitality: p<0.001, and mental health: p<0.001). There was a significant difference in the M-FES in both groups (p=0.040). These results indicate that water-based exercises are beneficial to improve the QOL, as well as physical activities, of community-dwelling elderly compared with land-based exercise. Water-based exercises would be useful to improve physical and psychological health in the elderly people with history of falling. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Association Between Nutritional Status and Quality of Life in (Pre) Frail Community-Dwelling Older Persons.

PubMed

Luger, E; Haider, S; Kapan, A; Schindler, K; Lackinger, C; Dorner, T E

2016-01-01

BACKGROUND: For developed countries, healthy aging is one of the challenges and the number of healthy life years and especially the quality of life (QoL) are important. OBJECTIVE: This study aimed to assess the association between nutritional status and different domains of QoL in (pre)frail community-dwelling elders. DESIGN: Baseline data from persons, who participated in a 12-week nutritional and physical training intervention program, conducted from September 2013 - July 2015. Setting: (Pre)frail community-dwelling elders living in Vienna, Austria. PARTICIPANTS: A total of 83 older persons living at home, 12 men and 71 women (86%) aged 65 to 98 years. Measurements: Structured interviews were conducted at participants’ homes. Mini Nutritional Assessment® long-form (MNA®-LF) was used to investigate the nutritional status. The QoL domains were assessed with the World Health Organization Quality of Life questionnaires. Simple and multiple linear regression analyses were performed to evaluate the association between nutritional status and QoL domains, adjusted for possible confounders. RESULTS: 45% of the participants were at risk of malnutrition and 3% were malnourished. Compared to normal nourished people, persons who had an impaired nutritional status, significantly differed in the QoL domain ‘autonomy’ with mean (SD) scores of 50.0 (14.9) vs. 57.3 (13.7); p=0.022 and in the QoL domain ‘social participation’ with scores of 40.1 (13.6) vs. 47.0 (11.2); p=0.014, respectively. According to linear regression analyses, the MNA®-LF score was significantly associated with ‘overall QoL’ (β=0.26; p=0.016) and the QoL domains ‘physical health’ (β=0.23; p=0.036), ‘autonomy’ (β=0.27; p=0.015), and ‘social participation’ (β=0.28; p=0.013).CONCLUSIONS: There was a significant association between nutritional status and QoL in elderly (pre)frail community-dwelling people, in particular for the QoL domains ‘autonomy’ and �

Balance and ankle range of motion in community-dwelling women aged 64 to 87 years: a correlational study.

PubMed

Mecagni, C; Smith, J P; Roberts, K E; O'Sullivan, S B

2000-10-01

This study investigated the relationship between balance measures and ankle range of motion (ROM) in community-dwelling elderly women with no health problems. Identification of modifiable factors associated with balance may enable clinicians to design treatments to help reduce the risk of falls in elderly people. The sample consisted of 34 women between the ages of 64 and 87 years (mean=74.7, SD=6.0). Goniometry was used to determine bilateral ankle active-assistive range of motion (AAROM) and passive range of motion. Balance capabilities were measured with the Functional Reach Test (FRT) and the Tinetti Performance-Oriented Mobility Assessment (POMA). Balance data for the FRT, POMA balance subtest, POMA gait subtest, and POMA total score were correlated with ankle ROM using the Pearson product moment correlation coefficient (PCC). Correlations between ROM and balance scores were found, ranging from.29 to.63. The POMA gait subtest and FRT resulted in higher correlations with ROM than did the POMA balance subtest (left total AAROM PCC=.63,.51, and.31). Correlations using composite ankle ROM scores were higher than individual motions. The strongest correlation existed between bilateral, total ankle AAROM and the POMA gait subtest scores (PCC=. 63) Correlations exist between ankle ROM and balance in community-dwelling elderly women. Additional research is needed to determine whether treatment directed at increasing ankle ROM can improve balance.

Prevalence and correlates of dizziness in community-dwelling older people: a cross sectional population based study.

PubMed

de Moraes, Suzana Albuquerque; Soares, Wuber Jefferson de Souza; Ferriolli, Eduardo; Perracini, Monica Rodrigues

2013-01-04

Dizziness is a common complaint among older adults and has been linked to a wide range of health conditions, psychological and social characteristics in this population. However a profile of dizziness is still uncertain which hampers clinical decision-making. We therefore sought to explore the relationship between dizziness and a comprehensive range of demographic data, diseases, health and geriatric conditions, and geriatric syndromes in a representative sample of community-dwelling older people. This is a cross-sectional, population-based study derived from FIBRA (Network for the Study of Frailty in Brazilian Elderly Adults), with 391 elderly adults, both men and women, aged 65 years and older. Elderly participants living at home in an urban area were enrolled through a process of random cluster sampling of census regions. The outcome variable was the self-report of dizziness in the last year. Several feelings of dizziness were investigated including vertigo, spinning, light or heavy headedness, floating, fuzziness, giddiness and instability. A multivariate logistic regression analysis was conducted to estimate the adjusted odds ratios and build the probability model for dizziness. The complaint of dizziness was reported by 45% of elderly adults, from which 71.6% were women (p=0.004). The multivariate regression analysis revealed that dizziness is associated with depressive symptoms (OR = 2.08; 95% CI 1.29-3.35), perceived fatigue (OR = 1.93; 95% CI 1.21-3.10), recurring falls (OR = 2.01; 95% CI 1.11-3.62) and excessive drowsiness (OR = 1.91; 95% CI 1.11-3.29). The discrimination of the final model was AUC = 0.673 (95% CI 0.619-0.727) (p< 0.001). The prevalence of dizziness in community-dwelling elderly adults is substantial. It is associated with other common geriatric conditions usually neglected in elderly adults, such as fatigue and drowsiness, supporting its possible multifactorial manifestation. Our findings demonstrate the need to expand the design in

Evaluation of anthropometric parameters and physical fitness in elderly Japanese.

PubMed

Miyatake, Nobuyuki; Miyachi, Motohiko; Tabata, Izumi; Numata, Takeyuki

2012-01-01

We evaluated anthropometric parameters and physical fitness in elderly Japanese. A total of 2,106 elderly Japanese (749 men and 1,357 women), aged 60-79 years, were enrolled in a cross-sectional investigation study. Anthropometric parameters and physical fitness, i.e., muscle strength and flexibility, were measured. Of the 2,106 subjects, 569 subjects (302 men and 267 women) were further evaluated for aerobic exercise level, using the ventilatory threshold (VT). Muscle strength in subjects in their 70s was significantly lower than that in subjects in their 60s in both sexes. Two hundred and twenty-nine men (30.6%) and 540 women (39.8%) were taking no medications. In men, anthropometric parameters were significantly lower and muscle strength, flexibility, and work rate at VT were significantly higher in subjects without medications than these values in subjects with medications. In women, body weight, body mass index (BMI), and abdominal circumference were significantly lower, and muscle strength was significantly higher in subjects without medications than these values in subjects with medications. This mean value may provide a useful database for evaluating anthropometric parameters and physical fitness in elderly Japanese subjects.

The prevalence and correlates of elder abuse and neglect in a rural community of Negeri Sembilan state: baseline findings from The Malaysian Elder Mistreatment Project (MAESTRO), a population-based survey.

PubMed

Sooryanarayana, Rajini; Choo, Wan Yuen; Hairi, Noran N; Chinna, Karuthan; Hairi, Farizah; Ali, Zainudin Mohamad; Ahmad, Sharifah Nor; Razak, Inayah Abdul; Aziz, Suriyati Abdul; Ramli, Rohaya; Mohamad, Rosmala; Mohammad, Zaiton Lal; Peramalah, Devi; Ahmad, Noor Ani; Aris, Tahir; Bulgiba, Awang

2017-09-01

As Malaysia is fast becoming an ageing nation, the health, safety and welfare of elders are major societal concerns. Elder abuse is a phenomenon recognised abroad but less so locally. This paper presents the baseline findings from the Malaysian Elder Mistreatment Project (MAESTRO) study, the first community-based study on elder abuse in Malaysia. Cross-sectional study, analysing baseline findings of a cohort of older adults. Kuala Pilah district, Negeri Sembilan state, Malaysia. To determine the prevalence of elder abuse among community dwelling older adults and its associated factors. A total of 2112 community dwelling older adults aged 60 years and above were recruited employing a multistage sampling using the national census. Elder abuse, measured using a validated instrument derived from previous literature and the modified Conflict Tactic Scales, similar to the Irish national prevalence survey on elder abuse with modification to local context. Factors associated with abuse and profiles of respondents were also examined. The prevalence of overall abuse was reported to be 4.5% in the past 12 months. Psychological abuse was most common, followed by financial, physical, neglect and sexual abuse. Two or more occurrences of abusive acts were common, while clustering of various types of abuse was experienced by one-third of abused elders. Being male (adjusted OR (aOR) 2.15, 95% CI 1.23 to 3.78), being at risk of social isolation (aOR 1.96, 95% CI 1.07 to 3.58), a prior history of abuse (aOR 3.28, 95% CI 1.40 to 7.68) and depressive symptomatology (aOR 7.83, 95% CI 2.88 to 21.27) were independently associated with overall abuse. Elder abuse occurred among one in every 20 elders. The findings on elder abuse indicate the need to enhance elder protection in Malaysia, with both screening of and interventions for elder abuse. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use

The prevalence and correlates of elder abuse and neglect in a rural community of Negeri Sembilan state: baseline findings from The Malaysian Elder Mistreatment Project (MAESTRO), a population-based survey

PubMed Central

Choo, Wan Yuen; Hairi, Noran N; Chinna, Karuthan; Hairi, Farizah; Ali, Zainudin Mohamad; Ahmad, Sharifah Nor; Razak, Inayah Abdul; Aziz, Suriyati Abdul; Ramli, Rohaya; Mohamad, Rosmala; Mohammad, Zaiton Lal; Peramalah, Devi; Ahmad, Noor Ani; Aris, Tahir; Bulgiba, Awang

2017-01-01

Background As Malaysia is fast becoming an ageing nation, the health, safety and welfare of elders are major societal concerns. Elder abuse is a phenomenon recognised abroad but less so locally. This paper presents the baseline findings from the Malaysian Elder Mistreatment Project (MAESTRO) study, the first community-based study on elder abuse in Malaysia. Design Cross-sectional study, analysing baseline findings of a cohort of older adults. Setting Kuala Pilah district, Negeri Sembilan state, Malaysia. Objectives To determine the prevalence of elder abuse among community dwelling older adults and its associated factors. Participants A total of 2112 community dwelling older adults aged 60 years and above were recruited employing a multistage sampling using the national census. Primary and secondary outcome measures Elder abuse, measured using a validated instrument derived from previous literature and the modified Conflict Tactic Scales, similar to the Irish national prevalence survey on elder abuse with modification to local context. Factors associated with abuse and profiles of respondents were also examined. Results The prevalence of overall abuse was reported to be 4.5% in the past 12 months. Psychological abuse was most common, followed by financial, physical, neglect and sexual abuse. Two or more occurrences of abusive acts were common, while clustering of various types of abuse was experienced by one-third of abused elders. Being male (adjusted OR (aOR) 2.15, 95% CI 1.23 to 3.78), being at risk of social isolation (aOR 1.96, 95% CI 1.07 to 3.58), a prior history of abuse (aOR 3.28, 95% CI 1.40 to 7.68) and depressive symptomatology (aOR 7.83, 95% CI 2.88 to 21.27) were independently associated with overall abuse. Conclusion Elder abuse occurred among one in every 20 elders. The findings on elder abuse indicate the need to enhance elder protection in Malaysia, with both screening of and interventions for elder abuse. PMID:28864485

Association of hemoglobin A1c and glycated albumin with carotid atherosclerosis in community-dwelling Japanese subjects: the Hisayama Study.

PubMed

Mukai, Naoko; Ninomiya, Toshiharu; Hata, Jun; Hirakawa, Yoichiro; Ikeda, Fumie; Fukuhara, Masayo; Hotta, Taeko; Koga, Masafumi; Nakamura, Udai; Kang, Dongchon; Kitazono, Takanari; Kiyohara, Yutaka

2015-06-24

It is not clear which glucose measure is more useful in the assessment of atherosclerosis. We investigated the associations of hemoglobin A1c (HbA1c), glycated albumin (GA), 1,5-anhydroglucitol (1,5-AG), fasting plasma glucose (FPG), and 2-hour postload glucose (PG) with carotid intima-media thickness (IMT) in community-dwelling Japanese subjects. A total of 2702 subjects aged 40-79 years underwent a 75-g oral glucose tolerance test and measurements of HbA1c, GA, 1,5-AG, and carotid IMT by ultrasonography in 2007-2008. Carotid wall thickening was defined as a maximum IMT of >1.0 mm. The crude and multivariable-adjusted linear and logistic regression models were used to analyze cross-sectional associations between levels of glycemic measures and carotid IMT. The crude average of the maximum IMT increased significantly with rising quartiles of HbA1c, GA, FPG, and 2-hour PG levels in subjects with and without glucose intolerance (GI), while no clear association was observed for 1,5-AG. After adjustment for other confounding factors, positive trends for HbA1c, GA, and FPG (all p for trend < 0.05), but not 2-hour PG (p = 0.07) remained robust in subjects with GI, but no such associations were found in those without GI. When estimating multivariable-adjusted β values for the associations of 1 SD change in glycemic measures with the maximum IMT in subjects with GI, the magnitude of the influence of HbA1c (β = 0.021), GA (β = 0.024), and FPG (β = 0.024) was larger than that of 2-hour PG (β = 0.014) and 1,5-AG (β = 0.003). The multivariable-adjusted odds ratios for the presence of carotid wall thickening increased significantly with elevating HbA1c, GA, and FPG levels only in subjects with GI (all p for trend < 0.001). Among subjects with GI, the area under the receiver operating characteristic curve significantly increased by adding HbA1c (p = 0.04) or GA (p = 0.04), but not 1,5-AG, FPG, or 2-hour PG, to the model including other cardiovascular risk factors. In

Association between gait abnormality and malnutrition in a community-dwelling elderly population.

PubMed

Misu, Shogo; Asai, Tsuyoshi; Doi, Takehiko; Sawa, Ryuichi; Ueda, Yuya; Saito, Takashi; Nakamura, Ryo; Murata, Shunsuke; Sugimoto, Taiki; Yamada, Minoru; Ono, Rei

2017-08-01

Malnutrition is common in older adults, and contributes to the risk of falls and functional impairment. Gait performance also contributes to falls and functional impairment; however, the association between malnutrition and gait performance remains unclear. The purpose of the present study was to investigate the association between malnutrition risk and gait performance. The study participants included 204 community-dwelling older adults with a mean age of 73.4 ± 4.3 years. Nutritional status was evaluated using the short version of the Mini-Nutritional Assessment. A score of 11 points was used as the cut-off, and the participants were categorized into two groups: ≤11, malnutrition-risk group; and ≥12, well-nourished group. Gait performance was assessed by gait speed and walking smoothness. Walking smoothness was quantified by harmonic ratios (HR), which were derived from vertical (VT), mediolateral (ML) and anteroposterior trunk accelerations, recorded during over-ground walking. Skeletal muscle mass index, handgrip strength and physical functions were also measured. HR in the ML direction was significantly lower in the malnutrition-risk group than the well-nourished group (P = 0.002); however, no differences between the two groups were observed in gait speed or HR in the VT and anteroposterior directions. The relationship between malnutrition and HR in the ML direction was independent of skeletal muscle mass index, handgrip strength, physical function, gait speed, and other confounders (P < 0.05). In community-dwelling older adults, malnutrition is related to decreased walking smoothness in the ML direction, suggesting that nutritional status affects lateral trunk control during walking. Geriatr Gerontol Int 2017; 17: 1155-1160. © 2016 Japan Geriatrics Society.

Relationship between swallowing functions and health-related quality of life among community-dwelling dependent older individuals.

PubMed

Morisaki, Naoko

2017-10-01

This study analyzed the association between swallowing function levels and health-related quality of life (QOL) among community-dwelling dependent older persons in Japan. A cross-sectional survey of a purposive sample of community-dwelling dependent older individuals in Japan was conducted. Two swallowing functions (tongue pressure and lip-closure force), the risk of dysphagia, and health-related QOL (SF-8) were surveyed. There were 86 (38.2%) men and 139 (61.8%) women, with a mean age of 81.6 ± 7.4 years. The activities of daily living-20 evaluation yielded a total score of 46.39 ± 10.18. The elderly participants had decreased swallowing functions. The risk-of-dysphagia score demonstrated a significant negative correlation with respect to the SF-8 subcategory scores. Moreover, the multiple regression analyses indicated that three variables exhibited significant negative differences: general health perceptions, mental health (SF-8 subarea), and activities of daily living. An increasing risk of dysphagia can lead to a deterioration in the health-related QOL among community-dwelling dependent older individuals. This implies that homecare interventions that address the deterioration of swallowing and the risk of dysphagia could be in high demand in the future. © 2017 Japan Academy of Nursing Science.

Oral health conditions and frailty in Mexican community-dwelling elderly: a cross sectional analysis

PubMed Central

2012-01-01

Background Oral health is an important component of general well-being for the elderly. Oral health-related problems include loss of teeth, nonfunctional removable dental prostheses, lesions of the oral mucosa, periodontitis, and root caries. They affect food selection, speaking ability, mastication, social relations, and quality of life. Frailty is a geriatric syndrome that confers vulnerability to negative health-related outcomes. The association between oral health and frailty has not been explored thoroughly. This study sought to identify associations between the presence of some oral health conditions, and frailty status among Mexican community-dwelling elderly. Methods Analysis of baseline data of the Mexican Study of Nutritional and Psychosocial Markers of Frailty, a cohort study carried out in a representative sample of people aged 70 and older residing in one district of Mexico City. Frailty was defined as the presence of three or more of the following five components: weight loss, exhaustion, slowness, weakness, and low physical activity. Oral health variables included self-perception of oral health compared with others of the same age; utilization of dental services during the last year, number of teeth, dental condition (edentate, partially edentate, or completely dentate), utilization and functionality of removable partial or complete dentures, severe periodontitis, self-reported chewing problems and xerostomia. Covariates included were gender, age, years of education, cognitive performance, smoking status, recent falls, hospitalization, number of drugs, and comorbidity. The association between frailty and dental variables was determined performing a multivariate logistic regression analysis. Final models were adjusted by socio-demographic and health factors Results Of the 838 participants examined, 699 had the information needed to establish the criteria for diagnosis of frailty. Those who had a higher probability of being frail included women (OR�

Depression and subjective economy among elderly people in Asian communities: Japan, Taiwan, and Korea.

PubMed

Imai, Hissei; Chen, Wen-ling; Fukutomi, Eriko; Okumiya, Kiyohito; Wada, Taizo; Sakamoto, Ryota; Fujisawa, Michiko; Ishimoto, Yasuko; Kimura, Yumi; Chang, Chia-Ming; Matsubayashi, Kozo

2015-01-01

The objective of this study is to investigate the cross-cultural relationship between depressive state and subjective economic status, as well as subjective quality of life (QOL) and activities of daily living (ADL) among elderly people in communities in Japan, Taiwan, and Korea. We studied 595 subjects aged 65 years or older in three Asian communities (261 subjects in T town in Japan, 164 in D town in Taiwan, and 170 in H town in Korea). The Geriatric Depression Scale-15, a self-rating questionnaire assessing ADL, subjective QOL, social situations, and past and current medical status, was used. Depression of the elderly was associated with dependence in basic ADL, subjective QOL, and subjective sense of low economic status. After adjusting for the effects of age, sex, and basic ADL, subjective sense of low economic status was closely associated with depression in community-living elderly people in all three communities in Asia. In conclusion, absolute and objective economic status is an important contributing factor to depressive state or psychosocial deterioration, however, we should pay more attention to the roles of perception of low economic status in determining depressive state in community-dwelling elderly people. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Salivary flow rate and risk of malnutrition - a study among dentate, community-dwelling older people.

PubMed

Syrjälä, Anna-Maija H; Pussinen, Päivi I; Komulainen, Kaija; Nykänen, Irma; Knuuttila, Matti; Ruoppi, Piia; Hartikainen, Sirpa; Sulkava, Raimo; Ylöstalo, Pekka

2013-12-01

To analyse the relation between unstimulated and stimulated salivary secretion and the risk of malnutrition among home-dwelling elderly people. Saliva has an important role in eating. Despite this, there are only a few studies on the role of salivary secretion in the development of malnutrition among elderly people. The study population consisted of 157 subjects aged 75 or older. This was a part of GeMS study carried out in Kuopio, in eastern Finland. The data used in this study were collected by means of interviews and geriatric and oral clinical examinations. The risk of malnutrition was measured using the Mini Nutritional Assessment Short-Form. Logistic regression models were used to estimate odds ratios (OR) and their 95% Confidence Intervals (CI). Subjects with a low unstimulated salivary flow rate (<0.1 ml/min) or stimulated salivary flow rate (<1.0 ml/min) had no statistically significant increase in risk of malnutrition, OR: 1.3, CI: 0.5-3.9, OR: 1.5, CI: 0.5-4.2, respectively, when compared with those with a normal unstimulated and stimulated salivary flow rate. Our results do not support the concept that low salivary secretion is an important risk factor for malnutrition among community-dwelling elders. © 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

Correlate of self-care and self-neglect among community-dwelling older adults.

PubMed

Mardan, Homa; Hamid, TengkuAizan; Redzuan, Ma'rof; Ibrahim, Rahimah

2014-02-01

The prevalence of self-neglect among the elderly is expected to rise with a rapid increase in the growth of the older population. However, self-neglect in the elderly and the factors related to it are not fully understood due to the limited research in the area, lack of consensus in the definition of the concept, and limited instrumentation. The purpose of this study was to investigate the relationship between selected socio-demographic factors on self-care and self-neglect among older persons living in the community. A cross-sectional survey design with cluster sampling was adopted for the study. Data were gathered from 201 older persons aged 60 years and over in the state of Selangor, Malaysia, through face-to-face interviews in their homes with a team of trained enumerators. A new instrument was developed to measure self-neglect. The internal consistency of the new instrument showed a reliability of 0.90. A significant bivariate relationship was noted between self-care and self-neglect. The socio-demographic factors were also reported between self-care and self-neglect. The new instrument of elder self-neglect (ESN) could be used to measure self-neglect in a community dwelling. The need to increase the self-care skills and the capacity of self-care among older adults is crucial in order to reduce self-neglect and enhance their well-being.

Prevalence of fibromyalgia and chronic widespread pain in community-dwelling elderly subjects living in São Paulo, Brazil.

PubMed

Santos, Adriana M Barsante; Burti, Juliana Schulze; Lopes, Jaqueline B; Scazufca, Márcia; Marques, Amélia Pasqual; Pereira, Rosa Maria R

2010-11-01

To estimate the prevalence of fibromyalgia (FM) and chronic widespread pain (CWP) in community-dwelling elderly individuals living in São Paulo, to assess the spectrum of problems related to these diseases using the Fibromyalgia Impact Questionnaire (FIQ) and to correlate the FIQ with the number of tender points and with pain threshold. Our sample consisted of 361 individuals (64% women, 36% men, mean age of 73.3±5.7 years). Individuals were classified into four groups: FM (according to American College of Rheumatology criteria), CWP, regional pain (RP) and no pain (NP). Pain characteristics and dolorimetry for 18 tender points and the FIQ were assessed. The prevalence of FM was 5.5% [95% confidence interval (CI)=5.4-5.7], and the prevalence of CWP was 14.1% (95% CI: 10.5-17.7%). The frequency of RP was 52.6% and the prevalence of NP was 27.7%. FIQ scores were higher in people with FM (44.5), followed by CWP (31.4), RP (18.1) and NP (5.5) (p<0.001). There was a positive correlation between the domains of the FIQ and the number of tender points (p<0.05), and a negative correlation between FIQ score and pain threshold (p<0.05). In our elderly subjects, the prevalence of FM was slightly higher compared to previously reported studies, and CWP was around 14%. The spectrum of problems related to chronic pain was more severe in FM followed by CWP, strongly suggesting that these conditions should be diagnosed and adequately treated in older individuals. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Association of subjective memory complaints with subsequent cognitive decline in community-dwelling elderly individuals with baseline cognitive impairment.

PubMed

Schofield, P W; Marder, K; Dooneief, G; Jacobs, D M; Sano, M; Stern, Y

1997-05-01

The validity of subjective memory complaints has been questioned by clinical studies that have shown little relationship between memory complaints and objective memory performance. These studies often have been cross-sectional in design, have excluded individuals with cognitive impairment, or have lacked a comparison group. The authors conducted a study that attempted to avoid these limitations. Memory complaints of 364 nondemented, community-dwelling elderly individuals were recorded as present or absent at the baseline evaluation. After 1 year, 169 subjects were reevaluated. Standardized neurologic and neuropsychological evaluations were used at each assessment to classify subjects as normal or cognitively impaired. At baseline, 31% of the normal subjects and 47% of those with cognitive impairment had memory complaints. Subjects with memory complaints had higher Hamilton depression scale scores than subjects without memory complaints but equivalent scores on a measure of total recall. At follow-up, multivariate analyses showed that subjects with baseline memory complaints had significantly greater decline in memory and cognition than subjects without memory complaints. Secondary analyses showed this effect to be confined to subjects with baseline cognitive impairment. Memory complaints may lack validity in subjects with normal cognition, but in nondemented individuals with cognitive impairment, memory complaints may predict subsequent cognitive decline.

Development of the Japanese 15D instrument of health-related quality of life: verification of reliability and validity among elderly people.

PubMed

Okamoto, Nozomi; Hisashige, Akinori; Tanaka, Yuu; Kurumatani, Norio

2013-01-01

The 15D is a self-administered questionnaire for assessment of health-related quality of life, which contains 15 questions with 5 response options each. This study was conducted to evaluate the reliability and validity of the Japanese 15D. The subjects were 430 community-dwelling elderly people. Each item of the 15D was scored on a 5-point Likert scale, with level 1 being the best, score 1. Reliability was assessed by determination of the internal consistency and test-retest reliability. Criterion-based validity was assessed using the Japanese version of the Nottingham Health Profile (NHP) and Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG index). Acceptability was assessed by inquiring about the time required to complete the questionnaire and the burden felt in responding to it. The answers of 423 individuals who responded to all items were analyzed. The median time required to complete the questionnaire was 5.0 minutes, and the proportion of subjects who indicated that the questionnaire was easy to complete was 98.3%. The Cronbach's alpha coefficients for all 15 items in the 2 surveys were 0.793 and 0.792, respectively. The intraclass correlation coefficients for the 15 items ranged from 0.44 to 0.72. In the relationship between the 15D and the NHP, the correlation coefficients between the corresponding domains were higher than those between non-corresponding domains. The prevalence of disability in higher-level functional capacity was higher in the "level 2 to 5" group than in the "level 1" group. The Japanese version of the 15D showed sufficient internal consistency and moderate repeatability. Because of the short time required to complete the Japanese 15D and the significant relationships between the scores on the 15D and the NHP, and between the 15D and higher-level functional capacity, the acceptability and validity of the Japanese 15D were considered to be sufficient.

Association of anorexia with sarcopenia in a community-dwelling elderly population: results from the ilSIRENTE study.

PubMed

Landi, Francesco; Liperoti, Rosa; Russo, Andrea; Giovannini, Silvia; Tosato, Matteo; Barillaro, Christian; Capoluongo, Ettore; Bernabei, Roberto; Onder, Graziano

2013-04-01

There is increasing evidence that anorexia of aging can cause physical and mental impairment. The aim of the present study was to evaluate the relationship between anorexia and sarcopenia in elderly persons aged 80 years or older. Data are from the baseline evaluation of 354 subjects enrolled in the ilSIRENTE study. The ilSIRENTE study is a prospective cohort study performed in the mountain community living in the Sirente geographic area (L'Aquila, Abruzzo) in Central Italy. We defined anorexia as the presence of loss of appetite and/or lower food intake. According to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria, diagnosis of sarcopenia required the documentation of low muscle mass plus the documentation of either low muscle strength or low physical performance. The relationship between anorexia and sarcopenia was estimated by deriving odds ratios from the multiple logistic regression models considering sarcopenia as the dependent variable. Nearly 21 % of the study sample showed symptoms of anorexia. Using the EWGSOP-suggested algorithm, 103 subjects (29.1 %) with sarcopenia were identified. Thirty-four (46.6 %) participants were affected by sarcopenia among subjects with anorexia compared to 69 subjects [24.6 %] without anorexia (p < 0.001). After adjusting for potential confounders including age, gender, functional and cognitive impairment, physical activity, urinary incontinence, comorbidity, congestive heart failure, COPD, depression, anti-cholinergic drugs, and TNF-α plasmatic levels, participants with anorexia had a higher risk of sarcopenia compared with non-anorexic subjects (HR 1.88, 95 % CI 1.01-3.51). Anorexia is common among community-dwelling older subjects in Italy. Our results suggest that among old-old subjects, anorexia is independently associated with sarcopenia.

Gender differences of social interactions and their effects on subjective well-being among Japanese elders.

PubMed

Okabayashi, Hideki; Hougham, Gavin W

2014-01-01

Gender differences of social interactions and their effects on subjective well-being among Japanese elders over three years were examined. Repeated measurements of 498 elders over a three-year survey interval were obtained from a baseline mail survey and two- and three-year follow-up surveys. Outcomes were analyzed using Hierarchical Linear Modeling. Male elders were more likely to have a spouse and work at paid jobs, while female elders were likely to have more frequent contacts with their child/children and more interactions with friends. As the elders aged over three years, life satisfaction decreased, while depression did not show any significant overall trend. There were no beneficial effects of social interactions on change in well-being, although social participation, interaction with friends, and conversation with spouse were beneficially related to baseline levels of both depressive tendency and life satisfaction. Among female elders only, the number of children had beneficial effects on life satisfaction. There are modest gender differences of the impact of social interactions on the well-being of Japanese elders, and the number of children seems to be more important as potential sources of support for female rather than male elders. Spousal conversation and non-obligatory social interaction such as unpaid social activities and friendship seem to be important for both male and female elders in Japan. These findings suggest that social relations among Japanese elders may be moving away from more gender dependent patterns seen in the past.

[Influence of comprehensive intervention composed of nutrition and exercise on the development of exercise habits and self-perceived health among community-dwelling elderly individuals].

PubMed

Takai, Itsushi

2013-01-01

The purpose of this study was to investigate the effects of comprehensive intervention on the development of exercise habits and self-perceived health among community-dwelling elderly individuals. A total of 44 elderly individuals (mean age: 71.1±5.0SD) who had provided consent to participate in the study were randomly allocated to either an intervention (n=23) or control group (n=21). The intervention group participated in a comprehensive intervention program (including nutrition classes, group exercise and enjoying meals with other community members). The following factors were measured: age, the frequency of going out, a history of falls, the frequency of exercise, the duration of exercise, self-efficacy for exercise, the stage model of change, self-perceived health before, immediately after and one month after the intervention. The attendance rate in the intervention group was over 90%. The intervention group exhibited significant improvements in the frequency of exercise (p=0.001), duration of exercise (p=0.02) and self-efficacy for exercise (p=0.012) compared with the control group following the intervention program. On follow-up, the intervention group demonstrated significant improvements in the frequency of exercise (p=0.027) and self-efficacy for exercise (p=0.043) compared with the control group. These findings suggested that a comprehensive intervention program composed of nutrition and exercise can improve the developing exercise habits and self-perceived health. Self-perceived health was improved by several factors, which appeears to have contributed to the results. These factors include sharing and exchanging ideas and having the opportunity to enjoy meals with other community members. Further activities promoting such interactions and exercise habits are therefore necessary.

Differential effects of power rehabilitation on physical performance and higher-level functional capacity among community-dwelling older adults with a slight degree of frailty.

PubMed

Ota, Atsuhiko; Yasuda, Nobufumi; Horikawa, Shunichi; Fujimura, Takashi; Ohara, Hiroshi

2007-03-01

Evidence is still insufficient regarding the effects of Power Rehabilitation (PR) on physical performance and higher-level functional capacity of community-dwelling frail elderly people. This nonrandomized controlled interventional trial consisted of 46 community-dwelling elderly individuals with light levels of long-term care needs. They were allocated to the intervention (I-group, n = 24) and control (C-group, n = 22) groups. Of them, 32 persons (17 in the I-group; 15 in the C-group) (median age, 77 years; sex, 28% male) completed the study. The I-group subjects underwent PR twice a week for 12 weeks. The outcomes were physical performance (muscle strength, balance, flexibility, and mobility) and higher-level functional capacity as evaluated by the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) and the level of long-term care need as certified by the public long-term care insurance. The I-group demonstrated a significant improvement in the measured value of the timed up-and-go test (median change, a decrease of 4.4 seconds versus a decrease of 0.2 seconds, p = 0.033) and the timed 10-meter walk (a decrease of 3.0 seconds versus an increase of 0.2 seconds, p = 0.007) in comparison with the C-group. No significant change was observed in the TMIG-IC scores or in the level of long-term care need in the I-group. PR improved mobility of community-dwelling frail elderly people; however, such improvement did not translate into higher-level functional capacity. Our findings demonstrate the difficulty in transferring the positive effects associated with PR into an improvement in higher-level functional capacity.

Correlate of self-care and self-neglect among community-dwelling older adults

PubMed Central

Mardan, Homa; Hamid, TengkuAizan; Redzuan, Ma’rof; Ibrahim, Rahimah

2014-01-01

Background: The prevalence of self-neglect among the elderly is expected to rise with a rapid increase in the growth of the older population. However, self-neglect in the elderly and the factors related to it are not fully understood due to the limited research in the area, lack of consensus in the definition of the concept, and limited instrumentation. The purpose of this study was to investigate the relationship between selected socio-demographic factors on self-care and self-neglect among older persons living in the community. Materials and Methods: A cross-sectional survey design with cluster sampling was adopted for the study. Data were gathered from 201 older persons aged 60 years and over in the state of Selangor, Malaysia, through face-to-face interviews in their homes with a team of trained enumerators. A new instrument was developed to measure self-neglect. Results: The internal consistency of the new instrument showed a reliability of 0.90. A significant bivariate relationship was noted between self-care and self-neglect. The socio-demographic factors were also reported between self-care and self-neglect. Conclusions: The new instrument of elder self-neglect (ESN) could be used to measure self-neglect in a community dwelling. The need to increase the self-care skills and the capacity of self-care among older adults is crucial in order to reduce self-neglect and enhance their well-being. PMID:25949256

Association Between Social Participation and Instrumental Activities of Daily Living Among Community-Dwelling Older Adults

PubMed Central

Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

2016-01-01

Background Population-based data examining the relationship between social participation (SP) and instrumental activities of daily living (IADL) are scarce. This study examined the cross-sectional relationship between SP and IADL in community-dwelling elderly persons. Methods Self-administered questionnaires were mailed to 23 710 residents aged ≥65 years in Nara, Japan (response rate: 74.2%). Data from 14 956 respondents (6935 males and 8021 females) without dependency in basic activities of daily living (ADL) were analyzed. The number, type, and frequency of participation in social groups (SGs) were used to measure SP. SGs included volunteer groups, sports groups, hobby groups, senior citizens’ clubs, neighborhood community associations, and cultural groups. IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression models stratified by gender were used. Results After adjustment for putative confounding factors, including demographics, health status, life-style habits, ADL, depression, cognitive function, social networks, social support, and social roles, participation in various SGs among both genders was inversely associated with poor IADL, showing a significant dose-response relationship between an increasing number of SGs and a lower proportion of those with poor IADL (P for trend <0.001). A significant inverse association between frequent participation and poor IADL was observed for all types of SGs among females, whereas the association was limited to sports groups and senior citizens’ clubs among males. Conclusions Our results show that participation in a variety of SGs is associated with independent IADL among the community-dwelling elderly, regardless of gender. However, the beneficial effects of frequent participation on IADL may be stronger for females than for males. PMID:27180933

Association Between Social Participation and Instrumental Activities of Daily Living Among Community-Dwelling Older Adults.

PubMed

Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

2016-10-05

Population-based data examining the relationship between social participation (SP) and instrumental activities of daily living (IADL) are scarce. This study examined the cross-sectional relationship between SP and IADL in community-dwelling elderly persons. Self-administered questionnaires were mailed to 23 710 residents aged ≥65 years in Nara, Japan (response rate: 74.2%). Data from 14 956 respondents (6935 males and 8021 females) without dependency in basic activities of daily living (ADL) were analyzed. The number, type, and frequency of participation in social groups (SGs) were used to measure SP. SGs included volunteer groups, sports groups, hobby groups, senior citizens' clubs, neighborhood community associations, and cultural groups. IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression models stratified by gender were used. After adjustment for putative confounding factors, including demographics, health status, life-style habits, ADL, depression, cognitive function, social networks, social support, and social roles, participation in various SGs among both genders was inversely associated with poor IADL, showing a significant dose-response relationship between an increasing number of SGs and a lower proportion of those with poor IADL (P for trend <0.001). A significant inverse association between frequent participation and poor IADL was observed for all types of SGs among females, whereas the association was limited to sports groups and senior citizens' clubs among males. Our results show that participation in a variety of SGs is associated with independent IADL among the community-dwelling elderly, regardless of gender. However, the beneficial effects of frequent participation on IADL may be stronger for females than for males.

A New Approach to Improve Cognition, Muscle Strength, and Postural Balance in Community-Dwelling Elderly with a 3-D Virtual Reality Kayak Program.

PubMed

Park, Junhyuck; Yim, JongEun

2016-01-01

Aging is usually accompanied with deterioration of physical abilities, such as muscular strength, sensory sensitivity, and functional capacity. Recently, intervention methods with virtual reality have been introduced, providing an enjoyable therapy for elderly. The aim of this study was to investigate whether a 3-D virtual reality kayak program could improve the cognitive function, muscle strength, and balance of community-dwelling elderly. Importantly, kayaking involves most of the upper body musculature and needs the balance control. Seventy-two participants were randomly allocated into the kayak program group (n = 36) and the control group (n = 36). The two groups were well matched with respect to general characteristics at baseline. The participants in both groups performed a conventional exercise program for 30 min, and then the 3-D virtual reality kayak program was performed in the kayak program group for 20 min, two times a week for 6 weeks. Cognitive function was measured using the Montreal Cognitive Assessment. Muscle strength was measured using the arm curl and handgrip strength tests. Standing and sitting balance was measured using the Good Balance system. The post-test was performed in the same manner as the pre-test; the overall outcomes such as cognitive function (p < 0.05), muscle strength (p < 0.05), and balance (standing and sitting balance, p < 0.05) were significantly improved in kayak program group compared to the control group. We propose that the 3-D virtual reality kayak program is a promising intervention method for improving the cognitive function, muscle strength, and balance of elderly.

QOL models constructed for the community-dwelling elderly with ikigai (purpose in life) as a composition factor, and the effect of habitual exercise.

PubMed

Demura, Shinichi; Kobayashi, Hidetsugu; Kitabayashi, Tamotsu

2005-09-01

The purpose of this study was to construct QOL models for the elderly that included ikigai as a composition factor and to clarify differences in two kinds of models, one constructed for the elderly with habitual exercise and the other for those without it. The subjects were 1,566 healthy community-dwelling independent people aged 60 years or more (752 males, 814 females). First, the ratio of subjects with ikigai was calculated. The ratios of subjects with different kinds of objects of ikigai were also calculated. Next, structural equation models (SEM) were constructed on the basis of social, physical, and mental QOL and ikigai. Fits of the models were evaluated. To examine whether the presence or absence of habitual exercise caused any difference in the QOL model, subjects were divided into 4 groups according to whether they were male or female and whether they had or did not have an exercise habit. Multi-population group simultaneous analysis was then performed among the four groups. More than 85% of the subjects had objects of ikigai. Ikigai is an important factor for comprehending the QOL of the elderly. It was possible to construct QOL models for the elderly with ikigai as a composition factor. The effect of physical QOL on mental QOL was negligible in females irrespective of whether they had an exercise habit. The effect of social QOL on mental QOL was profound in aged females with an exercise habit. The effect of the living situation on mental QOL was profound in aged females without an exercise habit. The effect of mental QOL on ikigai was more marked in subjects without an exercise habit than in those with an exercise habit.

Benefits of home-based rocking-chair exercise for physical performance in community-dwelling elderly women: a randomized controlled trial.

PubMed

Niemelä, Kristiina; Väänänen, Ilkka; Leinonen, Raija; Laukkanen, Pia

2011-08-01

Home-based exercise is a viable alternative for older adults with difficulties in exercise opportunities outside the home. The aim of this study was to investigate the benefits of home-based rocking-chair training, and its effects on the physical performance of elderly women. Community- dwelling women (n=51) aged 73-87 years were randomly assigned to the rocking-chair group (RCG, n=26) or control group (CG, n=25) by drawing lots. Baseline and outcome measurements were hand grip strength, maximal isometric knee extension, maximal walking speed over 10 meters, rising from a chair five times, and the Berg Balance Scale (BBS). The RCG carried out a six-week rocking-chair training program at home, involving ten sessions per week, twice a day for 15 minutes per session, and ten different movements. The CG continued their usual daily lives. After three months, the RCG responded to a mail questionnaire. After the intervention, the RCG improved and the CG declined. The data showed significant interactions of group by time in the BBS score (p=0.001), maximal knee extension strength (p=0.006) and maximal walking speed (p=0.046), which indicates that the change between groups during the follow-up period was significant. Adherence to the training protocol was high (96%). After three months, the exercise program had become a regular home exercise habit for 88.5% of the subjects. Results indicate that home-based elderly women benefit from this easily implemented rocking-chair exercise program. The subjects became motivated to participate in training and continued the exercises. This is a promising alternative exercise method for maintaining physical activity and leads to improvements in physical performance.

Comparison of Carotid-Femoral and Brachial-Ankle Pulse-Wave Velocity in Association With Target Organ Damage in the Community-Dwelling Elderly Chinese: The Northern Shanghai Study.

PubMed

Lu, Yuyan; Zhu, Mengyun; Bai, Bin; Chi, Chen; Yu, Shikai; Teliewubai, Jiadela; Xu, Henry; Wang, Kai; Xiong, Jing; Zhou, Yiwu; Ji, Hongwei; Fan, Ximin; Yu, Xuejing; Li, Jue; Blacher, Jacques; Zhang, Yi; Xu, Yawei

2017-02-20

Carotid-femoral pulse-wave velocity (cf-PWV) and brachial-ankle PWV (ba-PWV) are the 2 most frequently applied PWV measurements. However, little is known about the comparison of hypertensive target organ damage (TOD) with cf-PWV and ba-PWV. A total of 1599 community-dwelling elderly subjects (age >65 years) in northern Shanghai were recruited from June 2014 to August 2015. Both cf-PWV and ba-PWV were measured using SphygmoCor and VP1000 systems, respectively. Within the framework of comprehensive cardiovascular examinations, risk factors were assessed, and asymptomatic TOD, including left ventricular mass index, peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity (E/Ea), carotid intima-media thickness, arterial plaque, creatinine clearance rate, and urinary albumin-creatinine ratio were all evaluated. Both PWVs were significantly associated with male sex, age, waist/hip circumference, fasting plasma glucose, and systolic blood pressure, and ba-PWV was also significantly related to body mass index. Both PWVs were significantly correlated with most TOD. When cf-PWV and ba-PWV were both or separately put into the stepwise linear regression model together with cardiovascular risk factors and treatment, only cf-PWV, but not ba-PWV, was significantly associated with carotid intima-media thickness and creatinine clearance rate ( P <0.05). When cf-PWV and ba-PWV were both or separately put into the same full-mode model after adjustment for confounders, only cf-PWV, but not ba-PWV, showed significant association with carotid intima-media thickness and creatinine clearance rate ( P <0.05). Similar results were observed in logistic regression analysis. Taken together, in the community-dwelling elderly Chinese, cf-PWV seems to be more closely associated with hypertensive TOD, especially vascular and renal TOD, as compared with ba-PWV. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02368938. © 2017 The Authors. Published on behalf of

eGFRs from Asian-modified CKD-EPI and Chinese-modified CKD-EPI equations were associated better with hypertensive target organ damage in the community-dwelling elderly Chinese: the Northern Shanghai Study.

PubMed

Ji, Hongwei; Zhang, Han; Xiong, Jing; Yu, Shikai; Chi, Chen; Bai, Bin; Li, Jue; Blacher, Jacques; Zhang, Yi; Xu, Yawei

2017-01-01

With increasing age, estimated glomerular filtration rate (eGFR) decline is a frequent manifestation and is strongly associated with other preclinical target organ damage (TOD). In literature, many equations exist in assessing patients' eGFR. However, these equations were mainly derived and validated in the population from Western countries, which equation should be used for risk stratification in the Chinese population remains unclear, as well as their comparison. Considering that TOD is a good marker for risk stratification in the elderly, in this analysis, we aimed to investigate whether the recent eGFR equations derived from Asian and Chinese are better associated with preclinical TOD than the other equations in elderly Chinese. A total of 1,599 community-dwelling elderly participants (age >65 years) in northern Shanghai were prospectively recruited from June 2014 to August 2015. Conventional cardiovascular risk factors were assessed, and hypertensive TOD including left ventricular mass index (LVMI), carotid-femoral pulse wave velocity (cf-PWV), carotid intima-media thickness (IMT), ankle-brachial index (ABI) and urine albumin to creatinine ratio (UACR) was evaluated for each participant. Participant's eGFR was calculated from the Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Chinese-abbreviated MDRD (c-aMDRD), Asian-modified CKD-EPI (aCKD-EPI) equation and Chinese-modified CKD-EPI (cCKD-EPI) equation. In multivariate regression analysis, only eGFRs from aCKD-EPI were significantly and inversely associated with carotid IMT ( P =0.005). In multivariate logistic models, decreased eGFR from all the equations were significantly associated with lower ABI ( P <0.001), microalbuminuria ( P =0.02 to P <0.001) and increased cf-PWV ( P <0.001). Only decreased eGFRs from aCKD-EPI and cCKD-EPI equations were significantly associated with increased IMT (both crude P <0.05). In the receiver operator characteristic

Assessment of mental competency in community-dwelling elderly.

PubMed

Schmand, B; Gouwenberg, B; Smit, J H; Jonker, C

1999-01-01

We studied the utility of a "vignette method" to assess mental competency for decision making on medical treatment and research participation. A vignette is a description of an imaginary situation in which the subject is asked to decide on a proposed treatment or on participation in research. His or her understanding of the situation and the quality of the reasoning underlying that choice are tested by a short series of questions. Subjects were participants in the Amsterdam Study of the Elderly (AMSTEL), a population-based study on cognitive decline and dementia. The sample consisted of elderly people (70-90 years), who were cognitively intact (n = 176) or had a dementia syndrome (n = 64; mostly Alzheimer disease). Dementia was diagnosed using the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX) schedule. Two vignettes were used as competency assessment instruments. The answers to the vignette questions were summed to form a competency score. The reliability (internal consistency) of this score was 0.82 for both vignettes combined. After dichotomization into competent/incompetent (cutoff at the fifth centile of the control group), the agreement between the vignette method and a physician's judgment of competency was poor (kappa = 0.36) in the demented group. There was no agreement whatsoever when subjects with "minimal dementia" (n = 14) were left out of this analysis (kappa = 0.04). As expected, mean competency scores declined with increasing dementia severity. A multiple regression analysis showed that mental competency as measured by the vignette method was determined mainly by recent memory, expressive language, and abstract thinking. In the control group the competency score was only slightly related to education (r = 0.12) and verbal intelligence (r = 0.27). We conclude that the vignette method is a reliable and valid method for the assessment of mental competency in elderly people with cognitive decline. The vignette method is preferred

Gender differences of social interactions and their effects on subjective well-being among Japanese elders

PubMed Central

2013-01-01

Objectives Gender differences of social interactions and their effects on subjective well-being among Japanese elders over three years were examined. Methods Repeated measurements of 498 elders over a three-year survey interval were obtained from a baseline mail survey and two- and three-year follow-up surveys. Outcomes were analyzed using Hierarchical Linear Modeling. Results Male elders were more likely to have a spouse and work at paid jobs, while female elders were likely to have more frequent contacts with their child/children and more interactions with friends. As the elders aged over three years, life satisfaction decreased, while depression did not show any significant overall trend. There were no beneficial effects of social interactions on change in well-being, although social participation, interaction with friends, and conversation with spouse were beneficially related to baseline levels of both depressive tendency and life satisfaction. Among female elders only, the number of children had beneficial effects on life satisfaction. Conclusions There are modest gender differences of the impact of social interactions on the well-being of Japanese elders, and the number of children seems to be more important as potential sources of support for female rather than male elders. Spousal conversation and non-obligatory social interaction such as unpaid social activities and friendship seem to be important for both male and female elders in Japan. These findings suggest that social relations among Japanese elders may be moving away from more gender dependent patterns seen in the past. PMID:23614456

Safety and efficacy of ipragliflozin in elderly versus non-elderly Japanese patients with type 2 diabetes mellitus: a subgroup analysis of the STELLA-LONG TERM study.

PubMed

Maegawa, Hiroshi; Tobe, Kazuyuki; Tabuchi, Hiromi; Nakamura, Ichiro; Uno, Satoshi

2018-03-01

This subgroup analysis of STELLA-LONG TERM interim data explored the long-term safety and efficacy of ipragliflozin in non-elderly vs. elderly Japanese type 2 diabetes mellitus (T2DM) patients. STELLA-LONG TERM is an ongoing 3-year prospective surveillance study of Japanese T2DM patients receiving ipragliflozin 50 mg once daily. In this subgroup analysis, patient characteristics, laboratory variables, and adverse drug reactions (ADRs) were compared between non-elderly (<65 years) and elderly (≥65 years) patients. Non-elderly patients had significantly higher body mass index and low-density lipoprotein cholesterol than elderly patients (P < 0.001). The proportion of patients with hemoglobin A1c (HbA1c) <8.0% was significantly higher among elderly patients (P < 0.001). HbA1c, fasting plasma glucose, and body weight significantly decreased from baseline to 3 and 12 months in both groups (all P < 0.05 vs. baseline). The ADR incidence was 10.83% vs. 10.42% in non-elderly and elderly patients. The incidence of skin complications was 0.98% vs. 1.65% and that of renal disorder was 0.47% vs. 0.95% in non-elderly and elderly patients (both P = 0.003). Ipragliflozin was effective in non-elderly and elderly Japanese T2DM patients in a real-world clinical setting. The incidence of renal disorder and skin complications was significantly higher in elderly vs. non-elderly patients.

Medication-related risk factors associated with health-related quality of life among community-dwelling elderly in China.

PubMed

Zhang, Sha; Meng, Long; Qiu, Feng; Yang, Jia-Dan; Sun, Shusen

2018-01-01

Previous studies have demonstrated that medication adherence has an impact on health-related quality of life (HRQoL). However, other medication-related factors that may influence HRQoL have not been extensively studied, especially factors based on the Medication-Risk Questionnaire (MRQ), and such studies are mostly done in Western countries. Our objective was to explore risk factors associated with HRQoL among community-dwelling elderly with chronic diseases in mainland China, especially the medication-related risk factors regarding MRQ. The study was conducted in a community health service center through surveys to eligible patients. The main outcomes of HRQoL were assessed by the EuroQol-5D (EQ-5D) scale and EQ-visual analog scale (EQ-VAS). Medication-related risk factors according to MRQ associated with HRQoL were identified using a multiple linear regression. A total of 311 patients were analyzed, averaging 71.19±5.33 years, and 68.8% were female. The mean EQ-5D index was 0.72±0.09, and the mean EQ-VAS score was 71.37±11.97. The most prevalent problem was pain/discomfort, and 90.0% believed that they could take care of themselves without any problems. Sex, age, educational level, frailty, function status, and certain medication-related factors regarding MRQ were found to be significant factors impacting the HRQoL. A multivariate analysis showed that MRQ factors of polypharmacy, multimorbidity, feeling difficultly with taking medicines as prescribed, and taking medicines with narrow therapeutic index had negative impacts on the quality of life. Patient's internal characteristics and medication-related risk factors according to MRQ were associated with quality of life. The results of the MRQ is an indicator of quality of life that can identify patients who need interventions.

Relationship between home care service use and changes in the care needs level of Japanese elderly.

PubMed

Kato, Gohei; Tamiya, Nanako; Kashiwagi, Masayo; Sato, Mikiya; Takahashi, Hideto

2009-12-21

With the introduction of long-term care insurance (LTCI) in Japan, more home care services are available for the community-dwelling elderly. To deliver effective home care services, it is important to know the effects of service use. In this study, as the first step to determine this, we sought to describe different home service use in the sustained/improved group and deteriorated group in their care needs levels, and to report the relationship between the use of home care services and changes in care needs levels. The participants included 624 of a total of 1,474 users of LTCI services in one city in Japan. Home care service users were stratified into a 'lower care needs level subgroup' and a 'higher care needs level subgroup' based on the baseline care needs level. Simple statistical comparison and multiple logistic regression analyses in which the change in care needs level was set as a dependent variable were performed. Gender, age, and baseline care needs level were designated as control variables. Home based services were treated as independent variables. In this study, home care services consisted of home help, home bathing services, a visiting nurse, home rehabilitation, nursing home daycare, health daycare, loan of medical devices, respite stay in a nursing home, respite stay in a health care facility, respite stay in a sanatorium-type medical care facility, and medical management by a physician. In the lower care needs level subgroup, age (OR = 1.04, CI, 1.01-1.08), use of respite stay in a nursing home (OR = 2.55; CI, 1.43-4.56), and the number of types of long-term care services (OR = 1.33; CI, 1.02-1.74) used during an 11 month period were significantly related to a deterioration of the user's care needs level. In the higher care needs level subgroup, use of medical management by a physician (OR = 6.99; CI, 1.42-41.25) was significantly related to a deterioration of the user's care needs level. There were no home based services significantly related to

Characteristics of indoor radon and its progeny in a Japanese dwelling while using air appliances.

PubMed

Pornnumpa, C; Tokonami, S; Sorimachi, A; Kranrod, C

2015-11-01

Characteristics of radon and its progeny were investigated in different air conditions by turning four types of indoor air appliances on and off in a two-story concrete Japanese dwelling. The four appliances were air conditioner, air cleaner, gas heater and cooker hood. The measurements were done using two devices: (1) a Si-based semiconductor detector for continuous measurement of indoor radon concentration and (2) a ZnS(Ag) scintillation counting system for equilibrium-equivalent radon concentration. Throughout the entire experiment, the cooker hood was the most effective in decreasing indoor radon concentration over a long period of time and the less effective was the air conditioner, while the air cleaner and gas heater did not affect the concentration of radon. However, the results measured in each air condition will differ according to the lifestyles and activities of the inhabitants. In this study, indoor radon and its progeny in a Japanese dwelling will be characterised by the different air conditions. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Chronic Pain and Attention in Older Community-Dwelling Adults.

PubMed

van der Leeuw, Guusje; Leveille, Suzanne G; Dong, Zhiyong; Shi, Ling; Habtemariam, Daniel; Milberg, William; Hausdorff, Jeffrey M; Grande, Laura; Gagnon, Peggy; McLean, Robert R; Bean, Jonathan F

2018-06-06

To examine the cross-sectional relationship between chronic pain and complex attention in a population of community-living older adults. Prospective cross-sectional cohort study. Population-based Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston Study II. Individuals aged 71 to 101 (N=354). Chronic pain was measured using the pain severity and interference subscales of the Brief Pain Inventory. Four subscales of the Test of Everyday Attention were used to measure domains of attention switching and selective, sustained, and divided attention. Before and after multivariable adjustment, pain severity was associated with poorer scores on measures of selective and sustained attention. Pain interference scores also were significantly inversely associated with selective attention. Chronic pain is associated with poorer performance in selective and sustained attention in community-dwelling older adults. Further research is needed to determine whether effective pain management could lead to better attentional performance in older adults. Older adults who live with chronic pain, often undertreated, are potentially at risk of cognitive difficulties and related functional consequences. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Predictive Cutoff Values of the Five-Times Sit-to-Stand Test and the Timed "Up & Go" Test for Disability Incidence in Older People Dwelling in the Community.

PubMed

Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Tsutsumimoto, Kota; Nakakubo, Sho; Hotta, Ryo; Suzuki, Takao

2017-04-01

Lower extremity functioning is important for maintaining activity in elderly people. Optimal cutoff points for standard measurements of lower extremity functioning would help identify elderly people who are not disabled but have a high risk of developing disability. The purposes of this study were: (1) to determine the optimal cutoff points of the Five-Times Sit-to-Stand Test and the Timed "Up & Go" Test for predicting the development of disability and (2) to examine the impact of poor performance on both tests on the prediction of the risk of disability in elderly people dwelling in the community. This was a prospective cohort study. A population of 4,335 elderly people dwelling in the community (mean age = 71.7 years; 51.6% women) participated in baseline assessments. Participants were monitored for 2 years for the development of disability. During the 2-year follow-up period, 161 participants (3.7%) developed disability. The optimal cutoff points of the Five-Times Sit-to-Stand Test and the Timed "Up & Go" Test for predicting the development of disability were greater than or equal to 10 seconds and greater than or equal to 9 seconds, respectively. Participants with poor performance on the Five-Times Sit-to-Stand Test (hazard ratio = 1.88; 95% CI = 1.11-3.20), the Timed "Up & Go" Test (hazard ratio = 2.24; 95% CI = 1.42-3.53), or both tests (hazard ratio = 2.78; 95% CI = 1.78-4.33) at the baseline assessment had a significantly higher risk of developing disability than participants who had better lower extremity functioning. All participants had good initial functioning and participated in assessments on their own. Causes of disability were not assessed. Assessments of lower extremity functioning with the Five-Times Sit-to-Stand Test and the Timed "Up & Go" Test, especially poor performance on both tests, were good predictors of future disability in elderly people dwelling in the community. © 2017 American Physical Therapy Association

Prevalence of substance abuse and socio-economic differences in substance abuse in an Australian community-dwelling elderly sample

PubMed Central

Li, Wendy; Caltabiano, Nerina

2017-01-01

A sample of 324 55–90-year-old Australian adults participated in a survey on elderly substance abuse using the Clinical Assessment Scales for the Elderly. Overall, males had a higher prevalence rate of substance abuse than females. Significant differences in substance abuse mean scores were found for gender, age, income, community involvement, and retirement. The findings also reveal that being a female, involved in community groups, being a retiree, and being a non-baby boomer are protective factors of substance abuse. Being an upper medium income earner appears to be a risk factor of substance abuse. PMID:28567302

Development of a community commitment scale with cross-sectional survey validation for preventing social isolation in older Japanese people.

PubMed

Kono, Ayumi; Tadaka, Etsuko; Kanaya, Yukiko; Dai, Yuka; Itoi, Waka; Imamatsu, Yuki

2012-10-24

Elderly social isolation could be prevented by facilitating communication or mutual helping at the neighborhood level. The helping of elderly neighbors by local volunteers may relate to their community commitment (CC), but ways to measure CC have not been identified. The aim of the present study was to develop a Community Commitment Scale (CCS) to measure psychological sense of belonging and socializing in the community among local volunteers, for research in prevention of elderly social isolation. We also tested the CCS in a general population of the elderly. A pilot test of 266 Japanese urban residents was conducted to examine face validity for 24 identified items, of which 12 items were selected for the CCS, based on a 4-point Likert-type scale. The CCS was developed via self-report questionnaires to 859 local volunteers in two suburban cities and to 3484 randomly sampled general residents aged 55 years or older living in one of the cities. To assess concurrent validity, data were collected using the Brief Sense of Community Scale (Peterson; 2008) and two types of single questions on self-efficacy for helping elderly neighbors. Item analysis and factor analysis identified 8 items, which were classified between two datasets under the domains of "belonging" and "socializing" in the local volunteers and the general residents. Cronbach's alpha (which conveyed the internal consistency of the CCS) was 0.75 in local volunteers and 0.78 in general residents. The correlation coefficients between the scores of the CCS and BSCS were 0.54 for local volunteers and 0.62 for general residents. ANOVA comparing the CCS between the confidence levels of the two types of single question of self-efficacy on helping elderly neighbors showed a strong relationship in the volunteers and residents. These results demonstrate acceptable internal consistency and concurrent validity for the CCS, with the two dimensions "belonging" and "socializing", among the local volunteers and general

Association of Cognitive Function and Risk for Elder Abuse in a Community-Dwelling Population

PubMed Central

Dong, XinQi; Simon, Melissa; Rajan, Kumar; Evans, Denis A.

2011-01-01

Aim This study aimed to examine the cross-sectional association between cognitive function and elder abuse. Methods The Chicago Health and Aging Project (CHAP) is a population-based study conducted in a geographically defined community (n = 8,932). We identified 238 CHAP participants who had elder abuse reported to a social services agency. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), the Symbol Digit Modalities Test (perceptual speed), and both immediate and delayed recall of the East Boston Memory Test (episodic memory). An index of global cognitive function scores was derived by averaging the z-scores of all tests. Logistic regression models were used to assess the association of cognitive function domains and risk of elder abuse. Results After adjusting for confounders, lowest tertiles of global cognition (odd's ratio, OR 4.18, 95% confidence interval, 95% CI 2.44–7.15), MMSE (OR 2.97, 95% CI 1.93–4.57), episodic memory (OR 2.27, 95% CI 1.49–3.43) and perceptual speed (OR 2.37, 95% CI 1.51–3.73) were associated with increased risk of elder abuse. The lowest levels of global cognitive function were associated with an increased risk of physical abuse (OR 3.56, 95% CI 1.08–11.67), emotional abuse (OR 3.02, 95% CI 1.41–6.44), caregiver neglect (OR 6.24, 95% CI 2.68–14.54), and financial exploitation (OR 3.71, 95% CI 1.88–7.32). Conclusion Lower levels of global cognitive function, MMSE, episodic memory and perceptual speed are associated with an increased risk of elder abuse. PMID:22095098

Is there a relationship between complaints of impaired balance and postural control disorder in community-dwelling elderly women? A cross-sectional study with the use of posturography

PubMed Central

Tanaka, Erika H.; Santos, Paulo F.; Reis, Júlia G.; Rodrigues, Natalia C.; Moraes, Renato; Abreu, Daniela C. C.

2015-01-01

Background: Risk of falls increases as age advances. Complaints of impaired balance are very common in the elderly age group. Objectives: The objective of this study was to investigate whether the subjective perception of impaired balance was associated with deficits in postural control (objective analysis) in elderly community-dwelling women. Method: Static posturography was used in two groups: elderly women with (WC group) and without (NC group) complaints of impaired balance. The area, mean sway amplitude and mean speed of the center of pressure (COP) in the anterior-posterior (AP) and medial-lateral (ML) directions were analyzed in three stances: single-leg stance, double-leg stance and tandem stance, with eyes open or closed on two different surfaces: stable (firm) and unstable (foam). A digital chronometer was activated to measure the time limit (Tlimit) in the single-leg stance. Kruskal-Wallis tests followed by Mann-Whitney tests, Friedman analyses followed by post hoc Wilcoxon tests and Bonferroni corrections, and Spearman statistical tests were used in the data analysis. Differences of p<0.05 were considered statistically significant. Results: The results of posturography variables revealed no differences between groups. The timed single-leg stance test revealed a shorter Tlimit in the left single-leg stance (p=0.01) in WC group compared to NC group. A negative correlation between posturography variables and Tlimit was detected. Conclusions: Posturography did not show any differences between the groups; however, the timed single-leg stance allowed the authors to observe differences in postural control performance between elderly women with and those without complaints of impaired balance. PMID:26083602

Is there a relationship between complaints of impaired balance and postural control disorder in community-dwelling elderly women? A cross-sectional study with the use of posturography.

PubMed

Tanaka, Erika H; Santos, Paulo F; Reis, Júlia G; Rodrigues, Natalia C; Moraes, Renato; Abreu, Daniela C C

2015-01-01

Risk of falls increases as age advances. Complaints of impaired balance are very common in the elderly age group. The objective of this study was to investigate whether the subjective perception of impaired balance was associated with deficits in postural control (objective analysis) in elderly community-dwelling women. Static posturography was used in two groups: elderly women with (WC group) and without (NC group) complaints of impaired balance. The area, mean sway amplitude and mean speed of the center of pressure (COP) in the anterior-posterior (AP) and medial-lateral (ML) directions were analyzed in three stances: single-leg stance, double-leg stance and tandem stance, with eyes open or closed on two different surfaces: stable (firm) and unstable (foam). A digital chronometer was activated to measure the time limit (Tlimit) in the single-leg stance. Kruskal-Wallis tests followed by Mann-Whitney tests, Friedman analyses followed by post hoc Wilcoxon tests and Bonferroni corrections, and Spearman statistical tests were used in the data analysis. Differences of p<0.05 were considered statistically significant. The results of posturography variables revealed no differences between groups. The timed single-leg stance test revealed a shorter Tlimit in the left single-leg stance (p=0.01) in WC group compared to NC group. A negative correlation between posturography variables and Tlimit was detected. Posturography did not show any differences between the groups; however, the timed single-leg stance allowed the authors to observe differences in postural control performance between elderly women with and those without complaints of impaired balance.

Outcomes of Community-Based Screening for Depression and Suicide Prevention among Japanese Elders

ERIC Educational Resources Information Center

Oyama, Hirofumi; Fujita, Motoi; Goto, Masahiro; Shibuya, Hiroshi; Sakashita, Tomoe

2006-01-01

Purpose: In this study we evaluate outcomes of a community-based program to prevent suicide among elderly individuals aged 65 and older. Design and Methods: We used a quasi-experimental design with intervention and referent municipalities. The program included a 7-year implementation of depression screening with follow-up by general practitioners…

Physical activity level and fall risk among community-dwelling older adults.

PubMed

Low, Sok Teng; Balaraman, Thirumalaya

2017-07-01

[Purpose] To find the physical activity level and fall risk among the community-dwelling Malaysian older adults and determine the correlation between them. [Subjects and Methods] A cross-sectional study was conducted in which, the physical activity level was evaluated using the Rapid Assessment of Physical Activity questionnaire and fall risk with Fall Risk Assessment Tool. Subjects recruited were 132 community-dwelling Malaysian older adults using the convenience sampling method. [Results] The majority of the participants were under the category of under-active regular light-activities and most of them reported low fall risk. The statistical analysis using Fisher's exact test did not show a significant correlation between physical activity level and fall risk. [Conclusion] The majority of community-dwelling Malaysian older adults are performing some form of physical activity and in low fall risk category. But this study did not find any significant correlation between physical activity level and fall risk among community-dwelling older adults in Malaysia.

Association between objectively measured sleep quality and obesity in community-dwelling adults aged 80 years or older: a cross-sectional study.

PubMed

Kim, Miji

2015-02-01

The purpose of this study was to examine the association between objective measures of sleep quality and obesity in older community-dwelling people. This cross-sectional study included 189 community-dwelling adults aged ≥ 80 yr (83.4 ± 2.5 yr [age range, 80-95 yr]). Participants wore an accelerometer (ActiGraph GT3X+) on their non-dominant wrist 24 hr per day for 7 consecutive nights. Sleep parameters measured included total sleep time, sleep efficiency, and wake after sleep onset (WASO) during the night. Associations between sleep parameters and obesity were investigated by using multivariate logistic regression analysis. In multivariate models, those with sleep efficiency lower than 85% had a 2.85-fold increased odds of obesity, compared with those with sleep efficiency of 85% or higher. Similarly, those with WASO of ≥ 60 min (compared with < 60 min) had a 3.13-fold increased odds of obesity. However, there were no significant associations between total sleep time or self-reported napping duration and obesity. We found that poor sleep quality was an independent risk factor for obesity in community-dwelling Japanese adults aged ≥ 80 yr, even after controlling for potential confounding factors, including daily physical activity.

[SCREENING OF NUTRITIONAL STATUS AMONG ELDERLY PEOPLE AT FAMILY MEDICINE].

PubMed

Račić, M; Ivković, N; Kusmuk, S

2015-11-01

The prevalence of malnutrition in elderly is high. Malnutrition or risk of malnutrition can be detected by use of nutritional screening or assessment tools. This systematic review aimed to identify tools that would be reliable, valid, sensitive and specific for nutritional status screening in patients older than 65 at family medicine. The review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were retrieved using MEDLINE (via Ovid), PubMed and Cochrane Library electronic databases and by manual searching of relevant articles listed in reference list of key publications. The electronic databases were searched using defined key words adapted to each database and using MESH terms. Manual revision of reviews and original articles was performed using Electronic Journals Library. Included studies involved development and validation of screening tools in the community-dwelling elderly population. The tools, subjected to validity and reliability testing for use in the community-dwelling elderly population were Mini Nutritional Assessment (MNA), Mini Nutritional Assessment-Short Form (MNA-SF), Nutrition Screening Initiative (NSI), which includes DETERMINE list, Level I and II Screen, Seniors in the Community: Risk Evaluation for Eating, and Nutrition (SCREEN I and SCREEN II), Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), and Malaysian and South African tool. MNA and MNA-SF appear to have highest reliability and validity for screening of community-dwelling elderly, while the reliability and validity of SCREEN II are good. The authors conclude that whilst several tools have been developed, most have not undergone extensive testing to demonstrate their ability to identify nutritional risk. MNA and MNA-SF have the highest reliability and validity for screening of nutritional status in the community-dwelling elderly, and the reliability and validity of SCREEN II are satisfactory. These

Elder abuse.

PubMed

Kurrle, Susan

2004-10-01

Elder abuse is a common and yet often unrecognised problem in our community. With up to 5% of the community dwelling older population being victims of abuse, the general practitioner has a pivotal role in identifying this abuse. This article provides an outline of the definition of elder abuse, describes the types of abuse seen and the reasons for occurrence of abuse. It summarises the role of the GP in the identification and management of abuse and provides guidance on intervention strategies. Case studies are used to illustrate the issues discussed. Elder abuse is defined as any pattern of behaviour which causes physical, psychological, financial or social harm to an older person. The role of the GP in identifying abuse is critical. The vast majority of older people visit their GP at least once a year, and the GP often has a long standing relationship with their patient and the patient's family. They are therefore ideally placed to identify elder abuse.

Five-year all-cause mortality rates across five categories of substantiated elder abuse occurring in the community.

PubMed

Burnett, Jason; Jackson, Shelly L; Sinha, Arup K; Aschenbrenner, Andrew R; Murphy, Kathleen Pace; Xia, Rui; Diamond, Pamela M

2016-01-01

Elder abuse increases the likelihood of early mortality, but little is known regarding which types of abuse may be resulting in the greatest mortality risk. This study included N = 1,670 cases of substantiated elder abuse and estimated the 5-year all-cause mortality for five types of elder abuse (caregiver neglect, physical abuse, emotional abuse, financial exploitation, and polyvictimization). Statistically significant differences in 5-year mortality risks were found between abuse types and across gender. Caregiver neglect and financial exploitation had the lowest survival rates, underscoring the value of considering the long-term consequences associated with different forms of abuse. Likewise, mortality differences between genders and abuse types indicate the need to consider this interaction in elder abuse case investigations and responses. Further mortality studies are needed in this population to better understand these patterns and implications for public health and clinical management of community-dwelling elder abuse victims.

Depression, quality of life (QoL) and will to live of community-dwelling postmenopausal women in three Asian countries: Korea, China and Japan.

PubMed

Ina, Koichiro; Hayashi, Toshio; Nomura, Hideki; Ishitsuka, Asako; Hirai, Hisako; Iguchi, Akihisa

2011-01-01

The purpose of this study was to examine the prevalence of screening-detected depression and the association of depression with QoL in community-dwelling postmenopausal women living in three Asian countries. We examined self-reported questionnaires and conducted the study. A total of 698 community-dwelling postmenopausal women living in three Asian countries participated in this study. The mean age was 59.4±6.6 years (±SD) Depressive symptoms were assessed using a 15-item geriatric depression scale (GDS-15). Using the cut-off of 5/6 for the GDS-15, the percentages of subjects with depression were 39.0% of the Korean subjects, 29.2% of the Chinese subjects, and 33.9% of the Japanese subjects. For the assessment of QoL, we used the EQ-5D of the EuroQoL Group. The following five dimensions were assessed: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The proportions of subjects reporting problems for each dimension were examined. Subjects with depression had significantly lower levels of some dimensions of QoL than those without depression in all three countries. In all three countries, 29.2-39.0% of community-dwelling postmenopausal women had screening-detected depression, which was significantly associated with a lower level of some dimensions of QoL. These results suggest that clinicians should pay more attention to depression in community-dwelling postmenopausal women. Copyright © 2010. Published by Elsevier Ireland Ltd.

Association between vitamin K intake from fermented soybeans, natto, and bone mineral density in elderly Japanese men: the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study.

PubMed

Fujita, Y; Iki, M; Tamaki, J; Kouda, K; Yura, A; Kadowaki, E; Sato, Y; Moon, J-S; Tomioka, K; Okamoto, N; Kurumatani, N

2012-02-01

A cross-sectional analysis of 1,662 community dwelling elderly Japanese men suggested that habitual natto intake was significantly associated with higher bone mineral density (BMD). When adjustment was made for undercarboxylated osteocalcin levels, this association was insignificant, showing the natto-bone association to be primarily mediated by vitamin K. Low vitamin K intake is associated with an increased risk of hip fracture, but reports have been inconsistent on its effect on BMD. Our first aim was to examine the association between BMD and intake of fermented soybeans, natto, which contain vitamin K1 (20 μg/pack) and K2 (380 μg/pack). Our second aim was to examine the association between undercarboxylated osteocalcin (ucOC), a biomarker of vitamin K intake, and BMD to evaluate the role of vitamin K in this association. Of the Japanese men aged ≥65 years who participated in the baseline survey of the Fujiwara-kyo Osteoporosis Risk in Men study, 1,662 men without diseases or medications known to affect bone metabolism were examined for associations between self-reported natto intake or serum ucOC levels with lumbar spine or hip BMD. The subjects with greater intake of natto showed significantly lower level of serum ucOC. Analysis after adjustment for confounding variables showed an association of greater intake of natto with both significantly higher BMD and lower risk of low BMD (T-score < -1 SD) at the total hip and femoral neck. This association became insignificant after further adjustment for ucOC level. Habitual intake of natto was associated with a beneficial effect on bone health in elderly men, and this association is primarily due to vitamin K content of natto, although the lack of information on dietary nutrient intake, including vitamin K1 and K2, prevented us from further examining the association.

Community structure of grassland ground-dwelling arthropods along increasing soil salinities.

PubMed

Pan, Chengchen; Feng, Qi; Liu, Jiliang; Li, Yulin; Li, Yuqiang; Yu, Xiaoya

2018-03-01

Ground-dwelling arthropod communities are influenced by numerous biotic and abiotic factors. Little is known, however, about the relative importance of vegetation structure and abiotic environmental factors on the patterns of ground-dwelling arthropod community across a wide range of soil salinities. Here, a field survey was conducted to assess the driving forces controlling ground-dwelling arthropod community in the salinized grasslands in the Hexi Corridor, Gansu Province, China. The data were analyzed by variance partitioning with canonical correspondence analysis (CCA). We found that vegetation structure and edaphic factors were at least of similar importance to the pattern of the whole ground-dwelling arthropod community. However, when all collected ground-dwelling arthropods were categorized into three trophic guilds (predators, herbivores, and decomposers), as these groups use different food sources, their populations were controlled by different driving forces. Predators and decomposers were mainly determined by biotic factors such as vegetation cover and aboveground plant biomass and herbivores by plant density and vegetation cover. Abiotic factors were also major determinants for the variation occurring in these guilds, with predators strongly affected by soil electrical conductivity (EC) and the content of fine particles (silt + clay, CS), herbivores by soil N:P, EC, and CS, and decomposers by soil EC and organic matter content (SOM). Since plant cover, density, and aboveground biomass can indicate resource availability, which are mainly constrained by soil N:P, EC, CS, and SOM, we consider that the ground-dwelling arthropod community in the salinized grasslands was mainly influenced by resource availability.

The relationship between health and cognitive functioning in a sample of elderly people in the community.

PubMed

Christensen, H; Jorm, A F; Henderson, A S; Mackinnon, A J; Korten, A E; Scott, L R

1994-05-01

The association between health status and cognitive performance was examined in a sample of 708 community dwelling elderly people aged 70 years or over. Cognitive performance declined significantly across the age groups 70-74, 75-79, 80-84, and 85-89 years on the Mini-Mental State Examination and on measures of fluid intelligence and memory, but not on measures of crystallized intelligence. Health status declined significantly across age for five of 49 past and current medical conditions, for measures of Activities of Daily Living (ADL) and for systolic blood pressure, but did not decline significantly for global self-ratings of health, diastolic blood pressure or reports of smoking. Weak but significant correlations between health and cognitive performance were found for self-reported global ratings of health and for self-reports of some physical symptoms but not for diastolic or systolic blood pressure, or for many other physical conditions. Both self- and informant-based ratings of ADL correlated with cognitive performance. Age differences remained after cognitive performance was adjusted for health variables such as ADL, self-ratings of health and current health problems. It is concluded that, at the population level, lower levels of cognitive performance in community-dwelling elderly subjects are not strongly mediated by ill health.

Validity and reliability of the Physical Activity Scale for the Elderly (PASE) in Japanese elderly people.

PubMed

Hagiwara, Akiko; Ito, Naomi; Sawai, Kazuhiko; Kazuma, Keiko

2008-09-01

In Japan, there are no valid and reliable physical activity questionnaires for elderly people. In this study, we translated the Physical Activity Scale for the Elderly (PASE) into Japanese and assessed its validity and reliability. Three hundred and twenty-five healthy and elderly subjects over 65 years were enrolled. Concurrent validity was evaluated by Spearman's rank correlation coefficient between PASE scores and an accelerometer (waking steps and energy expenditure), a physical activity questionnaire for adults in general (the Japan Arteriosclerosis Longitudinal Study Physical Activity Questionnaire, JALSPAQ), grip strength, mid-thigh muscle area per bodyweight, static valance and bodyfat percentage. Reliability was evaluated by the test-retest method over a period of 3-4 weeks. The mean PASE score in this study was 114.9. The PASE score was significantly correlated with walking steps (rho = 0.17, P = 0.014), energy expenditure (rho = 0.16, P = 0.024), activity measured with the JALSPAQ (rho = 0.48, P < 0.001), mid-thigh muscle area per bodyweight (rho = 0.15, P = 0.006) and static balance (rho = 0.19, P = 0.001). The proportion of consistency in the response between the first and second surveys was adequately high. The intraclass correlation coefficient for the PASE score was 0.65. The Japanese version of PASE was shown to have acceptable validity and reliability. The PASE is useful to measure the physical activity of elderly people in Japan.

Physical performance measures that predict faller status in community-dwelling older adults.

PubMed

Macrae, P G; Lacourse, M; Moldavon, R

1992-01-01

Falls are a leading cause of fatal and nonfatal injuries among the elderly. Accurate determination of risk factors associated with falls in older adults is necessary, not only for individual patient management, but also for the development of fall prevention programs. The purpose of this study was to evaluate the effectiveness of clinical measures, such as the one-legged stance test (OLST), sit-to-stand test (STST), manual muscle tests (MMT), and response speed in predicting faller status in community-dwelling older adults (N = 94, age 60-89 years). The variables assessed were single-leg standing (as measured by OLST), STST, and MMT of 12 different muscle groups (hip flexors, hip abductors, hip adductors, knee flexors, knee extensors, ankle dorsiflexors, ankle plantarflexors, shoulder flexors, shoulder abductors, elbow flexors, elbow extensors, and finger flexors), and speed of response (as measured by a visual hand reaction and movement time task). Of the 94 older adults assessed, 28 (29.7%) reported at least one fall within the previous year. The discriminant analysis revealed that there were six variables that significantly discriminated between fallers and nonfallers. These variables included MMT of the ankle dorsiflexors, knee flexors, hip abductors, and knee extensors, as well as time on the OLST and the STST. The results indicate that simple clinical measures of musculoskeletal function can discriminate fallers from nonfallers in community-dwelling older adults. J Orthop Sports Phys Ther 1992;16(3):123-128.

Pinyon pine mortality alters communities of ground-dwelling arthropods

Treesearch

Robert J. Delph; Michael J. Clifford; Neil S. Cobb; Paulette L. Ford; Sandra L. Brantley

2014-01-01

We documented the effect of drought-induced mortality of pinyon pine (Pinus edulis Engelm.) on communities of ground-dwelling arthropods. Tree mortality alters microhabitats utilized by ground-dwelling arthropods by increasing solar radiation, dead woody debris, and understory vegetation. Our major objectives were to determine (1) whether there were changes in...

High depressive symptomatology among older community-dwelling Mexican Americans: the impact of immigration.

PubMed

Gerst, Kerstin; Al-Ghatrif, Majd; Beard, Holly A; Samper-Ternent, Rafael; Markides, Kyriakos S

2010-04-01

This analysis explores nativity differences in depressive symptoms among very old (75+) community-dwelling Mexican Americans. Cross-sectional analysis using the fifth wave (2004-2005) of the Hispanic Established Population for the Epidemiological Study of the Elderly (Hispanic EPESE). The sample consisted of 1699 non-institutionalized Mexican American men and women aged 75 years and above. Depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale (CES-D). Logistic regression was used to predict high depressive symptoms (CES-D score 16 or higher) and multinomial logistic regression was used to predict sub-threshold, moderate, and high depressive symptoms. Results showed that elders born in Mexico had higher odds of more depressive symptoms compared to otherwise similar Mexican Americans born in the US. Age of arrival, gender, and other covariates did not modify that risk. The findings suggest that older Mexican American immigrants are at higher risk of depressive symptomatology compared to persons born in the US, which has significant implications for research, policy, and clinical practice.

The gender gap in depressive symptoms among Japanese elders: evaluating social support and health as mediating factors.

PubMed

Tiedt, Andrew D

2010-09-01

Depression has been described as the world's most prevalent illness and a leading cause of disability across age groups. The global literature on aging and depression reports greater prevalence of depressive symptoms among women than men. This research applies data from the Nihon University Japanese Longitudinal Study of Aging to the gender gap in depressive symptoms reported by Japanese elders. This study takes the position that cultural norms centered on obligations to care determine both the prevalence of social support and its application by family members. Since gender is the lens through which social and cultural expectations are filtered, the experiences of men and women are distinguished from one another. This study hypothesized that coresidency and filial obligations should protect elders from depression. At the same time, combative relationships within households were posited to aggravate depressive symptoms among mothers-in-law and daughters-in-law. Weak social support networks, as captured through not being married, living alone and lack of community contact were also hypothesized to exacerbate isolation and heighten depressive symptoms. The analyses found that receipt of support both protected elders as well as worsened depressive symptoms. While women reported greater frequency of depressive symptoms overall, results indicated that men experienced a larger effect of decreased mobility and transitions to poor physical health on depressive symptoms than women.

Fall Risk Factors in Community-Dwelling Elderly Depending on Their Physical Function, Cognitive Status and Symptoms of Depression

PubMed Central

Kamińska, Magdalena Sylwia; Brodowski, Jacek; Karakiewicz, Beata

2015-01-01

Falls are the leading cause of unintentional injuries and injury-related disability, morbidity and mortality in the geriatric population. Therefore, they may also lower quality of life. The aim of this study was to analyze the fall risk factors in the community-dwelling elderly depending on their physical function, cognitive status and symptoms of depression. The study involved 304 individuals aged 65–100 years with a mean age of 78.6 ± 7.4. This survey-based study was conducted using the Geriatric Environmental Inquiry, the Barthel Scale (BS), the Abbreviated Mental Test Score (AMTS), the Geriatric Depression Scale (GDS) and the Tinetti Test (TT). There was a statistically significant correlation between the BS, the TT and the incidence of falls (p < 0.05). The number of falls correlated significantly with the results of the BS (R = −0.39), the GDS (R = 0.18), and the TT (R = −0.40). A statistically significant correlation was also noted between the TT results and the results of the BS (R = 0.77), the AMTS (R = 0.40) and the GDS (R = −0.37). The incidence of falls may significantly increase in people with a lower functional status, which may be related to cognitive process disturbances and lower affective functioning. A comprehensive geriatric assessment, related to all aspects of advanced-age patients’ efficiency, is recommended. Fall prevention strategies should include actions undertaken to evaluate and treat depression and cognitive disturbances. PMID:25811765

Prevalence estimates of depression in elderly community-dwelling African Americans in Indianapolis and Yoruba in Ibadan, Nigeria.

PubMed

Baiyewu, Olusegun; Smith-Gamble, Valerie; Lane, Kathleen A; Gureje, Oye; Gao, Sujuan; Ogunniyi, Adesola; Unverzagt, Frederick W; Hall, Kathleen S; Hendrie, Hugh C

2007-08-01

This is a community-based longitudinal epidemiological comparative study of elderly African Americans in Indianapolis and elderly Yoruba in Ibadan, Nigeria. A two-stage study was designed in which community-based individuals were first screened using the Community Screening Interview for Dementia. The second stage was a full clinical assessment, which included use of the Geriatric Depression Scale, of a smaller sub-sample of individuals selected on the basis of their performance in the screening interview. Prevalence of depression was estimated using sampling weights according to the sampling stratification scheme for clinical assessment. Some 2627 individuals were evaluated at the first stage in Indianapolis and 2806 in Ibadan. All were aged 69 years and over. Of these, 451 (17.2%) underwent clinical assessment in Indianapolis, while 605 (21.6%) were assessed in Ibadan. The prevalence estimates of both mild and severe depression were similar for the two sites (p=0.1273 and p=0.7093): 12.3% (mild depression) and 2.2% (severe depression) in Indianapolis and 19.8% and 1.6% respectively in Ibadan. Some differences were identified in association with demographic characteristics; for example, Ibadan men had a significantly higher prevalence of mild depression than Indianapolis men (p<0.0001). Poor cognitive performance was associated with significantly higher rates of depression in Yoruba (p=0.0039). Prevalence of depression was similar for elderly African Americans and Yoruba despite considerable socioeconomic and cultural differences between these populations.

Prevalence estimates of depression in elderly community-dwelling African Americans in Indianapolis and Yoruba in Ibadan, Nigeria

PubMed Central

Baiyewu, Olusegun; Smith-Gamble, Valerie; Lane, Kathleen A.; Gureje, Oye; Gao, Sujuan; Ogunniyi, Adesola; Unverzagt, Frederick W.; Hall, Kathleen S.; Hendrie, Hugh C.

2010-01-01

Background This is a community-based longitudinal epidemiological comparative study of elderly African Americans in Indianapolis and elderly Yoruba in Ibadan, Nigeria. Method A two-stage study was designed in which community-based individuals were first screened using the Community Screening Interview for Dementia. The second stage was a full clinical assessment, which included use of the Geriatric Depression Scale, of a smaller sub-sample of individuals selected on the basis of their performance in the screening interview. Prevalence of depression was estimated using sampling weights according to the sampling stratification scheme for clinical assessment. Results Some 2627 individuals were evaluated at the first stage in Indianapolis and 2806 in Ibadan. All were aged 69 years and over. Of these, 451 (17.2%) underwent clinical assessment in Indianapolis, while 605 (21.6%) were assessed in Ibadan. The prevalence estimates of both mild and severe depression were similar for the two sites (p = 0.1273 and p = 0.7093): 12.3% (mild depression) and 2.2% (severe depression) in Indianapolis and 19.8% and 1.6% respectively in Ibadan. Some differences were identified in association with demographic characteristics; for example, Ibadan men had a significantly higher prevalence of mild depression than Indianapolis men (p < 0.0001). Poor cognitive performance was associated with significantly higher rates of depression in Yoruba (p = 0.0039). Conclusion Prevalence of depression was similar for elderly African Americans and Yoruba despite considerable socioeconomic and cultural differences between these populations. PMID:17506912

Apolipoprotein E polymorphism in elderly Japanese-Brazilian immigrants does not explain the reduced cardiovascular risk factor incidence.

PubMed

Terra, N; Moriguchi, Y; Bittencourt, L; Trois, R S; Piccoli, J E C; Cruz, I B M

2011-09-09

Study of immigrant populations may contribute to a better understanding of the epidemiology of diseases associated with the aging process. We examined the prevalence of cardiovascular risk factors, including apolipoprotein E (ApoE) polymorphism, in elderly subjects who were born in Japan, migrated to South Brazil and have lived in that region for over 40 years, versus a group of elderly, locally born Brazilians living in the same region. These Japanese subjects came to Brazil after World War II (1950-1960) from several Japanese cities, mainly Nagasaki, Kumamoto and Hokkaido. Among 1007 subjects genotyped for ApoE polymorphism, we selected 540 elderly subjects (>60 years old), consisting of 270 Japanese-Brazilians and 270 Brazilians of European ancestry from Rio Grande do Sul State (Gaucha population). The Japanese-Brazilian group had significantly lower prevalences of obesity, type 2 diabetes mellitus, dyslipidemia, and metabolic syndrome than did the Gaucho population group. ApoE polymorphism frequencies were similar in the two groups. The differences in cardiovascular risk factors observed in the two populations cannot be explained by ApoE polymorphism; they could be related to conservation of Japanese lifestyle habits, such as diet.

Impact of Patient Education on Influenza Vaccine Uptake among Community-Dwelling Elderly: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Leung, Ka Chun; Mui, Carlo; Chiu, Wing Yan; Ng, Yuk Yiu; Chen, Matthew H. Y.; Ho, Pui Hung; Kwok, Chun Pong; Lam, Suki S. M.; Wong, Chun Yip; Wong, Kit Yee; Pang, Herbert H.

2017-01-01

This randomized controlled trial aimed to test the effectiveness of brief face-to-face patient education in increasing influenza vaccination rate among elderly in the community. Recruitment and intervention were conducted at two general outpatient clinics in Hong Kong. 529 eligible patients were randomly assigned to intervention or control group…

Optimizing social participation in community-dwelling older adults through the use of behavioral coping strategies.

PubMed

Provencher, Véronique; Desrosiers, Johanne; Demers, Louise; Carmichael, Pierre-Hugues

2016-01-01

This study aimed to (1) determine the categories of behavioral coping strategies most strongly correlated with optimal seniors' social participation in different activity and role domains and (2) identify the demographic, health and environmental factors associated with the use of these coping strategies optimizing social participation. The sample consisted of 350 randomly recruited community-dwelling older adults (≥65 years). Coping strategies and social participation were measured, respectively, using the Inventory of Coping Strategies Used by the Elderly and Assessment of Life Habits questionnaires. Information about demographic, health and environmental factors was also collected during the interview. Regression analyses showed a strong relationship between the use of cooking- and transportation-related coping strategies and optimal participation in the domains of nutrition and community life, respectively. Older age and living alone were associated with increased use of cooking-related strategies, while good self-rated health and not living in a seniors' residence were correlated with greater use of transportation-related strategies. Our study helped to identify useful behavioral coping strategies that should be incorporated in disability prevention programs designed to promote community-dwelling seniors' social participation. However, the appropriateness of these strategies depends on whether they are used in relevant contexts and tailored to specific needs. Our results support the relevance of including behavioral coping strategies related to cooking and transportation in disability prevention programs designed to promote community-dwelling seniors' social participation in the domains of nutrition and community life, respectively. Older age and living alone were associated with increased use of cooking-related strategies, while good self-rated health and not living in a seniors' residence were correlated with greater use of transportation

Occlusal force is correlated with cognitive function directly as well as indirectly via food intake in community-dwelling older Japanese: From the SONIC study.

PubMed

Ikebe, Kazunori; Gondo, Yasuyuki; Kamide, Kei; Masui, Yukie; Ishizaki, Taturo; Arai, Yasumichi; Inagaki, Hiroki; Nakagawa, Takeshi; Kabayama, Mai; Ryuno, Hirochika; Okubo, Hitomi; Takeshita, Hajime; Inomata, Chisato; Kurushima, Yuko; Mihara, Yusuke; Hatta, Kohdai; Fukutake, Motoyoshi; Enoki, Kaori; Ogawa, Taiji; Matsuda, Ken-Ichi; Sugimoto, Ken; Oguro, Ryosuke; Takami, Yoichi; Itoh, Norihisa; Takeya, Yasushi; Yamamoto, Koichi; Rakugi, Hiromi; Murakami, Shinya; Kitamura, Masahiro; Maeda, Yoshinobu

2018-01-01

Growing evidence suggests that oral health may be an important factor associated with cognitive function in aged populations. However, many previous studies on this topic used insensitive oral indicators or did not include certain essential covariates. Thus, we examined the association between occlusal force and cognitive function in a large sample of older adults, controlling for dietary intake, vascular risk factors, inflammatory biomarkers, depression, and genetic factors. In this cross-sectional study of older community-dwelling Japanese adults, we examined data collected from 994 persons aged 70 years and 968 persons aged 80 years. Cognitive function was measured using the Japanese version of the Montreal Cognitive Assessment (MoCA-J). Oral status and function were evaluated according to the number of remaining teeth, periodontal pocket depth, and maximal occlusal force. Associations between MoCA-J scores and occlusal force were investigated via bivariate and multivariate analyses. Education level, financial status, depression score, and intake of green and yellow vegetables, as well as number of teeth and occlusal force, were significantly correlated with MoCA-J scores in both age groups. Among individuals aged 80 years, CRP and periodontal status were weakly but significantly associated with MoCA-J score. After controlling for all significant variables via bivariate analyses, the correlation between maximal occlusal force and cognitive function persisted. A path analysis confirmed the hypothesis that cognitive function is associated with occlusal force directly as well as indirectly via food intake. After controlling for possible factors, maximal occlusal force was positively associated with cognitive function directly as well as indirectly through dietary intake.

Association of genetic variants of MAOA and SH2B1 with bone mineral density in community-dwelling Japanese women.

PubMed

Yamada, Yoshiji; Ando, Fujiko; Shimokata, Hiroshi

2008-01-01

Although bone mineral density (BMD) is a complex trait that is influenced by both genetic and environmental factors, heritability studies in twins and families have shown that genetic factors account for 60-85% of its variance. We examined the relation of the variable number of tandem repeats (VNTR) polymorphism of the monoamine oxidase A gene (MAOA) and the A↷G (Thr484Ala) polymorphism of the SH2B adaptor protein 1 gene (SH2B1) to BMD in community-dwelling Japanese women and men. The 2235 subjects (1107 women, 1128 men) were aged 40-79 years and were randomly recruited for a population-based prospective cohort study of aging and age-related diseases in Japan. BMD at the distal and proximal radius was measured by peripheral quantitative computed tomography, and the BMD of the total body, lumbar spine (L2-L4), right femoral neck and right trochanter was measured by dual-energy X-ray absorptiometry. The genotypes of the VNTR polymorphism of MAOA were determined by DNA fragment analysis, and those of the A↷G (Thr484Ala) polymorphism of SH2B1 by melting curve analysis. The VNTR polymorphism of MAOA was associated with the BMD of the distal radius, total body, lumbar spine and trochanter in all women, and with the BMD of the total body and trochanter in postmenopausal ones, with the L (four repeats) and S (two or three repeats) alleles reflecting increased and decreased BMD, respectively. The A↷G (Thr484Ala) polymorphism of SH2B1 was associated with the BMD of the lumbar spine in all women, with the BMD of the proximal radius in premenopausal women and with the BMD of the lumbar spine, femoral neck and trochanter in postmenopausal women, with the variant G allele being related to increased BMD. These results suggest that MAOA and SH2B1 are determinative loci for bone mass in Japanese women, especially in postmenopausal ones.

Use, perceived effectiveness, and gender differences of pain relief strategies among the community-dwelling elderly in Taiwan.

PubMed

Yu, Hsing-Yi; Tang, Fu-In; Yeh, Ming-Chen; Kuo, Benjamin Ing-Tiau; Yu, Shu

2011-03-01

Pain is a common problem among the elderly. The entire scope of chronic pain relief strategies used by community elderly is still unclear. A limited number of studies have investigated this issue from diverse culture perspectives. In the present study, we investigated the use and perceived effectiveness of pain relief strategies adopted by the elderly; gender differences between frequently used relief strategies were also explored. Two hundred nineteen participants living in Taiwan City, Taiwan, were recruited by a random sampling method and interviewed face to face. The prevalence of chronic pain among the elderly was 42.0% (n = 92). The elderly tended to adopt multiple strategies (mean ± SD = 9.08 ± 3.56; range = 2-18) to relieve their chronic pain. In three domains of pain relief strategies, conventional medicine was used more frequently than complementary and alternative medicine and psychologic approaches. Most pain relief strategies were ineffective. Among the 22 strategies used, no strategy was reported as "much improved" by a majority of users. The top five pain relief strategies used by men and women were the same. Elderly women tended to adopt more psychologic approaches, such as acceptance and ignoring to relieve pain, than men. The findings suggest that nurses should pay more attention to the issue of chronic pain relief and provide the elderly with more effective pain relief strategies. Copyright © 2011 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Dietary Protein Intake in Dutch Elderly People: A Focus on Protein Sources.

PubMed

Tieland, Michael; Borgonjen-Van den Berg, Karin J; Van Loon, Luc J C; de Groot, Lisette C P G M

2015-11-25

Sufficient high quality dietary protein intake is required to prevent or treat sarcopenia in elderly people. Therefore, the intake of specific protein sources as well as their timing of intake are important to improve dietary protein intake in elderly people. to assess the consumption of protein sources as well as the distribution of protein sources over the day in community-dwelling, frail and institutionalized elderly people. Habitual dietary intake was evaluated using 2- and 3-day food records collected from various studies involving 739 community-dwelling, 321 frail and 219 institutionalized elderly people. Daily protein intake averaged 71 ± 18 g/day in community-dwelling, 71 ± 20 g/day in frail and 58 ± 16 g/day in institutionalized elderly people and accounted for 16% ± 3%, 16% ± 3% and 17% ± 3% of their energy intake, respectively. Dietary protein intake ranged from 10 to 12 g at breakfast, 15 to 23 g at lunch and 24 to 31 g at dinner contributing together over 80% of daily protein intake. The majority of dietary protein consumed originated from animal sources (≥60%) with meat and dairy as dominant sources. Thus, 40% of the protein intake in community-dwelling, 37% in frail and 29% in institutionalized elderly originated from plant based protein sources with bread as the principle source. Plant based proteins contributed for >50% of protein intake at breakfast and between 34% and 37% at lunch, with bread as the main source. During dinner, >70% of the protein intake originated from animal protein, with meat as the dominant source. Daily protein intake in these older populations is mainly (>80%) provided by the three main meals, with most protein consumed during dinner. More than 60% of daily protein intake consumed is of animal origin, with plant based protein sources representing nearly 40% of total protein consumed. During dinner, >70% of the protein intake originated from animal protein, while during breakfast and lunch a large proportion of

A one-year proprioceptive exercise programme reduces the incidence of falls in community-dwelling elderly people: A before-after non-randomised intervention study.

PubMed

Pérez-Ros, Pilar; Martinez-Arnau, Francisco M; Malafarina, Vincenzo; Tarazona-Santabalbina, Francisco J

2016-12-01

The risk of falls increases with age. Balance alteration and polypharmacy are independent contributors to an increased risk of falls. The primary aim was to assess whether a proprioceptive exercise programme reduces the incidence of falls. A secondary aim was to assess the association between drugs and falls. This was a before-after non-randomised intervention study. The study recruited independent and cognitively intact community-dwelling people aged over 69 years, from December 2012 to May 2014. The intervention was done by a nurse and consisted of a monthly supervised group session of proprioceptive training for 1 year, supplemented by a home diary exercise. Daily medication was reviewed. We included 572 subjects (63.3% women), mean age 76.1±3.9 years. The mean number of drugs prescribed at the start of the study was 4.7±3.0and 353 of the participants (61.7%) were taking four or more drugs a day. The elderly who fell were more dependent in their activities of daily living (Barthel index), and their balance was worse (determined using the Tinetti scale), as were their results on a cognitive scale (the MEC). After the intervention, an increase in self-perceived quality of life (EQ5D) was reported. The incidence of falls was reduced from 37.5% in the 12 months prior to the intervention to 25.7% in the 12 months after the intervention. During the follow-up, beta-blocker use was associated with an increased incidence of falls (OR=2.05; 95%IC: 1.24-3.39; p=0.005). In contrast, antiplatelet/anticoagulation drugs were associated with a lower risk of falls (OR=0.7; 95%IC: 0.55-0.88; p=0.003). The proprioceptive exercise programme reduced the incidence of falls in community-dwelling older people. Multiple drug use was an independent predictor of an increased risk of falls, and specific drug groups were associated with falls. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Health status, health perception, and health promotion behaviors of low-income community dwelling elderly].

PubMed

Lee, Tae-Wha; Ko, Il-Sun; Lee, Kyung-Ja; Kang, Kyeong-Hwa

2005-04-01

The purpose of the study was to investigate the health status(present illness, ADL and IADL), health perception, and health promotion behaviors of low-income elderly who are receiving the visiting nurse service in the community. The sample of the study was 735 elderly over 65 years old with basic livelihood security, who were conveniently selected from 245 public health centers nation-wide. Data collection was done using a structured questionnaire through interviews by visiting nurses. The average number of present illnesses in the study subjects was 4.18. The average scores of ADL and IADL were 15.903.39 and 9.772.97 respectively, which indicates a relatively independent everyday life. However, 64.2% of the subjects perceived their health status as 'not healthy'. In terms of health promotion behaviors, 77.8% of the subjects had ceased smoking, 83.9% stopped drinking, 56.4% had a regular diet, 45.8% received regular physical check-ups during the past two years, and 66% received flu shots. Approximately 50% of the subjects were practicing 3-4 health promotion behaviors. Significant factors associated with health promotion behaviors were ADL, IADL and self-efficacy. Health promotion programs which focus on regular diet, exercise, and regular physical check-ups should be developed to improve independence of everyday life and quality of life among low-income elderly.

Associations Between Geriatric Syndromes and Mortality in Community-Dwelling Elderly: Results of a National Longitudinal Study in Taiwan.

PubMed

Huang, Chi-Chang; Lee, Jenq-Daw; Yang, Deng-Chi; Shih, Hsin-I; Sun, Chien-Yao; Chang, Chia-Ming

2017-03-01

Although geriatric syndromes have been studied extensively, their interactions with one another and their accumulated effects on life expectancy are less frequently discussed. This study examined whether geriatric syndromes and their cumulative effects are associated with risks of mortality in community-dwelling older adults. Data were collected from the Taiwan Longitudinal Study in Aging in 2003, and the participant survival status was followed until December 31, 2007. A total of 2744 participants aged ≥65 years were included in this retrospective cohort study; 634 died during follow-up. Demographic factors, comorbidities, health behaviors, and geriatric syndromes, including underweight, falls, functional impairment, depressive condition, and cognitive impairment, were assessed. Cox proportional hazard regression analysis was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the probability of survival according to the cumulative number of geriatric syndromes. The prevalence of geriatric syndromes increased with age. Mortality was significantly associated with age ≥75 years; male sex; ≤6 years of education; history of stroke, malignancy; smoking; not drinking alcohol; and not exercising regularly. Geriatric syndromes, such as underweight, functional disability, and depressive condition, contributed to the risk of mortality. The accumulative model of geriatric syndromes also predicted higher risks of mortality (N = 1, HR 1.50, 95% CI 1.19-1.89; N = 2, HR 1.69, 95% CI 1.25-2.29; N ≥ 3, HR 2.43, 95% CI 1.62-3.66). Community-dwelling older adults who were male, illiterate, receiving institutional care, underweight, experiencing a depressive condition, functionally impaired, and engaging in poor health behavior were more likely to have a higher risk of mortality. The identification of geriatric syndromes might help to improve comprehensive care for community-dwelling older adults. Copyright © 2016 AMDA – The Society for

Associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults

PubMed Central

Makino, Keitaro; Ihira, Hikaru; Mizumoto, Atsushi; Shimizu, Kotaro; Ishida, Toyoaki; Furuna, Taketo

2015-01-01

[Purpose] The purpose of this study was to examine the associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults. [Subjects] A total of 304 Japanese community-dwelling older adults (70.3 ± 4.1 years; 113 males and 191 females) participated in this study. [Methods] Demographic characteristics, medical conditions, exercise habits, and health-related outcomes were assessed by face-to-face interviews and self-reported questionnaires. Older adults who had exercise habits were classified into two groups: individual- and group-based exercise habits groups, and the health-related outcomes were compared between groups. [Results] The scores for the Geriatric Depression Scale, exercise self-efficacy, and dietary variety of older adults who had group-based exercise habits were better than those of older adults who had individual-based exercise habits. In addition, the exercise settings (individual- and group-based) were significantly associated with scores for the Geriatric Depression Scale (odds ratio = 0.76) and exercise self-efficacy (odds ratio = 1.26), even after adjusting for age and gender. [Conclusion] These results implied that habitual exercise in group settings may have an effective role in promoting exercise self-efficacy and mental health. PMID:26311955

The impact of pinyon mortality on ground-dwelling arthropod communities

Treesearch

Robert J. Delph

2008-01-01

We documented the indirect impact of drought-induced mortality of pinyon pine (Pinus edulis) on ground-dwelling arthropod communities. Tree mortality alters microhabitats utilized by ground-dwelling arthropods through increased solar radiation, dead woody debris, and understory vegetation. Our major objectives were to determine if there were...

Influence of clinical outcome and outcome period definitions on estimates of absolute clinical and economic benefits of influenza vaccination in community dwelling elderly persons.

PubMed

Nichol, K L; Nordin, J; Mullooly, J

2006-03-06

Studies assessing the clinical and economic benefits of vaccination in the elderly have used different clinical outcomes (e.g. hospitalizations for pneumonia or influenza versus hospitalizations for respiratory and cardiovascular causes) and different outcome periods (e.g. peak versus total influenza season) on which to base estimates of clinical effectiveness and cost effectiveness. We explored the implications of these varying approaches by comparing two health economic analysis models of influenza vaccination of community-dwelling elderly persons. We developed computerized models using clinical data from 3 large US HMOs for the 1998-1999 and 1999-2000 influenza seasons. The primary health economic model used a broad definition of clinical events and outcome period and included hospitalizations for all respiratory and cardiovascular events that occurred during the entire influenza season. The alternative model used more restrictive definitions and included pneumonia or influenza hospitalizations occurring during the peak influenza season. The results of Monte Carlo simulation showed that, with the more inclusive primary model, influenza vaccination resulted in net medical care cost savings due to fewer respiratory or cardiovascular hospitalizations of Dollars 71/person vaccinated (5th-95th percentile Dollars 32-118) and net savings of Dollars 809/year of life saved (5th-95th percentile Dollars 331-1450). In contrast, the alternate model found costs of Dollars 3.50/person vaccinated (5th-95th percentile Dollars -11 to 5) and net costs of Dollars 91/year of life saved (5th-95th percentile Dollars -309 to 126). Our findings confirm that influenza vaccination of the elderly is most likely cost saving and supports policies and programs that advocate routine immunization of all persons 65 and older. They also highlight how different outcome definitions can influence the results of health economic analyses.

Falls and fear of falling among community-dwelling seniors: the dynamic tension between exercising precaution and striving for independence.

PubMed

Ward-Griffin, Catherine; Hobson, Sandra; Melles, Pauline; Kloseck, Marita; Vandervoort, Anthony; Crilly, Richard

2004-01-01

The purpose of this phenomenological study was to explore the everyday experience of community-dwelling elders, with particular attention to seniors' perceptions of safety, fear of falling, independence, and quality of life. We also aimed to identify contextual factors that influence the health of elders who had fallen and/or had a fear of falling. Data from in-depth interviews with a purposeful sample (n = 9) of elders were analysed using interpretative analysis procedures. Both individual and team analysis was undertaken until interpretations of the experiences of the participants were inductively developed and crystallized into a holistic interpretation of the participants' shared experience. The holistic experience was comprised of two opposing, dynamic life forces: exercising precaution and striving for independence. Within each life force, participants used five major strategies that simultaneously constrained and expanded their life space. Health-promoting practice and policy implications, as well as areas for further research, are discussed.

Relationships between sarcopenia and household status and locomotive syndrome in a community-dwelling elderly women in Japan.

PubMed

Momoki, Chika; Habu, Daiki; Ogura, Juri; Tada, Arisa; Hasei, Ai; Sakurai, Kotone; Watanabe, Hatsumi

2017-01-01

The aim of the present study was to identify factors associated with sarcopenia in community-dwelling elderly women in Japan. A total of 186 women aged over 65 years attending preventive care classes were enrolled in the study. Muscle mass was assessed using bioelectrical impedance analysis. Sarcopenia was defined as low muscle mass and low muscle strength in accord with the consensus report of the Asian Working Group for Sarcopenia. Data regarding household status (living alone, with a spouse, or with children and/or grandchildren), calf circumference and the presence of locomotive syndrome were obtained, as well as dietary variety score, Tokyo Metropolitan Institute of Gerontology Index of Competence and Mini-Nutritional Assessment short form, and 10-item Eating Assessment Tool scores. Sarcopenia was identified in 21.0% of participants. Participants with sarcopenia were older, had a lower body mass index and calf circumference, and were more likely to have locomotive syndrome, and living with children and/or grandchildren. In multivariate analysis, age, body mass index <18.5 and locomotive syndrome were significantly associated with sarcopenia, as were associated living alone (OR 1.69, 95% CI 0.45-6.41), and living with children and/or grandchildren (OR 2.46, 95% CI 0.71-8.54) and dietary variety score ≥9 (OR 4.98, 95% CI 0.97-25.56). Age, body mass index, dietary variety score, locomotive syndrome and household status were associated with sarcopenia. Early interventions are required for older adults identified as having a higher risk of sarcopenia to prevent its adverse health consequences. Geriatr Gerontol Int 2017; 17: 54-60. © 2016 Japan Geriatrics Society.

Correlates of a Recent History of Disabling Low Back Pain in Community-dwelling Older Persons: The Pain in the Elderly (PAINEL) Study.

PubMed

Machado, Luciana A C; Viana, Joana U; da Silva, Sílvia L A; Couto, Flávia G P; Mendes, Liliane P; Ferreira, Paulo H; Ferreira, Manuela L; Dias, João M D; Dias, Rosângela C

2018-06-01

To investigate the correlates of a recent history of disabling low back pain (LBP) in older persons. The Pain in the Elderly (PAINEL) Study was derived from the Frailty among Brazilian Older Adults (FIBRA) Network Study. Data were collected through face-to-face/telephone interviews and clinical examination. A series of logistic regressions assessed associations between a recent history of disabling LBP and sociodemographic, physical/lifestyle, and psychological factors. Of the 378 community-dwelling elders included in the study (age±SD, 75.5±6.1), 9.3% experienced LBP that was bad enough to limit or change their daily activities during the past year. Those reporting a recent history of disabling LBP were more likely to be women and under financial strain, to present poor self-rated health, overweight, multimorbidity, low physical activity level, fatigue, depressive symptomatology/diagnosis and fear beliefs, and to report decreased sleep time, prolonged sitting time, chronic pain (in location other than lower back), and frequently recurring LBP. The multivariate logistic regression analysis indicated that overweight (odds ratio [OR], 29.6; 95% confidence interval [CI], 2.3-391.0), low physical activity level (OR, 4.4; 95% CI, 1.3-15.4), fatigue (OR, 10.3; 95% CI, 2.4-43.4), depression diagnosis (OR, 4.9; 95% CI, 1.3-18.4), and frequently recurring LBP (OR, 4.6; 95% CI, 1.0-20.1) were independently associated with a recent history of disabling LBP. Our study supports the link between disabling LBP and other age-related chronic conditions in a middle-income country with a rapidly aging population.

Prevalence of chronic obstructive pulmonary disease in independent community-dwelling older adults: The Fujiwara-kyo study.

PubMed

Yoshikawa, Masanori; Yamamoto, Yoshifumi; Tomoda, Koichi; Fujita, Yukio; Yamauchi, Motoo; Osa, Takao; Uyama, Hiroki; Okamoto, Nozomi; Kurumatani, Norio; Kimura, Hiroshi

2017-12-01

As the Japanese population ages, the number of older patients with chronic obstructive pulmonary disease (COPD) is expected to increase, but the prevalence of COPD in patients aged ≥80 years remains unclear. The purpose of the present study was to determine the prevalence of COPD in independent community-dwelling older adults aged ≥80 years. We investigated the prevalence of COPD in 2862 independent community-dwelling older adults (1504 men, 1358 women, mean age 77.7 ± 7.0 years) who underwent spirometry in the Fujiwara-kyo study, a study of successful aging in older adults. Those participants with airflow limitation (forced expiratory volume in 1 s/forced vital capacity <0.7) who indicated on a self-administered questionnaire that they had a history of smoking and did not have bronchial asthma were considered to have COPD. The prevalence of COPD was 16.9% among all participants and 37.4% among smokers. The prevalence among individuals aged ≥80 years (19.7%) was significantly higher than that among those aged <80 years (16.0%; P < 0.05). When forced expiratory volume in 1 s/forced vital capacity lower limit of normal was used as the criterion for airflow limitation, the prevalence fell to 11.0%. Patients with mild-to-moderate airflow limitation (stage I/stage II) accounted for the great majority (91.2%) of COPD patients aged ≥80 years. A high prevalence of mild-to-moderate COPD was observed even in the independent community-dwelling older adults aged ≥80 years. However, the benefits of the spirometric screening and treatment for these patients needs to be determined. Geriatr Gerontol Int 2017; 17: 2421-2426. © 2017 Japan Geriatrics Society.

Sharp turning and corner turning: comparison of energy expenditure, gait parameters, and level of fatigue among community-dwelling elderly.

PubMed

Justine, Maria; Manaf, Haidzir; Sulaiman, Affeenddie; Razi, Shahir; Alias, Hani Asilah

2014-01-01

This study compares energy expenditure (EE), gait parameters (GP), and level of fatigue (LOF) between 5-minute walking with sharp turning (ST) and corner turning (CT). Data were obtained from 29 community-dwelling elderly (mean age, 62.7 ± 3.54 years). For 5 minutes, in ST task, participants walked on a 3-meter pathway with 2 cones placed at each end (180° turning), while in CT task, participants walked on a 6-meter pathway with 4 cones placed at 4 corners (90° turning). The physiological cost index, pedometer, and 10-point Modified Borg Dyspnoea Scale were used to measure EE (beats/min), GP (no of steps), and LOF, respectively. Data were analyzed by using independent t-tests. EE during ST (0.62 ± 0.21 beats/min) was significantly higher than CT (0.48 ± 0.17 beats/min) (P < 0.05). GP (434 ± 92.93 steps) and LOF (1.40 ± 1.11) in ST were found to be lower compared to GP (463 ± 92.18 steps) and LOF (1.54 ± 1.34) in CT (All, P > 0.05). Higher EE in ST could be due to the difficulty in changing to a 180° direction, which may involve agility and different turning strategies (step-turn or pivot-turn) to adjust the posture carefully. In CT, participants could choose a step-turn strategy to change to a 90° direction, which was less challenging to postural control.

The relationship between physical activity, meaning in life, and subjective vitality in community-dwelling older adults.

PubMed

Ju, Haewon

2017-11-01

The present study examined the potential contribution of meaning in life to the relationship between physical activity and subjective vitality in older adults. Two-hundred and fifty community-dwelling elders completed the instruments assessing physical activity, meaning in life, and subjective vitality. Results from structural equation modeling indicated that physical activity was positively associated with both meaning in life and subjective vitality. Further, the relationship between physical activity and vitality was partially mediated by meaning in life. Although previous studies have consistently found a positive impact of physical activity on vitality, the current study suggested that it is more productive to focus not only on physical activity, but also on meaning in life, in order to vitalize elders. Further, a focus on meaning in life can be a productive way to continue to vitalize older adults who are unable to engage in regular physical activity. Copyright © 2017 Elsevier B.V. All rights reserved.

Neighborhood support network, perceived proximity to community facilities and depressive symptoms among low socioeconomic status Chinese elders.

PubMed

Chen, Yan-Yan; Wong, Gloria H Y; Lum, Terry Y; Lou, Vivian W Q; Ho, Andy H Y; Luo, Hao; Tong, Tracy L W

2016-01-01

Depressive symptoms are common in older people; most previous research on elderly depression focused on individual-level characteristics or neighborhood socioeconomic status. Modifiable neighborhood characteristics of older people dwelling in low-income communities are under-studied. This study aims to identify potentially modifiable social and physical neighborhood characteristics that influence depressive symptoms independent of individual-level characteristics among older Chinese. Data came from a cross-sectional survey conducted in four low-income public rental housing estates in Hong Kong in 2012. We interviewed a total of 400 elderly residents. The structured questionnaire covered demographics, activities of daily living, recent fall history, neighborhood support networks, and perceived proximity by walk to community facilities. Multiple regression was used to test whether inclusion of neighborhood factors in addition to individual characteristics increases model fit in explaining depressive symptoms in elders with low socioeconomic status. At individual level, activities of daily living and income significantly predicted depressive symptoms. Receiving support from friends or neighbors is associated with fewer depressive symptoms. However, participants who received organizational support had a 1.17 points of increase on the 15-item Geriatric Depression Scale (GDS-15). At-ease walkable proximity to medical facilities was positively associated with a better GDS score. Neighborhood support networks and perceived proximity by walk to community facilities contribute significantly to depressive symptoms among low-income elders. Programs and policies that facilitate neighborhood support and commuting or promote facility accessibility may help ameliorate depressive symptoms common among low-income elders.

Nutritional intervention and physical training in malnourished frail community-dwelling elderly persons carried out by trained lay “buddies”: study protocol of a randomized controlled trial

PubMed Central

2013-01-01

Background In elderly persons frailty and malnutrition are very common and can lead to serious health hazards such as increased mortality, morbidity, dependency, institutionalization and a reduced quality of life. In Austria, the prevalence of frailty and malnutrition are increasing steadily and are becoming a challenge for our social system. Physical training and adequate nutrition may improve this situation. Methods/design In this randomized controlled trial, 80 malnourished frail community-dwelling patients (≥ 65 years) hospitalized at wards for internal medicine are recruited. Additionally, 80 lay volunteers (≥ 50 years), named buddies are recruited and subsequently trained regarding health enhancing physical activity and nutrition in four standardized training sessions. These buddies visit the malnourished frail persons at home twice a week for about one hour during an initial period of 10–12 weeks. While participants allocated to the intervention group (n = 40) receive intervention to improve their fluid intake, protein and energy intake, perform strength training and try to increase their baseline activities, the control group (n = 40) only gets home visits without any intervention. After 10–12 weeks, both, the intervention and the control group, receive the nutritional intervention and the physical training. Health, nutritional and frailty status, physical fitness, body composition and chronic inflammation of buddies and frail persons are recorded before the intervention, after 10–12 weeks, 6 and 12 months. Discussion To your knowledge this trial is the first of its kind to provide nutritional and physical activity interventions to malnourished frail community-dwelling persons by trained lay buddies, in which an improvement of the frail persons´ and the buddies’ health status is measured. This study assesses the efficacy of such an intervention and may offer new perspectives for the management of frailty and malnutrition. Trail

Relationship between Perceived Needs and Assessed Needs for Services in Community-Dwelling Older Persons

ERIC Educational Resources Information Center

Cohen-Mansfield, Jiska; Frank, Julia

2008-01-01

Purpose: We examine the relationship between the perceived needs and assessed needs of community-dwelling seniors. Design and Methods: Trained research assistants administered the Naturally Occurring Retirement Community Baseline Survey to 268 community-dwelling older adults in suburban Maryland. Perceived and assessed needs were measured in the…

Gender and Transportation Access among Community-Dwelling Seniors

ERIC Educational Resources Information Center

Dupuis, Josette; Weiss, Deborah R.; Wolfson, Christina

2007-01-01

Purpose: This study estimates the prevalence of problems with transportation in a sample of community-dwelling seniors residing in an urban setting and investigates the role that gender plays in the ability of seniors to remain mobile in their communities. Design and Methods: Data collected as part of a study assessing the prevalence and…

Cognitive intervention through a training program for picture book reading in community-dwelling older adults: a randomized controlled trial.

PubMed

Suzuki, Hiroyuki; Kuraoka, Masataka; Yasunaga, Masashi; Nonaka, Kumiko; Sakurai, Ryota; Takeuchi, Rumi; Murayama, Yoh; Ohba, Hiromi; Fujiwara, Yoshinori

2014-11-21

Non-pharmacological interventions are expected to be important strategies for reducing the age-adjusted prevalence of senile dementia, considering that complete medical treatment for cognitive decline has not yet been developed. From the viewpoint of long-term continuity of activity, it is necessary to develop various cognitive stimulating programs. The aim of this study is to examine the effectiveness of a cognitive intervention through a training program for picture book reading for community-dwelling older adults. Fifty-eight Japanese older participants were divided into the intervention and control groups using simple randomization (n =29 vs 29). In the intervention group, participants took part in a program aimed at learning and mastering methods of picture book reading as a form of cognitive training intervention. The control group listened to lectures about elderly health maintenance. Cognitive tests were conducted individually before and after the programs. The rate of memory retention, computed by dividing Logical Memory delayed recall by immediate recall, showed a significant interaction (p < .05) in analysis of covariance. Simple main effects showed that the rate of memory retention of the intervention group improved after the program completion (p < .05). In the participants with mild cognitive impairment (MCI) examined by Japanese version of the Montreal Cognitive Assessment (MoCA-J) (n =14 vs 15), significant interactions were seen in Trail Making Test-A (p < .01), Trail Making Test-B (p < .05), Kana pick-out test (p < .05) and the Mini-Mental State Examination (p < .05). The intervention effect was found in delayed verbal memory. This program is also effective for improving attention and executive function in those with MCI. The short-term interventional findings suggest that this program might contribute to preventing a decline in memory and executive function. UMIN000014712 (Date of ICMJE and WHO compliant trial information

Telling her story: narrating a Japanese lesbian community.

PubMed

Welker, James

2010-01-01

This article explores queer Japanese women's narratives of their own histories and the history of the "Japanese lesbian community," which has been constructed as a space outside the heterosexual mainstream, a space where queer women can find at least temporary refuge. It begins with the acknowledgment that the evolution and the shape of the community, along with the identities of the women who comprise it, are shifting and contested. This article specifically looks at the long history of the lesbian bar scene as well as more recent history of lesbian dance parties; the early role of lesbian feminism and activism; lesbian community-based and commercial publications, paying special attention to the critical role translation has played in Japanese lesbian discourse and the construction of multiple lesbian identities; and, finally, lesbian, gay, bisexual, and transgender (LGBT) pride events and film festivals, through which the larger LGBT community has been gaining increasing visibility. This article argues that while some of the building blocks of the community are borrowed, from the "West" as well as from the Japanese gay community, there has also been creative translation, adaptation, and resistance to these imports. The resulting Japanese lesbian community is a complex and local construct, an innovative bricolage firmly sited in Japan.

Hierarchy of higher-level physical functions: a longitudinal investigation on a nationally representative population of community-dwelling middle-aged and elderly persons.

PubMed

Yeh, Chih-Jung; Wang, Ching-Yi; Tang, Pei-Fang; Lee, Meng-Chih; Lin, Hui-Sheng; Chen, Hui-Ya

2012-01-01

Understanding the hierarchy of higher-level physical functions to infer disability level (mild, moderate or severe) is essential for the precise targeting of preventive interventions and has been examined previously in a cross-sectional study. Based on longitudinal data, this study evaluated the hierarchy of higher-level physical functions. Data from a cohort of 2729 community-dwelling persons aged over 50 with no initial disability were drawn from the "Survey of Health and Living Status of the Elderly in Taiwan" from 1996 through 2007. The three-level hierarchy of eight chosen activities was examined by the median ages to disability onset with survival analyses and by Cox regressions, which examined the effects of sex and age on the development of this hierarchy. The progression of incident disability was as follows: mild level-running, carrying weight, and squatting; moderate level-climbing stairs, walking, and standing; and severe level-grasping and raising arms up. Women and older persons were at greater risk of developing more severe levels of disability. Another Cox regression with one index activity from each hierarchical level revealed similar results. The three-level hierarchy of higher-level physical functions has been validated longitudinally, suggesting rich research and clinical implications.

[Gender difference in risk factors for depression in community-dwelling elders].

PubMed

Kim, Chul-Gyu; Park, Seungmi

2012-02-01

This study was conducted to compare the degree of depression between men and women and to identify factors influencing their depression. Participants in this cross-sectional descriptive study were 263 persons over 65 years old (men: 103, women: 160). Data were collected through face to face interviews using questionnaires and were done in two urban areas in 2010. Research instruments utilized in this study were SGDS, MMSE-K, SRH, FILE, sleep pattern scale, family and friend support scale, and social support scale. Multivariate regression analysis was performed to identify factors influencing depression in elders. The proportions of participants with depression were significantly different between men and women (52.4% vs. 67.5%). Regression model for depression in elderly men significantly accounted for 54%; disease stress (32%), economic stress (10%), perceived health status (4%), and family support, educational level, age, and hypertension. Regression model for depression in elderly women significantly accounted for 47%; disease stress (25%), perceived social loneliness (8%), friend support (5%), family stress (4%), and sleep satisfaction, and family support. Results demonstrate that depression is an important health problem for elders, and show gender differences for factors influencing depression. These results could be used in the developing depression prevention programs.

Willingness to use and pay for options of care for community-dwelling older people in rural Vietnam

PubMed Central

2012-01-01

Background The proportion of people in Vietnam who are 60 years and over has increased rapidly. The emigration of young people and impact of other socioeconomic changes leave more elderly on their own and with less family support. This study assesses the willingness to use and pay for different models of care for community-dwelling elderly in rural Vietnam. Methods In 2007, people aged 60 and older and their family representatives, living in 2,240 households, were randomly selected from the FilaBavi Demographic Surveillance Site. They were interviewed using structured questionnaires to assess dependence in activities of daily living (ADLs), willingness to use and to pay for day care centres, mobile care teams, and nursing centres. Respondent socioeconomic characteristics were extracted from the FilaBavi repeated census. Percentages of those willing to use models and the average amount (with 95% confidence intervals) they are willing to pay were estimated. Multivariate analyses were performed to measure the relationship of willingness to use services with ADL index and socioeconomic factors. Four focus group discussions were conducted to explore people's perspectives on the use of services. The first discussion group was with the elderly. The second discussion group was with their household members. Two other discussion groups included community association representatives, one at the communal level and another at the village level. Results Use of mobile team care is the most requested service. The fewest respondents intend to use a nursing centre. Households expect to use services for their elderly to a greater extent than do the elderly themselves. Willingness to use services decreases when potential fees increase. The proportion of respondents who require that services be free-of-charge is two to three times higher than the proportion willing to pay full cost. Households are willing to pay more than the elderly for day care and nursing centres. The elderly are

Factors associated with progression of diabetic nephropathy in Japanese elderly patients with type 2 diabetes: sub-analysis of the Japanese Elderly Diabetes Intervention Trial.

PubMed

Araki, Shin-ichi; Nishio, Yoshihiko; Araki, Atsushi; Umegaki, Hiroyuki; Sakurai, Takashi; Iimuro, Satoshi; Ohashi, Yasuo; Uzu, Takashi; Maegawa, Hiroshi; Kashiwagi, Atsunori; Ito, Hideki

2012-04-01

Diabetic nephropathy is a serious complication in patients with type 2 diabetes. The aim of this study was to explore the factors associated with the progression of this complication in elderly patients with type 2 diabetes. This retrospective study of a subgroup of patients registered with the Japanese Elderly Diabetes Intervention Trial included 621 Japanese patients with type 2 diabetes mellitus (age ≥ 65 years, 346 with normoalbuminuria, 190 with microalbuminuria and 85 with overt proteinuria). Multivariate Cox proportional hazard regression model with a backward stepwise procedure was applied to select factors with significant effects on worsening of nephropathy stage and the doubling of serum creatinine. During the follow up (median 52 months), 21% of patients progressed from normoalbuminuria and microalbuminuria to a worse nephropathy stage. Aging, female sex and high-density lipoprotein cholesterol were identified as independent and significant factors that worsen nephropathy stage. Also, 6.1% of patients showed doubling of serum creatinine during follow up. A positive history of cardiovascular disease, hyperuricemia and conventional therapy were identified as significant factors involved in the doubling of serum creatinine. The cumulative incidence of the doubling of serum creatinine was significantly lower in the intensive therapy group than the conventional therapy group (P = 0.016), although that of progression of nephropathy stage was similar in the two groups. We identified several factors associated with the progression of diabetic nephropathy in elderly patients with type 2 diabetes. The results suggest that multiple risk factor intervention seems important in preventing deterioration of renal dysfunction. © 2012 Japan Geriatrics Society.

Falls risk among a very old home-dwelling population

PubMed Central

Iinattiniemi, Sari; Jokelainen, Jari; Luukinen, Heikki

2009-01-01

Objective The aim of this prospective study was to examine risk factors of falling in a very old home-dwelling population. Design A prospective study of home-dwelling elderly people. Methods Baseline data were collected by home-nursing staff through postal questionnaires and clinical tests. Data on falls were recorded in telephone interviews every other month during a follow-up of 11 months constituting 494 person years (PY). Negative binomial modeling was used to assess fall risk. Setting General community. Subjects A population sample of home-dwelling subjects aged 85 years or older (n = 555). Main outcome measures Fall rate and risk factors of falls. Results Altogether 512 falls occurred in 273 (49%) subjects, incidence rate 1.03/PY. According to a multivariate model, history of recurrent falling, trouble with vision when moving, use of antipsychotic drug, and feelings of anxiety, nervousness, or fear were independent risk factors for subsequent falls. Conclusion Appropriate care of poor vision and feelings of anxiety, nervousness, or fear, and avoidance of use of antipsychotic drugs might be useful in the prevention of falls among the most elderly home-dwellers. PMID:19065453

Urinalysis requests on the elderly residing in the Auckland community: tick box requesting?

PubMed

Upton, Arlo; McEwan, M; Williamson, Deborah

2016-01-29

Urinalysis for microscopy and culture is one of the most frequently requested tests for microbiology laboratories, particularly from elderly patients. This study sought to describe the clinical appropriateness of urinalysis from community-dwelling elderly patients and subsequent antibiotic prescription. Demographic, laboratory, and antibiotic prescription data were collected on all samples submitted from patients ≥ 70 years during August 2014 to Labtests Auckland. In addition, clinical data were collected by questionnaire from a subgroup of 200 patients. During August 2014, approximately 7% of the Auckland population aged ≥ 70 years had urinalysis submitted. Urine dipstick was not routinely performed before specimen submission, particularly from patients living at home rather than a long-term care facility, and nearly 50% of samples were not cultured due to absence of pyuria. Escherichia coli was isolated from 23% of female and 7% of male specimens. E. coli isolates from our cohort were less susceptible to all antibiotics tested against compared with all E. coli isolated from all urines in 2014. Clinical indications were absent in 40% of the subgroup of patients. Antibiotic prescription within 7 days of urinalysis was common (36%). This study highlights the frequency of urinalysis testing among the elderly residing in the community. Clinical indications are often absent, and treatment of asymptomatic bacteriuria is likely to be contributing to excessive antibiotic prescription in this group of patients.

Hippocampal atrophy and memory dysfunction associated with physical inactivity in community-dwelling elderly subjects: The Sefuri study.

PubMed

Hashimoto, Manabu; Araki, Yuko; Takashima, Yuki; Nogami, Kohjiro; Uchino, Akira; Yuzuriha, Takefumi; Yao, Hiroshi

2017-02-01

Physical inactivity is one of the modifiable risk factors for hippocampal atrophy and Alzheimer's disease. We investigated the relationship between physical activity, hippocampal atrophy, and memory using structural equation modeling (SEM). We examined 213 community-dwelling elderly subjects (99 men and 114 women with a mean age of 68.9 years) without dementia or clinically apparent depression. All participants underwent Mini-Mental State Examination (MMSE) and Rivermead Behavioral Memory Test (RBMT). Physical activities were assessed with a structured questionnaire. We evaluated the degree of hippocampal atrophy (z-score-referred to as ZAdvance hereafter), using a free software program-the voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) based on statistical parametric mapping 8 plus Diffeomorphic Anatomical Registration Through an Exponentiated Lie algebra. Routine magnetic resonance imaging findings were as follows: silent brain infarction, n  = 24 (11.3%); deep white matter lesions, n  = 72 (33.8%); periventricular hyperintensities, n  = 35 (16.4%); and cerebral microbleeds, n  = 14 (6.6%). Path analysis based on SEM indicated that the direct paths from leisure-time activity to hippocampal atrophy (β = -.18, p  < .01) and from hippocampal atrophy to memory dysfunction (RBMT) (β = -.20, p  < .01) were significant. Direct paths from "hippocampus" gray matter volume to RBMT and MMSE were highly significant, while direct paths from "whole brain" gray matter volume to RBMT and MMSE were not significant. The presented SEM model fit the data reasonably well. Based on the present SEM analysis, we found that hippocampal atrophy was associated with age and leisure-time physical inactivity, and hippocampal atrophy appeared to cause memory dysfunction, although we are unable to infer a causal or temporal association between hippocampal atrophy and memory dysfunction from the present observational study.

Socio-demographic, behavioral and functional characteristics of groups of community and institutionalized elderly Quechua Indians of Peru, and their association with nutritional status.

PubMed

Fortunato, Laura; Drusini, Andrea G

2005-06-01

Socio-demographic, behavioral, functional and anthropometric data for groups of elderly Quechua Indians of Peru were used to investigate the effects of gender and lifestyle patterns on nutritional status. Two community-dwelling samples were selected for study, representative of divergent lifestyles in terms of their combination of socio-economic, demographic and cultural contexts, plus an ad-hoc sample of institutionalized individuals with controlled food intake and reduced physical activity. Results suggest that differences in socio-demographic, behavioral and functional characteristics exist between the sexes and across settings (low- vs. highland) and lifestyles (institutionalized vs. community-dwelling; semi-urban vs. rural). These factors are likely to be related to diverging dietary and physical activity patterns, and have considerable effects on the nutritional status of the respondents.

Relationship between functional capacity and body mass index with plasma coenzyme Q10 and oxidative damage in community-dwelling elderly-people.

PubMed

Del Pozo-Cruz, Jesús; Rodríguez-Bies, Elizabeth; Navas-Enamorado, Ignacio; Del Pozo-Cruz, Borja; Navas, Plácido; López-Lluch, Guillermo

2014-04-01

The impact of aging and physical capacity on coenzyme Q10 (Q10) levels in human blood is unknown. Plasma Q10 is an important factor in cardiovascular diseases. To understand how physical activity in the elderly affects endogenous Q10 levels in blood plasma, we studied a cohort of healthy community-dwelling people. Volunteers were subjected to different tests of the Functional Fitness Test Battery including handgrip strength, six-minute walk, 30 s chair to stand, and time up and go tests. Anthropometric characteristics, plasma Q10 and lipid peroxidation (MDA) levels were determined. Population was divided according to gender and fitness. We found that people showing higher levels of functional capacity presented lower levels of cholesterol and lipid peroxidation accompanied by higher levels of Q10 in plasma. The ratio Q10/cholesterol and Q10/LDL increased in these people. No relationship was found when correlated to muscle strength or agility. On the other hand, obesity was related to lower Q10 and higher MDA levels in plasma affecting women more significantly. Our data demonstrate for the first time that physical activity at advanced age can increase the levels of Q10 and lower the levels of lipid peroxidation in plasma, probably reducing the progression of cardiovascular diseases. Copyright © 2014 Elsevier Inc. All rights reserved.

VNTR polymorphisms of the IL-4 and IL-1RN genes and their relationship with frailty syndrome in Mexican community-dwelling elderly.

PubMed

Pérez-Suárez, Thalía Gabriela; Gutiérrez-Robledo, Luis Miguel; Ávila-Funes, José Alberto; Acosta, José Luis; Escamilla-Tilch, Mónica; Padilla-Gutiérrez, Jorge Ramón; Torres-Carrillo, Norma; Torres-Castro, Sara; López-Ortega, Mariana; Muñoz-Valle, José Francisco; Torres-Carrillo, Nora Magdalena

2016-10-01

Inflammation is a key event that is closely associated with the pathophysiology of frailty. The relationship of genetic polymorphisms into inflammatory cytokines with frailty remains poorly understood. The aim of this study was to investigate the association between VNTR polymorphisms of the IL-4 and IL-1RN genes with the risk of frailty. We included a sample of 630 community-dwelling elderly aged 70 and older. Both IL-4 and IL-1RN VNTR polymorphisms were genotyped by the polymerase chain reaction (PCR) method. Mean age was 77.7 years (SD = 6.0) and 52.5 % were women. The participants classified as frail were more likely to be older, had lower MMSE score (p < 0.001), and had more disability for IADL (p < 0.001) and ADL (p < 0.001). Genotypic and allelic frequencies for the IL-4 VNTR polymorphism did not show significant differences between study groups (p > 0.05). However, we just observed a significant difference in the allelic frequencies for the A2 allele of the IL-1RN VNTR polymorphism between frail and nonfrail groups (OR 1.84, 95 % CI 1.08-3.12, p = 0.02). In addition, we analyzed the combined effect of the IL-4 and IL-1RN VNTR polymorphisms and their possible association with frailty, where the combined IL-4 (low) -IL-1Ra (high) genotype was identified as a marker of risk to frailty syndrome (OR 7.86, 95 % CI 1.83-33.69, p = 0.006). Our results suggest that both A2 allele and the combined IL-4 (low) -IL-1Ra (high) genotype might be genetic markers of susceptibility to frailty in Mexican elderly.

Prevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors

PubMed Central

2008-01-01

Executive Summary In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry’s newly released Aging at Home Strategy. After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person’s transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report. Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series. Aging in the Community: Summary of Evidence-Based Analyses Prevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based Analysis Behavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based Analysis Caregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based Analysis Social Isolation in Community-Dwelling Seniors: An Evidence-Based Analysis The Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) Objective To identify interventions that may be effective in reducing the probability of an elderly person’s falling and/or sustaining a fall-related injury. Background Although estimates of fall rates vary widely based on the location, age, and living arrangements of the elderly population, it is estimated that each year approximately 30% of community-dwelling individuals aged

The associations of gender, depression and elder mistreatment in a community-dwelling Chinese population: the modifying effect of social support.

PubMed

Dong, XinQi; Beck, Todd; Simon, Melissa A

2010-01-01

The aims of this study are to: (1) examine the gender differences in the association of depression and elder mistreatment (EM) in a community-dwelling Chinese population; and (2) examine the potential differential modifying effect of greater social support on these associations. We conducted a cross-sectional study of 141 women and 270 men aged 60 years or greater who presented to an urban medical center. EM was assessed using the modified Vulnerability to Abuse Screening Scale (VASS) and depression was assessed using the Geriatric Depression Scale (GDS) and overall social support was measured using the Social Support Index (SSI). After adjusting for potential confounders, depression was associated with 447% increased risk for EM among men (odds ratio, OR = 4.47; 95% confidence intervals (CI) = 1.52-13.13) and 854% increased risk for EM among women (OR = 8.54; 95% CI = 2.85-25.57). After examining the effect of greater social support on depression (social support x depression), depression was no longer associated with increased risk for EM in men (parameter estimate = PE = 0.62 + or - 0.82 (+ or - S.E.M.) = 0.82, p = 0.454). However, among women, depression remained as a significant risk factor for EM (PE = 1.49 + or - 0.68, p = 0.029). Depression is significant risk factor for EM for both men and women. However, effect of greater overall social support may have higher protective effect in men than in women. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Health-related quality of life of elderly living in the rural community and homes for the elderly in a district of India. Application of the short form 36 (SF-36) health survey questionnaire.

PubMed

Varma, G R; Kusuma, Y S; Babu, B V

2010-08-01

The present investigation aimed to assess the health-related QoL (HRQoL) of elderly people living in two settings: (i) rural community and (ii) homes for the elderly in a district of South India. The data are drawn from elderly (>60 years of age) sampled from both settings. The short form 36-item health survey (SF-36) was administered to all respondents. The average scores for several domains, including total physical health, total mental health and overall health (total SF-36 score) were around 50, which can be interpreted as a moderate level of health-related QoL. Residents living in a home for the elderly scored better in all domains except for role-physical and role-emotional. Though univariate analysis revealed some associations between characteristics of elderly SF-36 scores, the multiple regression analysis indicated that working status yields a significant but negative coefficient for total SF-36 score among community dwelling elderly. The elderly report that their lives are better when they are staying in homes for the elderly. Hence, despite the socio-economic conditions, provision of a better and conducive environment by setting up more charity-based homes for the elderly may be one of the options for relative betterment of the QoL of the elderly, particularly those who are socially and economically deprived. Finally, the study warrants the need of normative values of SF-36 for various population groups in India.

Acceptance and Use of Health Information Technology By Community-Dwelling Elders

PubMed Central

Fischer, Shira H; David, Daniel; Crotty, Bradley H; Dierks, Meghan; Safran, Charles

2014-01-01

Objectives With the worldwide population growing in age, information technology may help meet important needs to prepare and support patients and families for aging. We sought to explore the use and acceptance of information technology for health among the elderly by reviewing the existing literature. Methods Review of literature using PubMed and Google Scholar, references from relevant papers, and consultation with experts. Results Elderly people approach the Internet and health information technology differently than younger people, but have growing rates of adoption. Assistive technology, such as sensors or home monitors, may help ‘aging in place,' but these have not been thoroughly evaluated. Elders face many barriers to using technology for healthcare decision-making, including issues with familiarity, willingness to ask for help, trust of the technology, privacy, and design challenges. Conclusions Barriers must be addressed for these tools to be available to this growing population. Design, education, research, and policy all play roles in addressing these barriers to acceptance and use. PMID:24996581

Acceptance and use of health information technology by community-dwelling elders.

PubMed

Fischer, Shira H; David, Daniel; Crotty, Bradley H; Dierks, Meghan; Safran, Charles

2014-09-01

With the worldwide population growing in age, information technology may help meet important needs to prepare and support patients and families for aging. We sought to explore the use and acceptance of information technology for health among the elderly by reviewing the existing literature. Review of literature using PubMed and Google Scholar, references from relevant papers, and consultation with experts. Elderly people approach the Internet and health information technology differently than younger people, but have growing rates of adoption. Assistive technology, such as sensors or home monitors, may help 'aging in place', but these have not been thoroughly evaluated. Elders face many barriers in using technology for healthcare decision-making, including issues with familiarity, willingness to ask for help, trust of the technology, privacy, and design challenges. Barriers must be addressed for these tools to be available to this growing population. Design, education, research, and policy all play roles in addressing these barriers to acceptance and use. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Age independency of mobility decrease assessed using the Locomotive Syndrome Risk Test in elderly with disability: a cross-sectional study.

PubMed

Yamada, Keiko; Muranaga, Shingo; Shinozaki, Tomohiro; Nakamura, Kozo; Tanaka, Sakae; Ogata, Toru

2018-01-26

Mobility decrease is reportedly age-dependent in community dwelling elderly, and a major factor of disability in the geriatric population. The purpose of this study is to examine whether mobility decrease, as assessed using a set of tests, is similarly age-dependent in elderly adults who already have disability. One hundred thirty-five community-dwelling elderly (54 men, 81 women) with disability and 1469 independent community dwellers (1009 men, 460 women) were analyzed. Disability was defined having a certified need for care under the long-term care insurance system in Japan. Lower extremity mobility decrease was quantified using the Locomotive Syndrome Risk Test, which comprises the two-step test, stand-up test, and 25-Question Geriatric Locomotive Function Scale (GLFS-25). Multivariable regression analyses indicated no age-related decrease in the three test scores among elderly with disability, whereas these scores all decreased with age among independent community dwellers. All the test scores decreased as care level increased. Mobility decrease among elderly adults with disability is unrelated to age. However, the severity of care level is associated with mobility decrease.

An Elder's View of Community Resilience.

PubMed

Gladue, Ruth; Lund, Carrielynn

2008-01-01

This paper is an interview between Carrielynn Lund and Cree Elder Ruth Gladue on research and community resilience in her semi-remote, northern Alberta community. Ruth is a Cree Elder born "during the war years." She is married and has two girls, one boy, and "a few grandchildren." Ruth has worked as a Community Health Representative (CHR) and Licensed Practical Nurse (LPN) for over forty years. She lives in a semi-remote First Nations community in northern Alberta.

Chronic pain among community-dwelling elderly: a population-based clinical study.

PubMed

Rapo-Pylkkö, Susanna; Haanpää, Maija; Liira, Helena

2016-06-01

To present the occurrence, characteristics, etiology, interference, and medication of chronic pain among the elderly living independently at home. A total of 460 subjects in three cohorts aged 75, 80 and 85 years respectively received visits by communal home-care department nurses for a cross-sectional survey. Of them, 175 had chronic (duration ≥ 3 months) pain with an average intensity of ≥ 4/10 and/or ≥ moderate interference in daily life. Clinical assessment was performed for consenting subjects to define the location, intensity, etiology, type, interference and medications of chronic pain. According to home visits, elderly people with chronic pain rated their health and mobility worse and felt sadder, lonelier and more tired than those without chronic pain. A geriatrician made clinical assessments for 106 patients with chronic pain in 2009-2013. Of them, 66 had three, 35 had two and 5 had one pain condition. The worst pain was musculoskeletal in 88 (83%) of patients. Pain was pure nociceptive in 61 (58%), pure neuropathic in 9 (8%), combined nociceptive and neuropathic pain in 34 (32%), and idiopathic in 2 (2%) patients. On a numerical rating scale from 0 to 10, the mean and maximal intensity of the worst pain was 5.7 and 7.7, respectively, while the mean pain interference was 5.9. Mean pain intensity and maximal pain intensity decreased by age. Duration of pain was longer than 5 years in 51 (48%) patients. Regular pain medication was used by 82 (77%) patients, most commonly paracetamol or NSAIDs. Although pain limited the lives of the elderly with chronic pain, they were as satisfied with their lives as those without chronic pain. Elderly people in our study often suffered from chronic pain, mostly musculoskeletal pain, and the origin of pain was neuropathic in up to 40% of these cases. However, elderly people with chronic pain rarely used the medications specifically for neuropathic pain. Based on increased loneliness, sadness and tiredness, as well as

Perceived Neighborhood Environment and Walking for Specific Purposes Among Elderly Japanese

PubMed Central

Inoue, Shigeru; Ohya, Yumiko; Odagiri, Yuko; Takamiya, Tomoko; Kamada, Masamitsu; Okada, Shinpei; Oka, Kohichiro; Kitabatake, Yoshinori; Nakaya, Tomoki; Sallis, James F; Shimomitsu, Teruichi

2011-01-01

Background Recent research has revealed the importance of neighborhood environment as a determinant of physical activity. However, evidence among elderly adults is limited. This study examined the association between perceived neighborhood environment and walking for specific purposes among Japanese elderly adults. Methods This population-based, cross-sectional study enrolled 1921 participants (age: 65–74 years, men: 51.9%). Neighborhood environment (International Physical Activity Questionnaire Environmental Module) and walking for specific purposes (ie, transportation or recreation) were assessed by self-report. Multilevel logistic regression analyses with individuals at level 1 and neighborhoods at level 2 were conducted to examine the association between environment and walking, after adjustment for potential confounders. Results Access to exercise facilities, social environment, and aesthetics were associated with total neighborhood walking. Odds ratios (95% CI) were 1.23 (1.00–1.51), 1.39 (1.14–1.71), and 1.48 (1.21–1.81), respectively. Regarding walking for specific purposes, social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Environmental correlates differed by specific types of walking and by sex. Transportation walking significantly correlated with a greater variety of environmental attributes. Sex differences were observed, especially for transportation walking. Bicycle lanes, crime safety, traffic safety, aesthetics, and household motor vehicles were significant correlates among men, while access to shops, access to exercise facilities, and social environment were important among women. Conclusions Specific environment–walking associations differed by walking purpose and sex among elderly adults. Social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Improving these environmental features might be effective in

No association between dietary patterns and depressive symptoms among a community-dwelling population in Japan

PubMed Central

2012-01-01

Background Studies of the associations between diet and depression have primarily focused on single nutrients or foods. Recently, dietary patterns representing a combination of foods have attracted more interest than individual nutrient. The objective of this study was to examine the association between dietary patterns and depressive symptoms among a community-dwelling population in Japan. Methods We examined the association between dietary patterns and the risk of depression among 791 Japanese community-dwelling individuals. Diet was assessed with a validated brief-type self-administered diet history questionnaire (BDHQ). Dietary patterns from 52 predefined food groups [energy-adjusted food (g/d)] were extracted by principal component analysis. The Center for Epidemiologic Studies Depression Scale (CES-D) with a cut-off point of 16 was used to assess the prevalence of depression. Results A total of 97 subjects (12.3%) were classified as having depression. Four dietary patterns were identified: “Healthy”, “Western”, “Bread and confectionery”, and “Alcohol and accompanying” dietary patterns. After adjusting for potential confounders, the dietary patterns were not related to the risk of depression. Conclusions The present study failed to find associations between dietary patterns and the risk of depression. However, the interpretation of our results was hampered by the lack of certain data, including employment physical activity and longitudinal observations. Potential associations between dietary patterns and depressive symptoms were not completely ruled out. Future research exploring dietary patterns and depressive symptoms is warranted. PMID:23006931

Safety of ipragliflozin in elderly Japanese patients with type 2 diabetes mellitus (STELLA-ELDER): Interim results of a post-marketing surveillance study.

PubMed

Terauchi, Yasuo; Yokote, Koutaro; Nakamura, Ichiro; Sugamori, Haruko

2016-01-01

To determine the incidence of adverse drug reactions (ADRs) associated with ipragliflozin in elderly Japanese patients with type 2 diabetes mellitus. We report interim results of a postmarketing surveillance survey. Japanese physicians recorded ADRs in elderly patients (≥ 65 years old) who were first prescribed with ipragliflozin within 3 months of its launch (April 2014). Incidence of ADRs within 1 year of starting treatment with ipragliflozin. 898 ADRs occurred in 721/7,170 patients (10.06%). Skin complication-, volume depletion-, genital infection-, polyuria/pollakiuria-, urinary tract infection-, and hypoglycemia-related ADRs occurred in 2.23%, 1.90%, 1.45%, 1.32%, 0.77%, and 0.32%, respectively. ADRs were classified as serious in 44 (0.61%) patients. Half of the ADRs occurred within 30 days of starting treatment. There were no cases of Stevens-Johnson syndrome or toxic epidermal necrolysis. Most (92.1%) of the ADRs resolved or improved. Glycated hemoglobin, fasting blood glucose, body weight, and systolic blood pressure decreased by 0.6% (baseline 7.8%), 22.7 mg/dL (baseline 163.0 mg/dL), 2.3 kg (baseline 67.4 kg), and 3.1 mmHg (baseline 133.2 mmHg), respectively, from baseline to treatment discontinuation/last visit. Ipragliflozin is well tolerated and reduced surrogate endpoints in elderly Japanese patients with type 2 diabetes mellitus. Clinicaltrials.gov identifier: NCT02297620.

Multicomponent Program to Reduce Functional Decline in Frail Elderly People: A Cluster Controlled Trial.

PubMed

Ruikes, Franca G H; Zuidema, Sytse U; Akkermans, Reinier P; Assendelft, Willem J J; Schers, Henk J; Koopmans, Raymond T C M

2016-01-01

The increasing number of community-dwelling frail elderly people poses a challenge to general practice. We evaluated the effectiveness of a general practitioner-led extensive, multicomponent program integrating cure, care, and welfare for the prevention of functional decline. We performed a cluster controlled trial in 12 general practices in Nijmegen, the Netherlands. Community-dwelling frail elderly people aged ≥70 years were identified with the EASY-Care two-step older persons screening instrument. In 6 general practices, 287 frail elderly received care according to the CareWell primary care program. This consisted of proactive care planning, case management, medication reviews, and multidisciplinary team meetings with a general practitioner, practice and/or community nurse, elderly care physician, and social worker. In another 6 general practices, 249 participants received care as usual. The primary outcome was independence in functioning during (instrumental) activities of daily living (Katz-15 index). Secondary outcomes were quality of life [EuroQol (EQ5D+C) instrument], mental health and health-related social functioning (36-item RAND Short Form survey instrument), institutionalization, hospitalization, and mortality. Outcomes were assessed at baseline and at 12 months, and were analyzed with linear mixed-model analyses. A total of 204 participants (71.1%) in the intervention group and 165 participants (66.3%) in the control group completed the study. No differences between groups regarding independence in functioning and secondary outcomes were found. We found no evidence for the effectiveness of a multifaceted integrated care program in the prevention of adverse outcomes in community-dwelling frail elderly people. Large-scale implementation of this program is not advocated. © Copyright 2016 by the American Board of Family Medicine.

Domestic Environmental Risk Factors Associated with Falling in Elderly

PubMed Central

LÖK, Neslihan; AKIN, Belgin

2013-01-01

Background: This is a cross-sectional study aiming at analyzing the relation between falling and domestic environmental –risk factors in community-dwelling elderly. Methods: The study consisted of 243 randomly chosen community-dwelling elderly over 65 years of age living around a health care center in Central Selcuklu, Konya. Data were collected with a questionnaire form including socio-demographic and other characteristics, with the Rivermead Mobility Index for evaluating mobility condition and an Evaluation Form of Domestic Environmental Risk Factors of Falling (EFDERF), which is developed by the researcher to assess domestic environmental risk factors of falling. Results: Based on (EFDERF) high number of problems lived in bathroom/restroom, kitchen, bedroom, sitting room/saloon and in all other areas was a risk factor in terms of domestic falling characteristics while the number of problems lived in hall and stairs was not a significant risk factor. Conclusion: EFDERF may be used by the nurses and health professionals to evaluate risk of falling and collecting data after visits in primary-care of elderly. PMID:23515204

The Association between Elder Mistreatment and Suicidal Ideation among Community-Dwelling Chinese Older Adults in the U.S

PubMed Central

Dong, XinQi; Chen, Ruijia; Wu, Bei; Zhang, Ning Jackie; Mui, Ada Chan Yuk-Sim; Chi, Iris

2015-01-01

Background Elder mistreatment and suicidal ideation are important public health concerns among aging populations. However, very few studies have been conducted to explore the association between elder mistreatment and suicidal ideation. Objectives To examine the association between elder mistreatment and suicidal ideation among Chinese older adults in the U.S. Methods Guided by a community-based participatory research approach, this study conducted in-person interviews with Chinese older adults aged 60 years and older in the Greater Chicago Area from 2011–2013. Elder mistreatment was assessed by a 10-item instrument derived from the Hwalek-Sengstok Elder Abuse Screening Test (H-S/EAST) and the Vulnerability to Abuse Screening Scale (VASS). Suicidal ideation was assessed by the ninth item of the Patient Health Questionnaire (PHQ-9) and the Geriatric Mental State Examination-Version A (GMS-A). Results Overall, 3,159 Chinese older adults participated in this study and the mean age was 72.8. After controlling for age, gender, education, income, medical comorbidities, depressive symptoms, and social support, elder mistreatment was significantly associated with increased risk for 2-week suicidal ideation (OR 2.46, 95% CI 1.52 – 4.01) and 12-month suicidal ideation (OR 2.46, 95% CI 1.62 – 3.73). With respect to gender differences, the study found that the association remained significant in older women but not in older men after adjusting for all confounding factors. Conclusion As the largest epidemiology study conducted among Chinese older adults in the U.S., this study suggests that elder mistreatment was a risk factor for 2-week and 12-month suicidal ideation in older women but not in older men. Longitudinal studies should be conducted to explore the mechanisms through which elder mistreatment links with suicidal ideation. PMID:26336817

Aromatherapy: does it help to relieve pain, depression, anxiety, and stress in community-dwelling older persons?

PubMed

Tang, Shuk Kwan; Tse, M Y Mimi

2014-01-01

To examine the effectiveness of an aromatherapy programme for older persons with chronic pain. The community-dwelling elderly people who participated in this study underwent a four-week aromatherapy programme or were assigned to the control group, which did not receive any interventions. Their levels of pain, depression, anxiety, and stress were collected at the baseline and at the postintervention assessment after the conclusion of the four-week programme. Eighty-two participants took part in the study. Forty-four participants (37 females, 7 males) were in the intervention group and 38 participants (30 females, 8 males) were in the control group. The pain scores were 4.75 (SD 2.32) on a 10-point scale for the intervention group and 5.24 (SD 2.14) for the control group before the programme. There was a slight reduction in the pain score of the intervention group. No significant differences were found in the same-group and between-group comparisons for the baseline and postintervention assessments. The depression, anxiety, and stress scores for the intervention group before the programme were 11.18 (SD 6.18), 9.64 (SD 7.05), and 12.91 (SD 7.70), respectively. A significant reduction in negative emotions was found in the intervention group (P<0.05). The aromatherapy programme can be an effective tool to reduce pain, depression, anxiety, and stress levels among community-dwelling older adults.

Minor positive effects of health-promoting senior meetings for older community-dwelling persons on loneliness, social network, and social support.

PubMed

Gustafsson, Susanne; Berglund, Helene; Faronbi, Joel; Barenfeld, Emmelie; Ottenvall Hammar, Isabelle

2017-01-01

The aim of this study was to evaluate the 1-year effect of the health-promoting intervention "senior meetings" for older community-dwelling persons regarding loneliness, social network, and social support. Secondary analysis of data was carried out from two randomized controlled studies: Elderly Persons in the Risk Zone and Promoting Aging Migrants' Capabilities. Data from 416 participants who attended the senior meetings and the control group at baseline and the 1-year follow-up in the respective studies were included. Data were aggregated and analyzed with chi-square test and odds ratio (OR) to determine the intervention effect. The senior meetings had a positive effect on social support regarding someone to turn to when in need of advice and backing (OR 1.72, p =0.01). No positive intervention effect could be identified for loneliness, social network, or other aspects of social support. Health-promoting senior meetings for older community-dwelling persons have a minor positive effect on social support. The senior meetings might benefit from a revision to reinforce content focused on loneliness, social network, and social support. However, the modest effect could also depend on the lack of accessible social resources to meet participants' identified needs, a possible hindrance for a person's capability. This makes it necessary to conduct further research to evaluate the effect of the senior meetings and other health-promoting initiatives on social aspects of older community-dwelling people's lives, since these aspects are of high importance for life satisfaction and well-being in old age.

Minor positive effects of health-promoting senior meetings for older community-dwelling persons on loneliness, social network, and social support

PubMed Central

Gustafsson, Susanne; Berglund, Helene; Faronbi, Joel; Barenfeld, Emmelie; Ottenvall Hammar, Isabelle

2017-01-01

Objective The aim of this study was to evaluate the 1-year effect of the health-promoting intervention “senior meetings” for older community-dwelling persons regarding loneliness, social network, and social support. Methods Secondary analysis of data was carried out from two randomized controlled studies: Elderly Persons in the Risk Zone and Promoting Aging Migrants’ Capabilities. Data from 416 participants who attended the senior meetings and the control group at baseline and the 1-year follow-up in the respective studies were included. Data were aggregated and analyzed with chi-square test and odds ratio (OR) to determine the intervention effect. Results The senior meetings had a positive effect on social support regarding someone to turn to when in need of advice and backing (OR 1.72, p=0.01). No positive intervention effect could be identified for loneliness, social network, or other aspects of social support. Conclusion Health-promoting senior meetings for older community-dwelling persons have a minor positive effect on social support. The senior meetings might benefit from a revision to reinforce content focused on loneliness, social network, and social support. However, the modest effect could also depend on the lack of accessible social resources to meet participants’ identified needs, a possible hindrance for a person’s capability. This makes it necessary to conduct further research to evaluate the effect of the senior meetings and other health-promoting initiatives on social aspects of older community-dwelling people’s lives, since these aspects are of high importance for life satisfaction and well-being in old age. PMID:29158669

Effects of exercise and milk fat globule membrane (MFGM) supplementation on body composition, physical function, and hematological parameters in community-dwelling frail Japanese women: a randomized double blind, placebo-controlled, follow-up trial.

PubMed

Kim, Hunkyung; Suzuki, Takao; Kim, Miji; Kojima, Narumi; Ota, Noriyasu; Shimotoyodome, Akira; Hase, Tadashi; Hosoi, Erika; Yoshida, Hideyo

2015-01-01

To investigate the combined and separate effects of exercise and milk fat globule membrane (MFGM) supplementation on frailty, physical function, physical activity level, and hematological parameters in community-dwelling elderly Japanese women. A total of 131 frail, elderly women over 75 years were randomly assigned to one of four groups: exercise and MFGM supplementation (Ex+MFGM), exercise and placebo (Ex+Plac), MFGM supplementation, or the placebo group. The exercise group attended a 60-minute training program twice a week for three months, and the MFGM group ingested 1g of the MFGM supplement in pill form, daily for 3 months. The primary outcome measure was change in frailty status based on Fried's frailty phenotype. Secondary outcome measures included body composition, physical function and hematological parameters, and interview survey components assessing lifestyle factors. Participants were followed for 4 months post-intervention. Significant group × time interactions were observed for usual walking speed (P = 0.005), timed up & go (P<0.001), and insulin-like growth factor-binding protein 3/insulin-like growth factor 1 ratio (P = 0.013). The frailty components revealed that weight loss, exhaustion, low physical activity, and slow walking speed were reversed, but low muscle strength did not significantly changed. Frailty reversal rate was significantly higher in the Ex+MFGM (57.6%) than in the MFGM (28.1%) or placebo (30.3%) groups at post-intervention (χ2 = 8.827, P = 0.032), and at the follow-up was also significantly greater in the Ex+MFGM (45.5%) and Ex+Plac (39.4%) groups compared with the placebo (15.2%) group (χ2 = 8.607, P = 0.035). The exercise+MFGM group had the highest odds ratio (OR) for frailty reversal at post-intervention and follow-up (OR = 3.12, 95% confidence interval (CI) = 1.13-8.60; and OR = 4.67, 95% CI = 1.45-15.08, respectively). This study suggests that interventions including exercise and nutrition can improve frailty status

Effects of a resistance training program performed with an interocclusal splint for community-dwelling older adults: a randomized controlled trial

PubMed Central

Hirase, Tatsuya; Inokuchi, Shigeru; Matsusaka, Nobuou; Nakahara, Kazumi; Okita, Minoru

2016-01-01

[Purpose] To examine whether resistance training for elderly community-dwellers performed with an interocclusal splint resulted in greater lower extremity muscle strength and better balance than resistance training performed without an interocclusal splint. [Subjects and Methods] Eighty-eight elderly persons using Japanese community day centers were randomly divided into two groups: an intervention group (n=45), which performed resistance training with an interocclusal splint; and a control group (n=43), which performed resistance training without an interocclusal splint. The resistance training program comprised a 40-min session performed twice a week for 12 weeks. Outcome measures were the chair stand test (CST), timed up and go test (TUG), and one-leg standing test (OLST). Assessments were conducted before the intervention and every 2 weeks after the start of the intervention. [Results] There was a significant group × time interaction for the OLST, with the intervention group showing significant improvement from 8 to 12 weeks compared to the control group. For the CST and TUG, no significant differences were found between the two groups throughout the 12 weeks. [Conclusion] Resistance training with an interocclusal splint improved the balance ability of elderly community-dwellers more effectively than resistance training without an interocclusal splint. PMID:27313359

Effects of a resistance training program performed with an interocclusal splint for community-dwelling older adults: a randomized controlled trial.

PubMed

Hirase, Tatsuya; Inokuchi, Shigeru; Matsusaka, Nobuou; Nakahara, Kazumi; Okita, Minoru

2016-05-01

[Purpose] To examine whether resistance training for elderly community-dwellers performed with an interocclusal splint resulted in greater lower extremity muscle strength and better balance than resistance training performed without an interocclusal splint. [Subjects and Methods] Eighty-eight elderly persons using Japanese community day centers were randomly divided into two groups: an intervention group (n=45), which performed resistance training with an interocclusal splint; and a control group (n=43), which performed resistance training without an interocclusal splint. The resistance training program comprised a 40-min session performed twice a week for 12 weeks. Outcome measures were the chair stand test (CST), timed up and go test (TUG), and one-leg standing test (OLST). Assessments were conducted before the intervention and every 2 weeks after the start of the intervention. [Results] There was a significant group × time interaction for the OLST, with the intervention group showing significant improvement from 8 to 12 weeks compared to the control group. For the CST and TUG, no significant differences were found between the two groups throughout the 12 weeks. [Conclusion] Resistance training with an interocclusal splint improved the balance ability of elderly community-dwellers more effectively than resistance training without an interocclusal splint.

Resilience in Rural Community-Dwelling Older Adults

ERIC Educational Resources Information Center

Wells, Margaret

2009-01-01

Context: Identifying ways to meet the health care needs of older adults is important because their numbers are increasing and they often have more health care issues. High resilience level may be one factor that helps older adults adjust to the hardships associated with aging. Rural community-dwelling older adults often face unique challenges such…

Effects of Improvement on Selective Attention: Developing Appropriate Somatosensory Video Game Interventions for Institutional-Dwelling Elderly with Disabilities

ERIC Educational Resources Information Center

Chen, Shang-Ti; Chiang, I-Tsun; Liu, Eric Zhi-Feng; Chang, Maiga

2012-01-01

The purpose of this study was to develop appropriate somatosensory video game interventions on enhancing selective attention of institutional-dwelling elderly with disabilities. Fifty-eight participants aged 65[approximately]92 were recruited and divided into four groups, 4-week and 8-week experimental and two control groups, for evaluating the…

Cutoffs and cardiovascular risk factors associated with neck circumference among community-dwelling elderly adults: a cross-sectional study.

PubMed

Coelho, Hélio José; Sampaio, Ricardo Aurélio Carvalho; Gonçalvez, Ivan de Oliveira; Aguiar, Samuel da Silva; Palmeira, Rafael; Oliveira, José Fernando de; Asano, Ricardo Yukio; Sampaio, Priscila Yukari Sewo; Uchida, Marco Carlos

2016-01-01

In elderly people, measurement of several anthropometric parameters may present complications. Although neck circumference measurements seem to avoid these issues, the cutoffs and cardiovascular risk factors associated with this parameter among elderly people remain unknown. This study was developed to identify the cutoff values and cardiovascular risk factors associated with neck circumference measurements among elderly people. Cross-sectional study conducted in two community centers for elderly people. 435 elderly adults (371 women and 64 men) were recruited. These volunteers underwent morphological evaluations (body mass index and waist, hip, and neck circumferences) and hemodynamic evaluations (blood pressure values and heart rate). Receiver operating characteristic curve analyses were used to determine the predictive validity of cutoff values for neck circumference, for identifying overweight/obesity. Multivariate analysis was used to identify cardiovascular risk factors associated with large neck circumference. Cutoff values for neck circumference (men = 40.5 cm and women = 35.7 cm), for detection of obese older adults according to body mass index, were identified. After a second analysis, large neck circumference was shown to be associated with elevated body mass index in men; and elevated body mass index, blood pressure values, prevalence of type 2 diabetes and hypertension in women. The data indicate that neck circumference can be used as a screening tool to identify overweight/obesity in older people. Moreover, large neck circumference values may be associated with cardiovascular risk factors.

Serum level of LOX-1 ligand containing ApoB is associated with increased carotid intima-media thickness in Japanese community-dwelling men, especially those with hypercholesterolemia LOX-1 ligand and IMT in Japanese.

PubMed

Okamura, Tomonori; Miura, Katsuyuki; Sawamura, Tatsuya; Kadota, Aya; Hisamatsu, Takashi; Fujiyoshi, Akira; Miyamatsu, Naomi; Takashima, Naoyuki; Miyagawa, Naoko; Kadowaki, Takashi; Ohkubo, Takayoshi; Murakami, Yoshitaka; Nakamura, Yasuyuki; Ueshima, Hirotsugu

2016-01-01

The serum level of LOX-1 ligand containing ApoB (LAB) may reflect atherogenicity better than usual lipid parameters; however, the relationship between LAB and carotid intima-media thickness (IMT) was not clear even in Asian populations. A total of 992 community-dwelling Japanese men, aged 40 to 79 years, were enrolled in the present study. Serum LAB levels were measured by enzyme-linked immunosorbent assays (ELISAs) with recombinant LOX-1 and monoclonal anti-apolipoprotein B antibody. Serum LAB levels (median [interquartile range], μg cs/L) were 5341 μg cs/L (4093-7125). The mean average IMT of the common carotid artery was highest in the fourth LAB quartile (842 μm) compared with the first quartile (797 μm) after adjustment for age, high-density lipoprotein cholesterol, triglyceride, body mass index, hypertension, diabetes, high sensitivity C-reactive protein, smoking, and alcohol drinking. However, this statistically significant difference was lost after further adjustment for total cholesterol (TC). After stratification using the combination of median LAB and hypercholesterolemia (serum TC ≥ 6.21 mmol/L and/or lipid-lowering medication), the adjusted mean average IMT (standard error) in the high LAB/hypercholesterolemia group was 886 μm (12.7), 856 μm (16.7) in the low LAB/hypercholesterolemia group, and 833 μm (8.4) in the low LAB/normal cholesterol group (P = .004). After further adjustment for TC, mean average IMT in the high LAB group was significantly higher than that measured in the low LAB group in hypercholesterolemic participants not taking lipid-lowering medication. Serum LAB was associated with an increased carotid IMT in Japanese men, especially those with hypercholesterolemia. Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Low plasma tryptophan is associated with olfactory function in healthy elderly community dwellers in Japan.

PubMed

Adachi, Yusuke; Shimodaira, Yoshiki; Nakamura, Hidehiro; Imaizumi, Akira; Mori, Maiko; Kageyama, Yoko; Noguchi, Yasushi; Seki, Asuka; Okabe, Yuki; Miyake, Yuko; Ono, Kaori; Kumagai, Shu

2017-10-16

Decreased circulating tryptophan (Trp) levels are frequently observed in elderly patients with neurodegenerative disease including Alzheimer's disease. Trp may serve as a potential biomarker for monitoring disease risk in elderly people. We aimed to investigate the association between low plasma Trp levels and olfactory function, which is known to predict age-related diseases including dementia in elderly people. A total of 144 healthy elderly Japanese community (≥ 65 years old) dwellers from the Health, Aging and Nutritional Improvement study (HANI study) were the subjects of our analysis. Low Trp levels were classified using the lower limit values of the reference interval according to a previous report. Olfactory function was assessed using a card-type test called Open Essence, which includes 12 odour items that are familiar to Japanese people. The elderly subjects with low circulating Trp levels were compared to a control group with normal plasma Trp levels. We conducted the analyses using 144 people aged 65 years or older (mean age 73.7 ± 5.5 years; 36.1% men). The subjects showed normal serum albumin levels (4.4 ± 0.2 g/dL) and no daily living disabilities. Low plasma Trp levels (low Trp group) were found in 11.1% of the study population. The low Trp group showed a significantly lower correct-answer rate for the items india ink, perfume, curry and sweaty smelling socks than control group (P < 0.05). There was also a significant association between low Trp levels and low olfactory ability, after adjusting for age and sex. Lower plasma Trp levels were associated with a decrease in olfactory function in functionally competent older individuals. Because olfactory dysfunction predicts age-related diseases, low plasma Trp levels may represent a clinical sign of disease risk in elderly people.

Determinants of participation in colorectal cancer screening among community-dwelling Chinese older people: Testing a comprehensive model using a descriptive correlational study.

PubMed

Leung, Doris Y P; Wong, Eliza M L; Chan, Carmen W H

2016-04-01

The prevalence of colorectal cancer (CRC) among older people is high. Screening for CRC presents a cost-effective secondary prevention and control strategy which results in a significant reduction in mortality. This study aims to describe the prevalence of CRC screening and examine its risk factors among Chinese community-dwelling older people guided by a comprehensive model combining Health Belief Model and Extended Parallel Processing Model. A descriptive correlational study was conducted. A convenience sample of 240 community-dwelling adults aged ≥60 was recruited in May-July in 2012 in Hong Kong. Participants were asked to complete a questionnaire which collected information on demographic variables, CRC-related psychosocial variables and whether they had a CRC screening in the past 10 years. Among the participants, 25.4% reported having a CRC screening test. Results of logistic regression analyses indicated that participants with a higher level in cue to action, and lower perceived knowledge barriers and severity-fear were significantly associated with participation in CRC screening. But there were no significant associations between fatalism and cancer fear with screening. The prevalence of CRC screening was low in Hong Kong Chinese community-dwelling elders. A number of modifiable factors associated with CRC screening were identified which provides specific targets for interventions. This study also adds to the knowledge regarding the associations between fatalism and fear with CRC screening behaviors among Chinese older people. Copyright © 2015 Elsevier Ltd. All rights reserved.

Transformation of dwelling culture based on riverine community in Musi River Palembang

NASA Astrophysics Data System (ADS)

Wicaksono, Bambang; Siswanto, Ari; Kusdiwanggo, Susilo; Anwar, Widya Fransiska Febriati

2017-11-01

Palembang City development since the Palembang Darussalam Sultanate era to the reformation era has impact on the living culture community, less of the raft houses, houses on stilts transformed into a terraced house, and the house became the dominant land. Dwelling Culture oriented on transformation of river become land-oriented. The development has leaving identity, character, and potential of the riverine architecture and dwelling life of river. The goals of study are to describe a case and revealing the meaning of dwelling cultural transformation in Musi River society from the process of cultural acculturation and investigate the architectural aspect from the form of house and modes of dwelling through the structuralism approach. The data collection is conducted qualitatively by using data collection techniques such as observation, interview, literature study, whereas the method of analysis, is a method that is done through Levi-Strauss structuralism approach that identifies all the elements of community thought in a systematic procedure. The results showed the structure behind the orientation, position, shape, and layout of dwelling revealed through the meanings in it. It means, the change and development from cultural acculturation process which oriented in the land dwelling, based on structure thinking of Palembang society.

Oral conditions and dysphagia in Japanese, community-dwelling middle- and older- aged adults, independent in daily living.

PubMed

Inui, Akinari; Takahashi, Ippei; Kurauchi, Sizuka; Soma, Yuki; Oyama, Toshiaki; Tamura, Yoshihiro; Noguchi, Takao; Murashita, Kouichi; Nakaji, Shigeyuki; Kobayashi, Wataru

2017-01-01

Prevention, early detection and effective rehabilitation of dysphagia are important issues to be considered in an aging society. Previous studies have shown conflicting findings regarding the association between dysphagia and its potential risk factors, including age, malnutrition, oral conditions, lifestyle and medical history. Herein, we assessed the prevalence and association of dysphagia with potential risk factors in 50- to 79-year-old adults dwelling in a community in Japan. In this study, there were 532 participants (185 males and 347 females). Participants who responded positively to the question "Do you sometimes choke on drinks/food such as tea and soup?" or those who presented with abnormal repetitive saliva swallowing test findings were diagnosed with dysphagia. The data collected from these participants included the following: number of teeth, occurrence of oral dryness, age, body mass index, serum albumin concentration, smoking, drinking and exercise habits, presence of diseases, such as diabetes mellitus and hypertension, and questions from the Mini-Mental State Examination. Dysphagia was observed in 33 males (17.8%) and 76 females (21.9%). To explore the effect of the potential risk factors on the prevalence of dysphagia, a model was built by multivariate logistic regression analysis. Using the forced entry method, oral dryness (odds ratio [OR] =3.683 and P =0.003 in males; OR =1.797 and P =0.032 in females) and the number of teeth (OR =0.946 and P =0.038 in males) were found to be significantly related to dysphagia. This cross-sectional study demonstrated associations between oral conditions and dysphagia. Factors such as oral dryness and number of teeth may contribute to dysphagia more so than aging, lifestyle and comorbidity in community-dwelling adults over the age of 50.

Oral conditions and dysphagia in Japanese, community-dwelling middle- and older- aged adults, independent in daily living

PubMed Central

Inui, Akinari; Takahashi, Ippei; Kurauchi, Sizuka; Soma, Yuki; Oyama, Toshiaki; Tamura, Yoshihiro; Noguchi, Takao; Murashita, Kouichi; Nakaji, Shigeyuki; Kobayashi, Wataru

2017-01-01

Purpose Prevention, early detection and effective rehabilitation of dysphagia are important issues to be considered in an aging society. Previous studies have shown conflicting findings regarding the association between dysphagia and its potential risk factors, including age, malnutrition, oral conditions, lifestyle and medical history. Herein, we assessed the prevalence and association of dysphagia with potential risk factors in 50- to 79-year-old adults dwelling in a community in Japan. Patients and methods In this study, there were 532 participants (185 males and 347 females). Participants who responded positively to the question “Do you sometimes choke on drinks/food such as tea and soup?” or those who presented with abnormal repetitive saliva swallowing test findings were diagnosed with dysphagia. The data collected from these participants included the following: number of teeth, occurrence of oral dryness, age, body mass index, serum albumin concentration, smoking, drinking and exercise habits, presence of diseases, such as diabetes mellitus and hypertension, and questions from the Mini–Mental State Examination. Results Dysphagia was observed in 33 males (17.8%) and 76 females (21.9%). To explore the effect of the potential risk factors on the prevalence of dysphagia, a model was built by multivariate logistic regression analysis. Using the forced entry method, oral dryness (odds ratio [OR] =3.683 and P=0.003 in males; OR =1.797 and P=0.032 in females) and the number of teeth (OR =0.946 and P=0.038 in males) were found to be significantly related to dysphagia. Conclusion This cross-sectional study demonstrated associations between oral conditions and dysphagia. Factors such as oral dryness and number of teeth may contribute to dysphagia more so than aging, lifestyle and comorbidity in community-dwelling adults over the age of 50. PMID:28352164

Effects of social support and self-esteem on depressive symptoms in Japanese middle-aged and elderly people.

PubMed

Fukukawa, Y; Tsuboi, S; Niino, N; Ando, F; Kosugi, S; Shimokata, H

2000-04-01

We examined the relationship among social support, self-esteem, and depression. The subjects were 1,116 Japanese community-dwelling adults aged between 40-79, who were the first wave participants of the National Institute for Longevity Sciences--Longitudinal Study of Aging (NILS-LSA). Exploratory and confirmatory factor analyses were performed on the Rosenberg's self-esteem scale that supported the superiority of the bi-dimensional structure of the scale marked by self-confidence and self-deprecation subscales. The subsequent causal analyses, using structural equation modeling, demonstrated that social support reduced depressed affect through an increase in self-confidence and a decrease in self-deprecation. By contrast, social support did not show a direct effect on depressed affect. The findings suggest the importance of esteem-improving elements of social support in reducing depressive symptoms.

Elderly Japanese emigrants to Brazil before World War II: I. Clinical profiles based on specific historical background.

PubMed

Meguro, M; Meguro, K; Caramelli, P; Ishizaki, J; Ambo, H; Chubaci, R Y; Hamada, G S; Nitrini, R; Yamadori, A

2001-08-01

To research the demographic and clinical profiles of elderly Japanese emigrants, who arrived in Brazil before World War II, in order to give them appropriate psychogeriatric care. Elderly Japanese immigrants aged 65 years and over, belonging to the Miyagi Association in the São Paulo Metropolitan Area, were targeted. They emigrated from Miyagi Prefecture to Brazil and are now living in the area. We were able to interview 166 respondents. All data were gathered using standardized interview methods covering (a) free interview about the immigration history, (b) demographics, and (c) physical status. Through the free interview, we found their immigration histories, which affected their clinical profiles. The mean age and educational level were 77.5 years and 6.3 years, respectively. Sixty per cent of them immigrated when they were younger than 14. Ninety-four per cent of them still keep Japanese nationality. Fifty-seven per cent of them usually use Japanese, while 10% of them use Portuguese. Although their emigration histories were hard, 76% of them perceived their health as being excellent or relatively good. The percentages of subjects with histories of disease were hypertension, 52.5%; cardiac disease, 20.8%; diabetes mellitus, 24.2%; and hyperlipidemia, 25.0%, which were affected by the Brazilian environment. The elderly Japanese who emigrated to Brazil before World War II have a unique historical and demographic background. Their clinical profiles cannot be fully understood without knowing their histories. They definitely need high quality international psychogeriatric care. Copyright 2001 John Wiley & Sons, Ltd.

Self-Management Group Exercise Extends Healthy Life Expectancy in Frail Community-Dwelling Older Adults.

PubMed

Yamada, Minoru; Arai, Hidenori

2017-05-15

Preventing frailty and its adverse health outcomes is crucial in countries with a large elderly population, such as Japan. Since the long-term care insurance (LTCI) system was launched, the number of certified older adults with LTCI service requirement has continued to increase. This is a serious problem, because the LTCI service requirement certification is equivalent to disability. The aim of this study was to evaluate the effect of a self-management group intervention on new LTCI service requirement certifications in community-dwelling older adults in Japan. We analyzed the cohort data from a prospective study. In this study, we recruited community-dwelling adults aged 65 years and older who were independent in a city in Kyoto prefecture in 2012. The subjects in the participation group (n = 1620) attended 60-min group training sessions once or twice every two weeks from December 2012 to December 2016. The exercise sessions consisted of mild-intensity aerobic exercise, mild strength training, flexibility and balance exercises, and cool-down activities. These exercise classes were facilitated by well-trained volunteer staff. The outcome measure was the number of new LTCI requirement certifications during a four-year follow-up period. During the four-year follow-up period, 247 subjects (15.2%) in the participation group and 334 (20.6%) in the control group were newly certified for LTCI service requirements. The hazard ratio for new LTCI service requirements in the participation group compared with the control group was 0.73 (95% CI = 0.62-0.86) in the four-year follow-up period. These results indicate the usefulness of self-management group exercise to reduce the incidence of disability in older adults. Thus, increasing self-management group activities in each community should be encouraged.

Estimated Dietary Polyphenol Intake and Major Food and Beverage Sources among Elderly Japanese

PubMed Central

Taguchi, Chie; Fukushima, Yoichi; Kishimoto, Yoshimi; Suzuki-Sugihara, Norie; Saita, Emi; Takahashi, Yoshinari; Kondo, Kazuo

2015-01-01

Estimating polyphenol intake contributes to the understanding of polyphenols’ health benefits. However, information about human polyphenol intake is scarce, especially in the elderly. This study aimed to estimate the dietary intake and major sources of polyphenols and to determine whether there is any relationship between polyphenol intake and micronutrient intake in healthy elderly Japanese. First, 610 subjects (569 men, 41 women; aged 67.3 ± 6.1 years) completed food frequency questionnaires. We then calculated their total polyphenol intake using our polyphenol content database. Their average total polyphenol intake was 1492 ± 665 mg/day, the greatest part of which was provided by beverages (79.1%). The daily polyphenol intake differed largely among individuals (183–4854 mg/day), also attributable mostly to beverage consumption. Coffee (43.2%) and green tea (26.6%) were the major sources of total polyphenol; the top 20 food items accounted for >90%. The polyphenol intake did not strongly correlate with the intake of any micronutrient, suggesting that polyphenols may exert health benefits independently of nutritional intake. The polyphenol intake in this elderly population was slightly higher than previous data in Japanese adults, and beverages such as coffee and green tea contributed highly to the intake. PMID:26690212

Estimated Dietary Polyphenol Intake and Major Food and Beverage Sources among Elderly Japanese.

PubMed

Taguchi, Chie; Fukushima, Yoichi; Kishimoto, Yoshimi; Suzuki-Sugihara, Norie; Saita, Emi; Takahashi, Yoshinari; Kondo, Kazuo

2015-12-09

Estimating polyphenol intake contributes to the understanding of polyphenols' health benefits. However, information about human polyphenol intake is scarce, especially in the elderly. This study aimed to estimate the dietary intake and major sources of polyphenols and to determine whether there is any relationship between polyphenol intake and micronutrient intake in healthy elderly Japanese. First, 610 subjects (569 men, 41 women; aged 67.3 ± 6.1 years) completed food frequency questionnaires. We then calculated their total polyphenol intake using our polyphenol content database. Their average total polyphenol intake was 1492 ± 665 mg/day, the greatest part of which was provided by beverages (79.1%). The daily polyphenol intake differed largely among individuals (183-4854 mg/day), also attributable mostly to beverage consumption. Coffee (43.2%) and green tea (26.6%) were the major sources of total polyphenol; the top 20 food items accounted for >90%. The polyphenol intake did not strongly correlate with the intake of any micronutrient, suggesting that polyphenols may exert health benefits independently of nutritional intake. The polyphenol intake in this elderly population was slightly higher than previous data in Japanese adults, and beverages such as coffee and green tea contributed highly to the intake.

[Association between sleep quality and life function among elderly community residents].

PubMed

Tanaka, Mika; Kusaga, Mari; Tagaya, Hirokuni; Miyoko, I; Oshima, Asami; Watanabe, Chiho

2012-01-01

To investigate the association between sleep quality and life function in an elderly Japanese population. A total of 563 residents of a village in Kumamoto Prefecture aged ≥65 years were asked to fill out a self-administered questionnaire survey from June to July 2010. Sleep quality and life function were respectively evaluated using the Pittsburgh Sleep Quality Index (PSQI) and Basics Check List, which is used to screen elderly individuals at high risk of needing long-term care in the future. As adjustment factors, age, sex, economic situation, residency status, medical history, depression status, and cognitive function were assessed. We examined the relationship between sleep quality and life function using multiple logistic regression analysis, with life function as a dependent variable. Subjects already receiving care or with psychiatric disorders or severe cognitive disturbance were excluded from analysis. Among the subjects (n=395), a significant relationship was found between poor sleep quality and impaired life function in all models. The odds ratio was 1.82 (95% confidence interval: 1.03-3.23) in the final model controlling for all adjustment factors. Our findings here suggest a significant relationship between poor sleep quality and impaired life function among elderly community residents. Given these findings, intervention to improve sleep may help delay or prevent the need for long-term care among elderly individuals.

Depression and social networks in community dwelling elders: a descriptive study.

PubMed

Wilby, Frances

2011-04-01

Social isolation and inadequate social support have been identified as correlates of depression in older adults, although the relationship between depression and social isolation is not entirely understood (Dorfman et al., 1995). This study was conducted to describe the social networks of depressed older adults living in the community and to compare the social networks of depressed and nondepressed individuals, thus adding to the body of knowledge regarding social networks, older adults, and depression. The sample consisted of 91 respondents aged 65 and older who were randomly selected using the voter registry. About 27% (25) respondents reported significant levels of depressive symptomology as measured by the Center for Epidemiological Studies-Depression Scale (CES-D). All respondents completed semistructured interviews that included questions about social contacts with family and others during the prior week. All participants reported social contact with family and friends during this period. In this sample, depressed elders were not socially isolated. They were more likely to report contacts with friends than those who were not depressed, and equally likely to report involvement in volunteer activities. Their likelihood of seeking social support was also comparable. Results emphasize the importance of peer relationships and suggest that, in some groups of older adults, social isolation may not be a hallmark of depressive symptoms.

Relations of nutritional intake to age, sex and body mass index in Japanese elderly patients with type 2 diabetes: the Japanese Elderly Diabetes Intervention Trial.

PubMed

Yoshimura, Yukio; Kamada, Chiemi; Takahashi, Keiko; Kaimoto, Tae; Iimuro, Satoshi; Ohashi, Yasuo; Araki, Atsushi; Umegaki, Hiroyuki; Sakurai, Takashi; Ito, Hideki

2012-04-01

To determine the status of nutritional intake in elderly Japanese patients with type 2 diabetes aged 65 years or older, and to clarify relations of nutritional intake to age, sex and body mass index (BMI). Clinical parameters and nutritional intake were investigated and compared in 912 (417 men, 495 women) elderly Japanese patients with type 2 diabetes registered to the Japanese Elderly Diabetes Intervention Trial. The mean daily energy intake of patients was 1802 kcal in men and 1661 kcal in women, respectively. The energy intakes per kilogram of standard bodyweight in both sexes and the energy intakes per kilogram of present bodyweight in men increased significantly with age. The protein : fat : carbohydrate (PFC) energy ratio (%E) was 15.2:25.4:59.5 in men, and 15.7:25.8:58.6 in women, respectively. Grain, oil, alcohol and soft drink intakes were higher in men than in women. Potato, fruit and green vegetable intakes were higher in women than in men. Fruit intake showed a significant age-related increase in men. In women, there was an age-related significant decrease of meat intake. An increase of BMI correlated with a significant increase in bodyweight, waist circumference, hip circumference, waist-to-hip ratio, triglycerides and diastolic blood pressure. The mean energy intake of three BMI groups, lean (BMI < 18.5 kg/m(2)), normal (18.5 kg/m(2)

What community resources do older community-dwelling adults use to manage their osteoarthritis? A formative examination

PubMed Central

Martin, Kathryn Remmes; Schoster, Britta; Woodard, Janice

2011-01-01

Community resources can influence health outcomes, yet little research has examined how older individuals use community resources for osteoarthritis (OA) management. Six focus groups were conducted with 37 community-dwelling older adult African Americans and Caucasians who self-reported OA and resided in Johnston County, North Carolina. Descriptive analyses and qualitative constant comparison methodology revealed individuals use local recreational facilities, senior centers, shopping centers, religious organizations, medical providers, pharmacies and their social network for OA management. Participants also identified environmental characteristics (e.g., sidewalk conditions, curb-cuts, handicapped parking, automatic doors) that both facilitated and hindered use of community resources for OA management. Identified resources and environmental characteristics were organized around Corbin & Strauss framework tasks: medical/behavioral, role, and emotional management. As older Americans live with multiple chronic diseases, better understanding of what community resources are used for disease management may help improve the health of community-dwelling adults, both with and without OA. PMID:23049159

Opinions of dentists on the barriers in providing oral health care to community-dwelling frail older people: a questionnaire survey.

PubMed

Bots-VantSpijker, Pieternella C; Bruers, Josef J M; Bots, Casper P; Vanobbergen, Jacques N O; De Visschere, Luc M J; de Baat, Cees; Schols, Jos M G A

2016-06-01

The aim of this study was to investigate to what extent dentists in the Netherlands experience barriers in providing oral health care to community-dwelling older people. As most publications on the barriers in providing oral health care to older people consist of surveys on oral health care in care homes, it was decided to investigate the barriers dentists experience in their own dental practices while providing oral health care to community-dwelling frail older people. A representative sample of 1592 of the approximately 8000 dentists in the Netherlands aged 64 or younger were invited to respond to a questionnaire online. The dentists were asked to respond to 15 opinions concerning oral healthcare provision to community-dwelling frail older people aged 75 years or more who experience problems in physical, psychological and social areas, as well as possible financial problems. The total response rate was 37% (n = 595; male=76%; average age 49). The majority of those who responded agreed that the reimbursement of oral health care to older people is poor. Two thirds of those who responded (66%) agreed that there are limited opportunities to refer the frail and elderly with complex oral healthcare problems to a colleague with specific knowledge and skills. Dentists experienced barriers in two domains; a lack of knowledge and practical circumstances. It was concluded that the dentist's gender, age, year of graduation and the number of patients aged 75 years or more treated weekly were in some respect, related to the barriers encountered. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Aromatherapy: Does It Help to Relieve Pain, Depression, Anxiety, and Stress in Community-Dwelling Older Persons?

PubMed Central

Tse, M. Y. Mimi

2014-01-01

To examine the effectiveness of an aromatherapy programme for older persons with chronic pain. The community-dwelling elderly people who participated in this study underwent a four-week aromatherapy programme or were assigned to the control group, which did not receive any interventions. Their levels of pain, depression, anxiety, and stress were collected at the baseline and at the postintervention assessment after the conclusion of the four-week programme. Eighty-two participants took part in the study. Forty-four participants (37 females, 7 males) were in the intervention group and 38 participants (30 females, 8 males) were in the control group. The pain scores were 4.75 (SD 2.32) on a 10-point scale for the intervention group and 5.24 (SD 2.14) for the control group before the programme. There was a slight reduction in the pain score of the intervention group. No significant differences were found in the same-group and between-group comparisons for the baseline and postintervention assessments. The depression, anxiety, and stress scores for the intervention group before the programme were 11.18 (SD 6.18), 9.64 (SD 7.05), and 12.91 (SD 7.70), respectively. A significant reduction in negative emotions was found in the intervention group (P < 0.05). The aromatherapy programme can be an effective tool to reduce pain, depression, anxiety, and stress levels among community-dwelling older adults. PMID:25114901

Elderly Men Have Low Levels of Anti-Müllerian Hormone and Inhibin B, but with High Interpersonal Variation: A Cross-Sectional Study of the Sertoli Cell Hormones in 615 Community-Dwelling Men

PubMed Central

Chong, Yih Harng; Dennis, Nicola A.; Connolly, Martin J.; Teh, Ruth; Jones, Gregory T.; van Rij, Andre M.; Farrand, Stephanie; Campbell, A. John; MLennan, Ian S.

2013-01-01

The Sertoli cells of the testes secrete anti-Müllerian hormone (Müllerian inhibiting Substance, AMH) and inhibin B (InhB). AMH triggers the degeneration of the uterine precursor in male embryos, whereas InhB is part of the gonadal-pituitary axis for the regulation of sperm production in adults. However, both hormones are also putative regulators of homeostasis, and age-related changes in these hormones may therefore be important to the health status of elderly men. The levels of AMH in elderly men are unknown, with limited information being available about age-related changes in InhB. We have therefore used ELISAs to measure Sertoli cell hormone levels in 3 cohorts of community-dwelling men in New Zealand. In total, 615 men were examined, 493 of which were aged 65 or older. Serum AMH and InhB levels inversely correlated with age in men older than 50 years (p<0.001) but not in the younger men. A minority of elderly men had undetectable levels of AMH and InhB. The variation in hormone levels between similarly aged men increased with the age of men. AMH and InhB partially correlated with each other as expected (r = 0.48, p<0.001). However, the ratio of the two Sertoli hormones varied significantly between men, with this variation increasing with age. Elderly men selected for the absence of cardiovascular disease had AMH levels similar to those of young men whereas their InhB levels did not differ from aged-matched controls. These data suggests that Sertoli cell number and function changes with age, but with the extent and nature of the changes varying between men. PMID:23940675

Risk factors for a 6-year decline in physical disability and functional limitations among elderly people with type 2 diabetes in the Japanese Elderly Diabetes Intervention Trial.

PubMed

Sakurai, Takashi; Iimuro, Satoshi; Sakamaki, Kentaro; Umegaki, Hiroyuki; Araki, Atsushi; Ohashi, Yasuo; Ito, Hideki

2012-04-01

Type 2 diabetes increases the risk of disability. The purpose of this study was to clarify the explanatory factors for disability in Japanese diabetic elderly. The 6-year decline in physical disability and functional limitations was investigated among 317 elderly people with type 2 diabetes recruited in a large-scale prospective study of the Japanese Elderly Diabetes Intervention Trial. Information about diabetes, blood examinations and complications was obtained, and basic activities of daily living (ADL) and instrumental ADL (IADL) were assessed by total score of the Barthel index and the Tokyo Metropolitan Institute of Gerontology Index of Competence, respectively. After 6 years of follow up, 13.6% of patients had developed a new ADL disability and 38.3% had developed a new functional impairment. In the 65-74 years age group, basic ADL decreased only in males, whereas females became functionally impaired. In the 75-84 years age group, basic and IADL decreased in both males and females. Older age and metabolic syndrome were prognostic for impairment of basic ADL, whereas baseline IADL problems, lower cognitive function, physical inactivity and insulin therapy were significant predictors of a future decline in the IADL. This study identified several factors predicting the future decline of basic ADL and IADL in diabetic elderly patients, and provided a conceptual framework that might help to clarify the pathways leading to disability. Because the specific causes of each functional problem are modifiable, comprehensive treatment and care are needed to allow Japanese diabetic elderly patients to have more favorable living conditions. © 2012 Japan Geriatrics Society.

Muscle function-dependent sarcopenia and cut-off values of possible predictors in community-dwelling Turkish elderly: calf circumference, midarm muscle circumference and walking speed.

PubMed

Akın, S; Mucuk, S; Öztürk, A; Mazıcıoğlu, M; Göçer, Ş; Arguvanlı, S; Şafak, E D

2015-10-01

The aim of this study was to determine the prevalence of muscle strength-based sarcopenia and to determine possible predictors. This is a cross-sectional population-based study in the community-dwelling Turkish elderly. Anthropometric measurements, namely body height, weight, triceps skin fold (TSF), mid upper arm circumference (MUAC), waist circumference (WC) and calf circumference (CC), were noted. The midarm muscle circumference (MAMC) was calculated by using MUAC and TSF measurement. Sarcopenia was assessed, adjusted for body mass index (BMI) and gender, according to muscle strength. Physical performance was determined by 4 m walking speed (WS; m/s). The receiver operating curve analysis was performed to determine cut-offs of CC, MAMC and 4 m WS. A total of 879 elderly subjects, 50.1% of whom were female, were recruited. The mean handgrip strength (HGS) and s.d. was 24.2 (8.8) kg [17.9 (4.8) female, 30.6 (7.1) male]. The muscle function-dependent sarcopenia was 63.4% (female 73.5%, male 53.2%). The muscle mass-dependent sarcopenia for CC (<31 cm) and MAMC(<21.1 cm in males, <19.9 cm in females) was 6.7% and 7.3%, respectively. The prevalence of low 4 m WS (≤ 0.8 m/s) was 81.8% (91.3% in females and 72.3% in males, respectively). We compared MAMC, CC and 4 m WS and found that AUC for 4 m WS was the best predictor of sarcopenia. An adequate muscle mass may not mean a reliable muscle function. Muscle function may describe sarcopenia better compared with muscle mass. The CC, MAMC and 4 m WS cut-offs may be used to assess sarcopenia in certain age groups.

Documentation of daily sit-to-stands performed by community-dwelling adults.

PubMed

Bohannon, Richard W; Barreca, Susan R; Shove, Megan E; Lambert, Cynthia; Masters, Lisa M; Sigouin, Christopher S

2008-01-01

No information exists about how many sit-to-stands (STSs) are performed daily by community-dwelling adults. We, therefore, examined the feasibility of using a tally counter to document daily STSs, documented the number of daily STSs performed, and determined if the number of STSs was influenced by demographic or health variables. Ninety-eight community-dwelling adults (19-84 years) agreed to participate. After providing demographic and health information, subjects used a tally counter to document the number of STSs performed daily for 7 consecutive days. All but two subjects judged their counter-documented STS number to be accurate. Excluding data from these and two other subjects, the mean number of STSs for subjects was 42.8 to 49.3, depending on the day. The number was significantly higher on weekdays than weekends. No demographic or health variable was significantly related to the number of STSs in univariate or multivariate analysis. In conclusion, this study suggests that a tally counter may be a practical aid to documenting STS activity. The STS repetitions recorded by the counter in this study provide an estimate of the number of STSs that community-dwelling adults perform daily.

Concomitant use of analgesics and psychotropics in home-dwelling elderly people – Kuopio 75 + study

PubMed Central

Hartikainen, Sirpa; Mäntyselkä, Pekka; Louhivuori-Laako, Kirsti; Enlund, Hannes; Sulkava, Raimo

2005-01-01

Aims To investigate the extent of concomitant use of analgesic and psychotropic medicines among home-dwelling elderly people aged at least 75 years in Finland. Methods This was a population-based study in Finland, performed as part of Kuopio 75 + study focusing on the clinical epidemiology of diseases, medication and functional capacity. A random sample of 700 persons was drawn from the total population of the city of Kuopio, eastern Finland, aged 75 years on January 1, 1998 (n = 4518). Ninety-nine persons could not be examined and 78 were living in long-term institutions, so that the number of home-dwelling elderly persons amounted to 523. A trained nurse interviewed the participants about their use of medicines, and a geriatrician examined their overall physical and mental status. Dementia and depression were diagnosed according to the DSM IV criteria. Both regular and irregular prescribed and nonprescribed drug use was recorded. Results Every fourth elderly person (27.2%) used analgesics and psychotropics concomitantly, this use becoming twice as common with advancing age (19.6% in the age group 75–79 years, 38.2% among the oldest, aged 85 + years). Concomitant use of psychotropics and opioids also became more common with increasing age (2.8% in age group 75–79 years and 9.6% in the oldest group, aged 85 + years). The use of opioids was nearly twice as common among concomitant users (19.7%) than among those using only analgesics (11.3%). Concomitant users suffered from interfering daily pain and daily pain at rest more commonly than nonusers of analgesics. Depression, sleeping problems and polypharmacy were more common among the concomitant users, who had also had more hip fractures than the rest. Conclusions Concomitant use of analgesics and psychotropics becomes more common with advancing age and is a potential risk factor for adverse drug effects. PMID:16120070

Dietary patterns associated with fall-related fracture in elderly Japanese: a population based prospective study.

PubMed

Monma, Yasutake; Niu, Kaijun; Iwasaki, Koh; Tomita, Naoki; Nakaya, Naoki; Hozawa, Atsushi; Kuriyama, Shinichi; Takayama, Shin; Seki, Takashi; Takeda, Takashi; Yaegashi, Nobuo; Ebihara, Satoru; Arai, Hiroyuki; Nagatomi, Ryoichi; Tsuji, Ichiro

2010-06-01

Diet is considered an important factor for bone health, but is composed of a wide variety of foods containing complex combinations of nutrients. Therefore we investigated the relationship between dietary patterns and fall-related fractures in the elderly. We designed a population-based prospective survey of 1178 elderly people in Japan in 2002. Dietary intake was assessed with a 75-item food frequency questionnaire (FFQ), from which dietary patterns were created by factor analysis from 27 food groups. The frequency of fall-related fracture was investigated based on insurance claim records from 2002 until 2006. The relationship between the incidence of fall-related fracture and modifiable factors, including dietary patterns, were examined. The Cox proportional hazards regression model was used to examine the relationships between dietary patterns and incidence of fall-related fracture with adjustment for age, gender, Body Mass Index (BMI) and energy intake. Among 877 participants who agreed to a 4 year follow-up, 28 suffered from a fall-related fracture. Three dietary patterns were identified: mainly vegetable, mainly meat and mainly traditional Japanese. The moderately confirmed (see statistical methods) groups with a Meat pattern showed a reduced risk of fall-related fracture (Hazard ratio = 0.36, 95% CI = 0.13 - 0.94) after adjustment for age, gender, BMI and energy intake. The Vegetable pattern showed a significant risk increase (Hazard ratio = 2.67, 95% CI = 1.03 - 6.90) after adjustment for age, gender and BMI. The Traditional Japanese pattern had no relationship to the risk of fall-related fracture. The results of this study have the potential to reduce fall-related fracture risk in elderly Japanese. The results should be interpreted in light of the overall low meat intake of the Japanese population.

Behavioural interventions for urinary incontinence in community-dwelling seniors: an evidence-based analysis.

PubMed

2008-01-01

In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To assess the effectiveness of behavioural interventions for the treatment and management of urinary incontinence (UI) in community-dwelling seniors. TARGET POPULATION AND CONDITION Urinary incontinence defined as "the complaint of any involuntary leakage of urine" was identified as 1 of the key predictors in a senior's transition from independent community living to admission to a long-term care

Effects of Perceived Neighbourhood Environments on Self-Rated Health among Community-Dwelling Older Chinese.

PubMed

Wong, Moses; Yu, Ruby; Woo, Jean

2017-06-07

In response to the growing number of older people living in cities, the World Health Organization (WHO) introduced the concept of "Age-Friendly Cities" (AFC) to guide the way in designing physical and social environments to encourage active ageing. Limited research has studied the effects of neighbourhood age-friendliness on elderly health outcomes. Using the example of a highly urbanized city in Asia, this study examined the effects of perceived age-friendliness of neighbourhood environments on self-rated health (SRH) among community-dwelling older Chinese. A multi-stage sampling method was used to collect views of community-dwelling older people from two local districts of Hong Kong. A structured questionnaire covering the WHO's eight AFC domains was developed to collect information on the perceived neighbourhood environments, SRH and individual characteristics. Age-friendliness of neighbourhood was assessed by mean scores of AFC domains, which was used to predict SRH with adjustment for individual and objective neighbourhood characteristics. Furthermore, 719 respondents aged ≥60 years completed the questionnaire, of which 44.5% reported good SRH. Independent of individual and objective neighbourhood characteristics, multiple logistics regressions showed that higher satisfaction on outdoor spaces and buildings, transportation, housing, social participation, and respect and social inclusion was significantly associated with increased odds of reporting good SRH by more than 20% ( p < 0.05). Individuals aged 70-79 years, being female, lower education and residents of public or subsidized housing were less likely to report good SRH, after controlling for individual and neighbourhood characteristics. In addition to age, gender, education and housing type, AFC environments have important contributive influence on SRH, after controlling for individual and objective neighbourhood characteristics.

Effects of Perceived Neighbourhood Environments on Self-Rated Health among Community-Dwelling Older Chinese

PubMed Central

Wong, Moses; Yu, Ruby; Woo, Jean

2017-01-01

In response to the growing number of older people living in cities, the World Health Organization (WHO) introduced the concept of “Age-Friendly Cities” (AFC) to guide the way in designing physical and social environments to encourage active ageing. Limited research has studied the effects of neighbourhood age-friendliness on elderly health outcomes. Using the example of a highly urbanized city in Asia, this study examined the effects of perceived age-friendliness of neighbourhood environments on self-rated health (SRH) among community-dwelling older Chinese. A multi-stage sampling method was used to collect views of community-dwelling older people from two local districts of Hong Kong. A structured questionnaire covering the WHO’s eight AFC domains was developed to collect information on the perceived neighbourhood environments, SRH and individual characteristics. Age-friendliness of neighbourhood was assessed by mean scores of AFC domains, which was used to predict SRH with adjustment for individual and objective neighbourhood characteristics. Furthermore, 719 respondents aged ≥60 years completed the questionnaire, of which 44.5% reported good SRH. Independent of individual and objective neighbourhood characteristics, multiple logistics regressions showed that higher satisfaction on outdoor spaces and buildings, transportation, housing, social participation, and respect and social inclusion was significantly associated with increased odds of reporting good SRH by more than 20% (p < 0.05). Individuals aged 70–79 years, being female, lower education and residents of public or subsidized housing were less likely to report good SRH, after controlling for individual and neighbourhood characteristics. In addition to age, gender, education and housing type, AFC environments have important contributive influence on SRH, after controlling for individual and objective neighbourhood characteristics. PMID:28590435

Sex-specific association between obesity and self-reported falls and injuries among community-dwelling Canadians aged 65 years and older.

PubMed

Handrigan, G A; Maltais, N; Gagné, M; Lamontagne, P; Hamel, D; Teasdale, N; Hue, O; Corbeil, P; Brown, J P; Jean, S

2017-02-01

This study investigated the relationship between body mass index (BMI) and falls among community-dwelling elderly. Results indicate that obesity is associated with increased falls and there appears to be a sex-specific difference with obese men at higher risk of falling. Obesity is identified as a risk factor for falls in men. The prevalence of falls, fall-related injuries, and obesity has increased over the last decade. The objectives of this study were to investigate sex-specific association and dose-response relationship between BMI and falls (and related injuries) among community-dwelling elderly. Our study sample consisted of 15,860 adults aged 65 years or older (6399 men and 9461 women) from the 2008-2009 Canadian Community Health Survey-Healthy Aging (CCHS-HA). Falls, fall-related injuries, and BMI measures were self-reported. For both sex, dose-response curves presenting the relationship between BMI, falls, and fall-related injuries were first examined. Thereafter, multivariate logistic regression analyses were also performed to investigate these relationships after adjustment for potentially confounding variables. Of women, 21.7 % reported a fall and 16.9 % of men. The dose-response relationship between BMI and prevalence of falls showed that underweight and obese individuals reported falling more than normal and overweight individuals; this being more apparent in men than women. Finally, the dose relationship between BMI and prevalence of fall-related injuries showed that only obese men seem more likely to have sustained a fall-related injury. Results from the multivariate analysis showed that obesity in men was significantly associated with higher odds of falling odds ratio (OR) 1.33 (1.04-1.70) and was not significantly associated with higher odds of fall-related injuries OR 1.10 (0.66-1.84) over a 12-month period compared to normal weight men. For women, obesity was not significantly associated with higher fall prevalence OR 0.99 (0.79-1.25) and

Health determinants of nutritional status in community-dwelling older population: the VERISAÚDE study.

PubMed

Maseda, Ana; Gómez-Caamaño, Sarai; Lorenzo-López, Laura; López-López, Rocío; Diego-Diez, Clara; Sanluís-Martínez, Verónica; Valdiglesias, Vanessa; Millán-Calenti, José C

2016-08-01

Malnutrition is a common and relevant syndrome in elderly people due to its influence on quality of life. The main aim of the present study was to identify health determinants of malnutrition or risk of malnutrition. Cross-sectional study collecting information on sociodemographic and health factors (co-morbidity, cognitive or affective problems, prescription medication use, frailty status, self-rated health) as determinants of nutritional status, assessed by the short form of the Mini Nutritional Assessment. Forty-three senior centres from Galicia (north-western Spain) participated to recruit participants. A representative community-dwelling sample of 749 elderly people aged ≥65 years. Of the total participants, 14·3 % were malnourished/at risk of malnutrition. Presence of overweight or obesity, depressive symptoms, polypharmacy (use of five or more prescription medications), presence of pre-frailty or frailty status and poor self-rated health showed the strongest relationship to malnutrition/risk of malnutrition. This model predicted 86·0 % of the cases correctly. The best determinants for women were polypharmacy and poor self-rated health, reaching 82·8 % of cases of malnourishment/risk of malnutrition predicted correctly. In men, the main determinants were overweight or obesity, depressive symptomatology and polypharmacy, with 89·8 % of cases of malnourishmen/risk of malnutrition predicted correctly. Screening for nutritional status and its determinant factors should be included as part of comprehensive assessments to ensure an early screening of malnutrition and to propose possible intervention strategies that would be important for both elderly people and the health-care system.

Determining the predictors of change in quality of life self-ratings and carer-ratings for community-dwelling people with Alzheimer disease.

PubMed

Bosboom, Pascalle R; Alfonso, Helman; Almeida, Osvaldo P

2013-01-01

The aim of this study was to determine the factors that mediate changes in Health Related Quality of Life (HRQoL) ratings by community-dwelling people with Alzheimer disease (AD) and carers over a period of 18 months. We completed an 18-month longitudinal study of 80 community-dwelling older adults diagnosed with probable AD of mild or moderate severity (NINCDS-ADRD criteria) and their family carers. The primary outcome of interest was the 18-month change in HRQoL ratings as measured with the Quality of Life-AD (QoL-AD) (by carer and by self). Explanatory variables included demographics, lifestyle, cognition, awareness, psychopathology, burden-of-care, use of medication, and functionality in daily life. We found a significant decline (8.7%, P=0.003) in QoL-AD carer-ratings, but not in self-ratings. The final parsimonious model of predictors of changes in QoL-AD self-ratings explained 22.6% of the variance; only changes on Hospital Anxiety and Depression Scale Anxiety retained significance. The final model of predictors of changes in carer-ratings explained 55.0% of the variance: that is, changes on Informant Questionnaire on Cognitive Decline in the Elderly, changes on Hospital Anxiety and Depression Scale Depression, practicing hobbies at 18 months, and number of visit(s) or admission(s) to hospital. HRQoL self-ratings and carer-ratings of community-dwelling people with AD do not decline at same rate over 18 months and changes are associated with different factors. Interventions designed to optimize quality of life of people with AD should consider carefully whose HRQoL ratings they wish to change.

No association between dietary vitamin K intake and fracture risk in chinese community-dwelling older men and women: a prospective study.

PubMed

Chan, R; Leung, J; Woo, J

2012-05-01

Data on the association between dietary vitamin K intake and fracture risk are limited among Chinese. This study examined such an association in community-dwelling elderly in Hong Kong. We present data from 2,944 subjects (1,605 men, 1,339 women) who participated in a prospective cohort study. Baseline dietary intakes of energy, protein, calcium, vitamin D, and vitamin K were assessed using a food-frequency questionnaire. Data on incident hip fracture and nonvertebral fracture during a median of 6.9 follow-up years were collected from a hospital database. Cox regression analyses were performed with adjustments for age, education attainment, smoking status, alcohol use, body mass index, hip bone mineral density, physical activity, use of calcium supplement, and energy-adjusted nutrient intakes. There were 29 (1.8 %) men and 19 (1.4 %) women with incident hip fractures and 97 (6.0 %) men and 88 (6.6 %) women with nonvertebral fractures. The median (interquartile range) of dietary vitamin K intake was 241.8 (157.5-360.8) and 238.9 (162.4-343.6) μg/day in men and women, respectively. Similar dietary vitamin K intakes were observed between subjects with hip or nonvertebral fractures and subjects without hip or nonvertebral fractures. In both men and women, dietary vitamin K intake was not associated with fracture risks at all measured sites in either crude or adjusted models. In Chinese community-dwelling elderly, hip or nonvertebral fracture risk was not associated with dietary vitamin K intake. The high dietary vitamin K intake of the studied group may have limited the ability to detect the association between vitamin K intake and fracture risk.

Neighborhood attributes security and solidarity promote the well-being of community-dwelling older people in the Netherlands.

PubMed

Cramm, Jane M; Nieboer, Anna P

2014-07-01

To determine whether the neighborhood attributes solidarity and security positively affect the well-being of community-dwelling older people in the Netherlands after accounting for individual characteristics, and to test if a higher level of security in combination with a stronger sense of neighborhood solidarity results in a higher level of well-being. The study sample for the cross-sectional study consisted of 869 out of 2212 (39% response rate) independently-living older adults (aged >70 years) in 92 neighborhoods of Rotterdam. We fitted a hierarchical random-effects model to account for the structure of the study design: 869 older people (level 1) nested in 92 neighborhoods (level 2) in 10 districts (level 3). Neighborhood security and solidarity among neighbors varied significantly among the 10 districts. Univariate analyses showed that education, income, neighborhood security and solidarity within neighborhoods (all P ≤ 0.001) were significantly related to the well-being of community-dwelling older people. Multilevel analyses showed neighborhood security and solidarity within neighborhoods predicted the well-being of community-dwelling older people. Furthermore, a positive interaction effect was found between neighborhood security and solidarity within neighborhoods, and well-being of community-dwelling older people. Neighborhood security and solidarity among neighbors are important for the well-being of community-dwelling older people. Furthermore, neighborhoods with high levels of perceived security in combination with stronger solidarity among neighbors are especially beneficial to the well-being of community-dwelling older people. © 2013 Japan Geriatrics Society.

Accuracy of the 15-item Geriatric Depression Scale (GDS-15) in a community-dwelling oldest-old sample: the Pietà Study.

PubMed

Dias, Filipi Leles da Costa; Teixeira, Antônio Lúcio; Guimarães, Henrique Cerqueira; Barbosa, Maira Tonidandel; Resende, Elisa de Paula França; Beato, Rogério Gomes; Carmona, Karoline Carvalho; Caramelli, Paulo

2017-01-01

Late-life depression (LLD) is common, but remains underdiagnosed. Validated screening tools for use with the oldest-old in clinical practice are still lacking, particularly in developing countries. To evaluate the accuracy of a screening tool for LLD in a community-dwelling oldest-old sample. We evaluated 457 community-dwelling elderly subjects, aged ≥75 years and without dementia, with the Geriatric Depression Scale (GDS-15). Depression diagnosis was established according to DSM-IV criteria following a structured psychiatric interview with the Mini International Neuropsychiatric Interview (MINI). Fifty-two individuals (11.4%) were diagnosed with major depression. The area under the receiver operating characteristic (ROC) curve was 0.908 (p<0.001). Using a cut-off score of 5/6 (not depressed/depressed), 84 (18.4%) subjects were considered depressed by the GDS-15 (kappa coefficient = 53.8%, p<0.001). The 4/5 cut-off point achieved the best combination of sensitivity (86.5%) and specificity (82.7%) (Youden's index = 0.692), with robust negative (0.9802) and reasonable positive predictive values (0.3819). GDS-15 showed good accuracy as a screening tool for major depression in this community-based sample of low-educated oldest-old individuals. Our findings support the use of the 4/5 cut-off score, which showed the best diagnostic capacity.

[Association of the physical activity of community-dwelling older adults with transportation modes, depression and social networks].

PubMed

Tsunoda, Kenji; Mitsuishi, Yasuhiro; Tsuji, Taishi; Yoon, Ji-Yeong; Muraki, Toshiaki; Hotta, Kazushi; Okura, Tomohiro

2011-01-01

The purpose of this study was to cross-sectionally examine the relationships among leisure, household and occupational physical activity with the frequency of going out by various transportation modes, depression and social networks in older adults. We randomly selected a total of 2,100 community-dwelling adults aged 65 to 85 years of age from the Basic Resident Register. Of these, 340 people were the subjects of this study. The scales of measurement used were the Physical Activity Scale for the Elderly, the Lubben Social Network Scale (LSNS) and the Geriatric Depression Scale (GDS). In a regression model, leisure-time physical activity significantly correlated with frequency of going out by bicycle (β=0.17) and LSNS score (β=0.17). Household physical activity and occupational physical activity were significantly correlated with LSNS score (β=0.21) and frequency of going out by motor vehicle (β=0.25), respectively. For total physical activity, in the 3 above-mentioned activities a significant correlation was observed among frequency of going out by bicycle (β=0.10), by motor vehicle (β=0.23), GDS score (β=-0.16) and LSNS score (β=0.23). These results indicate that the frequency of going out by bicycle and by motor vehicle were significant factors to predict leisure and occupational physical activity. Furthermore, social networks appear to be important determiners in leisure and household physical activity in community-dwelling older adults.

The association between neighborhood social capital and self-reported dentate status in elderly Japanese--the Ohsaki Cohort 2006 Study.

PubMed

Aida, J; Kuriyama, S; Ohmori-Matsuda, K; Hozawa, A; Osaka, K; Tsuji, I

2011-06-01

Little is known about the influence of social capital on dental health. The aim of the present cross-sectional study was to determine the association between neighborhood social capital, individual social networks and social support and the number of remaining teeth in elderly Japanese. In December 2006, self-administered questionnaires were sent to 31,237 eligible community-dwelling individuals (response rate: 73.9%). Included in the analysis were 21,736 participants. Five neighborhood social capital variables were calculated from individual civic networks, sports and hobby networks, volunteer networks, friendship networks and social support variables. We used multilevel logistic regression models to estimate the odds ratio (OR) of having 20 or more teeth according to neighborhood social capital variables with adjustment for sex, age, individual social networks and social support, educational attainment, neighborhood educational level, dental health behavior, smoking status, history of diabetes and self-rated health. The average age of the participants was 74.9 (standard deviation; 6.6) years, and 28.5% of them had 20 or more teeth. In the univariate multilevel model, there were statistically significant associations between neighborhood sports and hobby networks, friendship networks and self-reported dentate status. In the multivariable multilevel model, compared with participants living in lowest friendship network neighborhoods, those living in highest friendship network neighborhoods had an OR 1.17 (95% confidence interval, 1.04-1.30) times higher for having 20 or more teeth. There is a significant association between one network aspect of neighborhood social capital and individual dentate status regardless of individual social networks and social support. © 2010 John Wiley & Sons A/S.

Measurement and visualization of face-to-face interaction among community-dwelling older adults using wearable sensors.

PubMed

Masumoto, Kouhei; Yaguchi, Takaharu; Matsuda, Hiroshi; Tani, Hideaki; Tozuka, Keisuke; Kondo, Narihiko; Okada, Shuichi

2017-10-01

A number of interventions have been undertaken to develop and promote social networks among community-dwelling older adults. However, it has been difficult to examine the effects of these interventions, because of problems in assessing interactions. The present study was designed to quantitatively measure and visualize face-to-face interactions among elderly participants in an exercise program. We also examined relationships among interactional variables, personality and interest in community involvement, including interactions with the local community. Older adults living in the same community were recruited to participate in an exercise program that consisted of four sessions. We collected data on face-to-face interactions of the participants by using a wearable sensor technology device. Network analysis identified the communication networks of participants in the exercise program, as well as changes in these networks. Additionally, there were significant correlations between the number of people involved in face-to-face interactions and changes in both interest in community involvement and interactions with local community residents, as well as personality traits, including agreeableness. Social networks in the community are essential for solving problems caused by the aging society. We showed the possible applications of face-to-face interactional data for identifying core participants having many interactions, and isolated participants having only a few interactions within the community. Such data would be useful for carrying out efficient interventions for increasing participants' involvement with their community. Geriatr Gerontol Int 2017; 17: 1752-1758. © 2017 Japan Geriatrics Society.

Assessing the Psychoeducational Approach to Transcendence and Health Program: An Intervention to Foster Self-Transcendence and Well-Being in Community-Dwelling Older Adults.

PubMed

McCarthy, Valerie Lander; Bowland, Sharon; Hall, Lynne A; Connelly, Jennifer

2015-12-01

The late-life developmental process of self-transcendence shapes elders' perspectives on self, others, the nature of this world, and of a dimension beyond the here and now. This qualitative pilot study evaluated the Psychoeducational Approach to Transcendence and Health (PATH) Program, a psychoeducational intervention to promote self-transcendence and well-being in community-dwelling women at a senior center. The intervention involved eight weekly group sessions using group processes, mindfulness practices, creative experiences, and independent at-home practice. The findings supported the underlying theory-based structure and content of the intervention and indicated the intervention may empower elders to attend to self-care, develop acceptance, and learn new skills associated with health and well-being, thus merits further study. Based on insights gained from facilitators' and participants' experiences and perceptions, the intervention will be revised and strengthened. © The Author(s) 2015.

Prevalence of and Risk Factors for Elder Abuse and Neglect in the Community: A Population-Based Study.

PubMed

Burnes, David; Pillemer, Karl; Caccamise, Paul L; Mason, Art; Henderson, Charles R; Berman, Jacquelin; Cook, Ann Marie; Shukoff, Denise; Brownell, Patricia; Powell, Mebane; Salamone, Aurora; Lachs, Mark S

2015-09-01

To estimate past-year prevalence and identify risk and protective factors of elder emotional abuse, physical abuse, and neglect. Cross-sectional, population-based study using random-digit-dial sampling and direct telephone interviews. New York State households. Representative (race, ethnicity, sex) sample (N = 4,156) of English- or Spanish-speaking, community-dwelling, cognitively intact individuals aged 60 and older. The Conflict Tactics Scale was adapted to assess elder emotional and physical abuse. Elder neglect was evaluated according to failure of a responsible caregiver to meet an older adult's needs using the Duke Older Americans Resources and Services (OARS) scale. Caseness thresholds were based on mistreatment behavior frequencies and elder perceptions of problem seriousness. Past-year prevalence of elder emotional abuse was 1.9%, of physical abuse was 1.8%, and of neglect was 1.8%, with an aggregate prevalence of 4.6%. Emotional and physical abuse were associated with being separated or divorced, living in a lower-income household, functional impairment, and younger age. Neglect was associated with poor health, being separated or divorced, living below the poverty line, and younger age. Neglect was less likely in older adults of Hispanic ethnicity. Elder abuse and neglect are common problems, with divergent risk and protective factor profiles. These findings have direct implications for public screening and education and awareness efforts designed to prevent elder mistreatment. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Identifying community healthcare supports for the elderly and the factors affecting their aging care model preference: evidence from three districts of Beijing.

PubMed

Liu, Tianyang; Hao, Xiaoning; Zhang, Zhenzhong

2016-11-15

The Chinese tradition of filial piety, which prioritized family-based care for the elderly, is transitioning and elders can no longer necessarily rely on their children. The purpose of this study was to identify community support for the elderly, and analyze the factors that affect which model of old-age care elderly people dwelling in communities prefer. We used the database "Health and Social Support of Elderly Population in Community". Questionnaires were issued in 2013, covering 3 districts in Beijing. A group of 1036 people over 60 years in age were included in the study. The respondents' profile variables were organized in Andersen's Model and community healthcare resource factors were added. A multinomial logistic model was applied to analyze the factors associated with the desired aging care models. Cohabiting with children and relying on care from family was still the primary desired aging care model for seniors (78 %), followed by living in institutions (14.8 %) and living at home independently while relying on community resources (7.2 %). The regression result indicated that predisposing, enabling and community factors were significantly associated with the aging care model preference. Specifically, compared with those who preferred to cohabit with children, those having higher education, fewer available family and friend helpers, and shorter distance to healthcare center were more likely to prefer to live independently and rely on community support. And compared with choosing to live in institutions, those having fewer available family and friend helpers and those living alone were more likely to prefer to live independently and rely on community. Need factors (health and disability condition) were not significantly associated with desired aging care models, indicating that desired aging care models were passive choices resulted from the balancing of family and social caring resources. In Beijing, China, aging care arrangement preference is the

Evaluation of an osteoporosis and fall risk intervention program for community-dwelling elderly. A quasi-experimental study of behavioral modifications.

PubMed

Grahn Kronhed, Ann-Charlotte; Blomberg, Carina; Löfman, Owe; Timpka, Toomas; Möller, Margareta

2006-06-01

Osteoporosis and fall fractures are increasing problems amongst the elderly. The aim of this study was to explore whether combined population-based and individual interventions directed at risk factors for osteoporosis and falls result in behavioral changes in an elderly population. A quasi-experimental design was used for the study. Persons aged >or=65 years were randomly selected in the intervention and control community. An intervention program was managed from the primary health care center and delivered to the community. Health education was designed to increase awareness of risk factors for the development of osteoporosis and falling. Questionnaires about lifestyle, health, previous fractures, safety behavior and physical activity level were distributed at baseline in 1989 and at the follow-ups in 1992 and 1994 in both communities. There was a difference of 17.7% between the dual intervention (receiving both population-based and individual interventions) and the control samples regarding the self-reported use of shoe/cane spikes, and a difference of 20.5% regarding the reported "moderate level" of physical activity in 1994. There was an increase in the number of participants in the dual intervention sample who, at baseline, had not reported equipping their homes with non-slip mats and removing loose rugs but who did report these changes in 1994. The increase in the reported use of shoe/cane spikes in the dual intervention sample was observed mainly for the period 1992-1994. A public health intervention model, including both population-based and individual interventions, can contribute to behavioral changes in the prevention of falls and changed physical activity patterns amongst elderly people.

The effectiveness of a comprehensive geriatric assessment intervention program for frailty in community-dwelling older people: a randomized, controlled trial.

PubMed

Li, Chia-Ming; Chen, Chin-Ying; Li, Chun-Yi; Wang, Wei-Dean; Wu, Shwu-Chong

2010-02-01

This randomized, controlled trial assessed the effectiveness of comprehensive geriatric assessment (CGA) and subsequent intervention in pre-frail and frail community-dwelling elderly based on the Fried Frailty Criteria (FFC) and the Barthel Index (BI) A total of 310 pre-frail or frail elderly from a single community were identified using the FFC. Of these, 152 were randomly assigned to the intervention group for CGA and appropriate intervention by medication adjustment, exercise instruction, nutrition support, physical rehabilitation, social worker consultation, and specialty referral. Clinical outcome was re-evaluated by the FFC and BI 6 months later. Compared to the control group, the intervention group tended to have a better outcome, with an odds ratio (OR) = 1.19, 95% confidence interval (95% CI) = 0.48-3.04, p = 0.71) and 3.29 (95% CI = 0.65-16.64, p = 0.15), respectively, and were less likely to deteriorate, with an OR = 0.78 (95% CI = 0.34-1.79, p = 0.57) and 0.94 (95% CI = 0.42-2.12, p = 0.88), respectively. Although no significant differences were observed, the CGA and subsequent intervention showed a favorable outcome in frail and pre-frail elderly based on the frailty status and BI. Inability to complete the CGA and poor compliance with the intervention program appear to be the main reasons for unfavorable outcomes. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Uric acid and endothelial function in elderly community-dwelling subjects.

PubMed

Ticinesi, Andrea; Lauretani, Fulvio; Ceda, Gian Paolo; Ruggiero, Carmelinda; Ferrucci, Luigi; Aloe, Rosalia; Larsson, Anders; Cederholm, Tommy; Lind, Lars; Meschi, Tiziana; Maggio, Marcello

2017-03-01

The role of serum uric acid (SUA), an inflammatory agent and potential mediator of cardiovascular diseases, in endothelial function (EF) has been tested only in middle-aged subjects affected by specific diseases. Our aim was to assess the relationship between SUA and measures of EF in a cohort of elderly community-dwellers. This study involved 424 males and 426 females aged 70years from the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS), having complete data on SUA and EF assessed by flow-mediated vasodilation (FMD) and by intra-arterial infusion of acetylcholine (endothelium-dependent vasodilation, EDV) and sodium nitroprusside (endothelium-independent vasodilation, EIDV). Univariate and multivariate regression models obtained by backward selection from initial fully-adjusted models were built to assess the relationship between SUA and measures of EF in both genders. Cardiovascular risk factors, serum hormonal and metabolic mediators, and body composition were considered as potential confounders. In the univariate model, SUA was inversely associated in both genders with log(EDV) (β±SE males -0.39±0.17, p=0.03; females -0.57±0.19, p=0.003) and log(EIDV) (males -0.23±0.12, p=0.05; females -0.49±0.15, p=0.002), but not with log(FMD). After adjustment for BMI, only the association between SUA and log(EIDV) in females persisted, though attenuated (-0.32±0.16, p=0.049), and was no longer significant in the fully-adjusted multivariate model including waist/hip ratio. In conclusion, in older subjects, especially women, SUA is associated with EF not independently of a list of confounders including BMI and trunk fat mass, suggesting a role as surrogate metabolic marker rather than an active player in EF. Copyright © 2017 Elsevier Inc. All rights reserved.

Uric acid and endothelial function in elderly community-dwelling subjects

PubMed Central

Ticinesi, Andrea; Lauretani, Fulvio; Ceda, Gian Paolo; Ruggiero, Carmelinda; Ferrucci, Luigi; Aloe, Rosalia; Larsson, Anders; Cederholm, Tommy; Lind, Lars; Meschi, Tiziana; Maggio, Marcello

2017-01-01

The role of serum uric acid (SUA), an inflammatory agent and potential mediator of cardiovascular diseases, in endothelial function (EF) has been tested only in middle-aged subjects affected by specific diseases. Our aim was to assess the relationship between SUA and measures of EF in a cohort of elderly community-dwellers. This study involved 424 males and 426 females aged 70 years from the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS), having complete data on SUA and EF assessed by flow-mediated vasodilation (FMD) and by intra-arterial infusion of acetylcholine (endothelium-dependent vasodilation, EDV) and sodium nitroprusside (endothelium-independent vasodilation, EIDV). Univariate and multivariate regression models obtained by backward selection from initial fully-adjusted models were built to assess the relationship between SUA and measures of EF in both genders. Cardiovascular risk factors, serum hormonal and metabolic mediators, and body composition were considered as potential confounders. In the univariate model, SUA was inversely associated in both genders with log(EDV) (β ± SE males −0.39 ± 0.17, p = 0.03; females −0.57 ± 0.19, p = 0.003) and log(EIDV) (males −0.23 ± 0.12, p = 0.05; females −0.49 ± 0.15, p = 0.002), but not with log(FMD). After adjustment for BMI, only the association between SUA and log(EIDV) in females persisted, though attenuated (−0.32 ± 0.16, p = 0.049), and was no longer significant in the fully-adjusted multivariate model including waist/hip ratio. In conclusion, in older subjects, especially women, SUA is associated with EF not independently of a list of confounders including BMI and trunk fat mass, suggesting a role as surrogate metabolic marker rather than an active player in EF. PMID:28057563

Assessment of postural balance in community-dwelling older adults - methodological aspects and effects of biofeedback-based Nintendo Wii training.

PubMed

Jørgensen, Martin Grønbech

2014-01-01

weeks of biofeedback-based Nintendo Wii training on static postural balance, mechanical lower limb muscle function, and functional performance in 58 community-dwelling older adults. Additionally, the study investigated the participant motivation for this type of training (Exergaming). Marked improvements in maximal leg muscle strength, rapid force capacity and functional performance were observed following the period of biofeedback-based Nintendo Wii training. Unexpectedly, static bilateral postural balance remained unaltered following the period of intervention. The study participants perceived the Nintendo Wii training as enjoyable and highly motivating, which suggests that this type of exercise may be successfully implemented at senior citizens' centers and/or in the home of the elderly. The results presented in this thesis suggest that strict control of time-of-day is an important methodological aspect when evaluating postural balance in older adults, and an assessment protocol using the Nintendo Wii-Balance Board is reproducible and valid. Biofeedback-based Nintendo Wii exercise intervention appeared unsuccessful in improving static bilateral postural balance, most likely due to a test ceiling effect in the selected outcome measures, but the intervention elicited marked positive changes in various key risk factors associated to fall accidents. Notably, Wii based biofeedback exercise was perceived by the older adults as a highly motivating type of training.

Cognitive Function is Associated with the Development of Mobility Impairments in Community-Dwelling Elders

PubMed Central

Buchman, Aron S.; Boyle, Patricia A.; Leurgans, Sue E.; Barnes, Lisa L.; Bennett, David A.

2010-01-01

Objective To examine the association of cognitive function with the risk of incident mobility impairments and the rate of declining mobility in older adults. Design Prospective, observational cohort study. Setting Retirement communities across metropolitan Chicago. Participants 1154 ambulatory elders from two longitudinal studies without baseline clinical dementia or history of stroke or Parkinson’s disease. Measurements All participants underwent baseline cognitive testing and annual mobility exams. Mobility impairments were based on annual timed walking performance. A composite mobility measure which summarized gait and balance measures was used to examine the annual rate of mobility change. Results During follow-up of 4.5 years, 423 of 836 (50.6%) participants developed impaired mobility. In a proportional hazards model controlled for age, sex, education and race, each 1-unit higher level of baseline global cognition was associated with a reduction to about half in the risk of mobility impairments (HR=0.51, 95% CI 0.40, 0.66) and was similar to a participant being about 13 years younger at baseline. These results did not vary by sex or race and were unchanged in analyses controlling for BMI, physical activity, vascular diseases and risk factors. The level of cognition in 5 different cognitive abilities was also related to incident mobility impairment. Cognition showed similar associations with incident loss of the ability to ambulate. Linear mixed-effects models showed that global cognition at baseline was associated with the rate of declining mobility. Conclusions Among ambulatory elders, cognition is associated with incident mobility impairment and mobility decline. PMID:21606900

Factors predicting dynamic balance and quality of life in home-dwelling elderly women.

PubMed

Karinkanta, S; Heinonen, A; Sievanen, H; Uusi-Rasi, K; Kannus, P

2005-01-01

Proper balance seems to be a critical factor in terms of fall prevention among the elderly. The purpose of this cross-sectional study was to examine factors that are associated with dynamic balance and health-related quality of life in home-dwelling elderly women. One hundred and fifty-three healthy postmenopausal women (mean age: 72 years, height: 159 cm, weight: 72 kg) were examined. General health and physical activity were assessed by a questionnaire. Quality of life was measured using a health-related quality of life questionnaire (Rand 36-Item Health Survey 1.0). Dynamic balance (agility) was tested by a figure-of-eight running test. Static balance (postural sway) was tested on an unstable platform. Maximal isometric strength of the leg extensors was measured with a leg press dynamometer. Dynamic muscle strength of lower limbs was tested by measuring ground reaction forces with a force platform during common daily activities (sit-to-stand and step-on-a-stair tests). Concerning physical activity, 33% of the subjects reported brisk exercise (walking, Nordic walking, cross-country skiing, swimming and aquatic exercises) at least twice a week, and 22% some kind of brisk activity once a week in addition to lighter physical exercise. The remaining 45% did not exercise regularly and were classified as sedentary. The correlations of step-on-a-stair and sit-to-stand ground reaction forces, and leg extensor strength to dynamic balance were from -0.32 to -0.43 (the better the strength, the better the balance). In the regression analysis with backward elimination, step-on-a-stair and sit-to-stand ground reaction forces, and leg extensor strength, age, brisk physical activity, number of diseases and dynamic postural stability explained 42% of the variance in the dynamic balance. Similarly, dynamic balance (figure-of-eight running time), number of diseases and walking more than 3 km per day explained 14% of the variance in the quality of life score. Of these, figure

Prevention of falls and fall-related injuries in community-dwelling seniors: an evidence-based analysis.

PubMed

2008-01-01

In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To identify interventions that may be effective in reducing the probability of an elderly person's falling and/or sustaining a fall-related injury. Although estimates of fall rates vary widely based on the location, age, and living arrangements of the elderly population, it is estimated that each year approximately 30% of community-dwelling individuals aged 65 and older, and 50% of those aged 85

Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals.

PubMed

Johansson, Jonas; Nordström, Anna; Gustafson, Yngve; Westling, Göran; Nordström, Peter

2017-11-01

fall-related injuries constitute major health risks in older individuals, and these risks are projected to increase in parallel with increasing human longevity. Impaired postural stability is a potential risk factor related to falls, although the evidence is inconclusive, partly due to the lack of prospective studies. This study aimed to investigate how objective measures of postural sway predict incident falls. this prospectively observational study included 1,877 community-dwelling individuals aged 70 years who participated in the Healthy Ageing Initiative between June 2012 and December 2015. postural sway was measured during eyes-open (EO) and eyes-closed (EC) trials using the Wii Balance Board. Functional mobility, muscle strength, objective physical activity and cognitive performance were also measured. Participants reported incident falls 6 and 12 months after the examination. during follow-up, 255 (14%) prospective fallers were identified. Division of centre of pressure (COP) sway lengths into quintiles revealed a nonlinear distribution of falls for EO trial data, but not EC trial data. After adjustment for multiple confounders, fall risk was increased by 75% for participants with COP sway lengths ≥400 mm during the EO trial (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.09-2.79), and approximately doubled for sway lengths ≥920 mm during the EC trial (OR 1.90, 95% CI 1.12-3.22). objective measures of postural sway independently predict incident falls in older community-dwelling men and women. Further studies are needed to evaluate whether postural sway length is of interest for the prediction of incident falls in clinical settings. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

Factors affecting cognitive function according to gender in community-dwelling elderly individuals.

PubMed

Kim, Miwon; Park, Jeong-Mo

2017-01-01

This study aimed to identify the factors affecting the cognitive function of elderly people in a community by gender. We obtained 4,878 secondary data of people aged ≥65 years in 2016 at a dementia prevention center in Gyeyang-gu, Incheon. Data were obtained through Mini-Mental Status Examination optimized for screening dementia and a questionnaire. The data were statistically analyzed using analysis of variance, analysis of covariance, and hierarchical regression. There were significant differences in cognitive function according to gender, and the differences were significant even when age was controlled, but gender differences disappeared when education was controlled. Age, education, social activities, number of comorbid diseases, and alcohol drinking affected cognitive function through interaction with gender, but interaction with gender disappeared when education was controlled. Regression analysis showed that depression, cohabitant, social activities etc., had a significant impact on both men and women under controlled education and age. In men, the effect of social activities was greater than that of women, and hyperlipidemia had the effect only in women. The differences in gender-related cognitive functions were due to differences in gender education period. The period of education is considered to have a great influence on cognitive function in relation to the economic level, occupation, and social activity.

Sleep/awake status throughout the night and circadian motor activity patterns in older nursing-home residents with or without dementia, and older community-dwelling people without dementia.

PubMed

Kume, Yu; Kodama, Ayuto; Sato, Kotaro; Kurosawa, Satoko; Ishikawa, Takashi; Ishikawa, Sachiko

2016-12-01

Sleep disturbances are commonly observed in older nursing home residents, mainly in combination with dementia. However, sleep-associated circadian motor activity patterns have not been thoroughly investigated in Japanese nursing homes. The present study aimed to respectively clarify the effect of community living and the presence of dementia on sleep disturbances and interrupted activity rhythm of older nursing-home residents with or without dementia and older community-dwelling people without dementia. Actigraph devices worn on the participants' non-dominant wrists for seven days were used to collect objective measurements of the sleep/awake status throughout the night and the circadian motor activity patterns. The presence of dementia was assessed by a trained medical doctor using the residents' records and the Clinical Dementia Rating (CDR). The functional capacity of the participants was determined using the Barthel Index (BI). Fifty-one older people in Akita prefecture were included in the current study, consisting of 17 residents with dementia (mean age: 82.2 years), 17 residents without dementia (84.5 years), and 17 community-dwelling people (83.6 years). The results showed that older nursing-home residents with dementia had significantly a lower rate of sleep efficiency and a longer awake time throughout the night than the other groups. Older nursing-home residents with and without dementia had more fragmented rhythm than community-dwelling people without dementia. These results provide evidence of poor sleep/awake status throughout the night and interrupted circadian activity rhythms in nursing-home residents with and without dementia. However, further studies performed according to dementia classifications are needed.

Decline in Physical Function and Risk for Elder Abuse Reported to Social Services in a Community-Dwelling Population of Older Adults

PubMed Central

Dong, XinQi; Simon, Melissa; Evans, Denis

2012-01-01

Objectives Elder abuse is an important public health and human rights issue and is associated with increased morbidity and mortality. This study aimed to examine the longitudinal association between decline in physical function and the risk for elder abuse. Design Prospective population-based study Setting Geographically defined community in Chicago. Participants Chicago Health and Aging Project (CHAP) is a population-based study (N=6,159), and we identified 143 CHAP participants who had elder abuse reported to social services agency from 1993–2010. Participants The primary independent variable was objectively assessed physical function using decline in physical performance testing (Tandem stand, measured walk and chair stand). Secondary independent variables were assessed using the decline in self-reported Katz, Nagi, and Rosow-Breslau scales. Outcomes were reported and confirmed elder abuse and specific subtypes of elder abuse (physical, psychological, caregiver neglect and financial exploitation). Logistic regression models were used to assess the association of decline in physical function measures and risk for elder abuse. Results After adjusting for potential confounders, every 1 point decline in physical performance testing (OR, 1.13(1.06–1.19)), Katz impairment (OR, 1.29(1.15–1.45)), Nagi impairment (OR, 1.30(1.13–1.49)) and Rosow Breslau impairment (OR, 1.42(1.15–1.74)) were associated with increased risk for elder abuse. Lowest tertiles of physical performance testing (OR, 4.92 (1.39–17.46), highest tertiles of Katz impairment (OR, 3.99 (2.18–7.31), Nagi impairment (OR, 2.37 (1.08–5.23), and Rosow Breslau impairment (2.85 (1.39–5.84) were associated with increased risk for elder abuse. Conclusion Decline in objectively assessed physical function and self-reported physical function are associated with increased risk for elder abuse. PMID:23002901

Perceptions of Elder Abuse From Community-Dwelling Older Persons and Professionals Working in Western Switzerland.

PubMed

Roulet Schwab, Delphine; Wangmo, Tenzin

2017-09-01

Older persons' perspectives regarding elder abuse remain little studied. However, definitions of elder abuse and effective prevention strategies require adaptation to the needs and cultures of targeted populations. This study explored the views of older persons and professionals to evaluate their converging and diverging perspectives toward elder abuse and its prevention. The study employed a qualitative approach where six focus groups were held in Western Switzerland (the French-speaking part of the country). Four focus groups with 25 older persons from varying socioeconomic backgrounds, and the other two focus groups were carried out with 16 professionals working in the field of elder abuse prevention. For the focus groups, we used the technique of free associations to begin the discussions and vignette-like statements to explore participants' attitudes toward elder abuse. These were followed by open-ended questions. The transcripts from the focus groups were analyzed thematically and resulted in four main themes: (a) varied associations of the term "abuse," (b) judging elder abuse situations in terms of abuse and severity, (c) self-identification with elder abuse, and (d) prevention of elder abuse. Study findings demonstrated that older persons hold views that are partly different from the views of professionals. Furthermore, perceptions of older persons could be stratified based on the socioeconomic status of the participants. These diverging perspectives reflect the heterogeneity of the senior citizen population and highlight the need for research cognizant of these differences. The results of this study provide strategies for improved targeting of preventive measures, underline the importance of integrating the perspectives of older persons, and reveal the need to expand the commonly accepted definitions of elder abuse so that they better reflect the affected individuals.

The impact of community-acquired pneumonia on the health-related quality-of-life in elderly.

PubMed

Mangen, Marie-Josée J; Huijts, Susanne M; Bonten, Marc J M; de Wit, G Ardine

2017-03-14

The sustained health-related quality-of-life of patients surviving community-acquired pneumonia has not been accurately quantified. The aim of the current study was to quantify differences in health-related quality-of-life of community-dwelling elderly with and without community-acquired pneumonia during a 12-month follow-up period. In a matched cohort study design, nested in a prospective randomized double-blind placebo-controlled trial on the efficacy of the 13-valent pneumococcal vaccine in community-dwelling persons of ≥65 years, health-related quality-of-life was assessed in 562 subjects hospitalized with suspected community-acquired pneumonia (i.e. diseased cohort) and 1145 unaffected persons (i.e. non-diseased cohort) matched to pneumonia cases on age, sex, and health status (EQ-5D-3L-index). Health-related quality-of-life was determined 1-2 weeks after hospital discharge/inclusion and 1, 6 and 12 months thereafter, using Euroqol EQ-5D-3L and Short Form-36 Health survey questionnaires. One-year quality-adjusted life years (QALY) were estimated for both diseased and non-diseased cohorts. Separate analyses were performed for pneumonia cases with and without radiologically confirmed community-acquired pneumonia. The one-year excess QALY loss attributed to community-acquired pneumonia was 0.13. Mortality in the post-discharge follow-up year was 8.4% in community-acquired pneumonia patients and 1.2% in non-diseased persons (p < 0.001). During follow-up health-related quality-of-life was persistently lower in community-acquired pneumonia patients, compared to non-diseased persons, but differences in health-related quality-of-life between radiologically confirmed and non-confirmed community-acquired pneumonia cases were not statistically significant. Community-acquired pneumonia was associated with a six-fold increased mortality and 16% lower quality-of-life in the post-discharge year among patients surviving hospitalization for community

Association Between Sarcopenia and Mild Cognitive Impairment Using the Japanese Version of the SARC-F in Elderly Patients With Diabetes.

PubMed

Ida, Satoshi; Nakai, Mari; Ito, Sho; Ishihara, Yuki; Imataka, Kanako; Uchida, Akihiro; Monguchi, Kou; Kaneko, Ryutaro; Fujiwara, Ryoko; Takahashi, Hiroka; Murata, Kazuya

2017-09-01

The purpose of this study was to investigate the association between sarcopenia and mild cognitive impairment (MCI) in elderly patients with diabetes using the Japanese version of the simple 5-item questionnaire (SARC-F-J). Cross-sectional study. Community hospital in Japan. Subjects were people with diabetes aged 65 years and older being treated on an outpatient basis at the Ise Red Cross Hospital. We used the Japanese version of the self-administered cognitive test Test Your Memory (TYM-J) to measure MCI and the self-administered questionnaire SARC-F-J, consisting of 5 items, to evaluate sarcopenia. We conducted a multiple logistic regression analysis with MCI as the dependent variable and sarcopenia as the explanatory variable to calculate the odds ratio of sarcopenia in association with MCI. A total of 250 cases (150 men and 100 women) were included in our study. The prevalence of sarcopenia in this sample was 19.5% and that of MCI was 40.3%. The adjusted odds ratio of sarcopenia in association with MCI was 2.96 (95% confidence interval, 1.09-7.70, P = .032). A statistically significant association was found between sarcopenia and MCI in an assessment of elderly patients with diabetes using the SARC-F-J. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement.

PubMed

Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Caughey, Aaron B; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kubik, Martha; Landefeld, Seth; Mangione, Carol M; Pignone, Michael; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

2018-04-24

Falls are the leading cause of injury-related morbidity and mortality among older adults in the United States. In 2014, 28.7% of community-dwelling adults 65 years or older reported falling, resulting in 29 million falls (37.5% of which needed medical treatment or restricted activity for a day or longer) and an estimated 33 000 deaths in 2015. To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on the prevention of falls in community-dwelling older adults. The USPSTF reviewed the evidence on the effectiveness and harms of primary care-relevant interventions to prevent falls and fall-related morbidity and mortality in community-dwelling older adults 65 years or older who are not known to have osteoporosis or vitamin D deficiency. The USPSTF found adequate evidence that exercise interventions have a moderate benefit in preventing falls in older adults at increased risk for falls and that multifactorial interventions have a small benefit. The USPSTF found adequate evidence that vitamin D supplementation has no benefit in preventing falls in older adults. The USPSTF found adequate evidence to bound the harms of exercise and multifactorial interventions as no greater than small. The USPSTF found adequate evidence that the overall harms of vitamin D supplementation are small to moderate. The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. (B recommendation) The USPSTF recommends that clinicians selectively offer multifactorial interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. Existing evidence indicates that the overall net benefit of routinely offering multifactorial interventions to prevent falls is small. When determining whether this service is appropriate for an individual, patients and clinicians should consider the balance of benefits and harms based on the circumstances of prior

Aortic pulse wave velocity predicts cardiovascular mortality in middle-aged and elderly Japanese men.

PubMed

Inoue, Noriko; Maeda, Ryo; Kawakami, Hideshi; Shokawa, Tomoki; Yamamoto, Hideya; Ito, Chikako; Sasaki, Hideo

2009-03-01

Aortic pulse wave velocity (PWV) is widely used as a noninvasive index of arterial stiffness and was used in the present study to investigate the relationship between PWV and cardiovascular mortality in the middle-aged and elderly Japanese population using a longitudinal study design. From 1988 to 2003, a total of 3,960 men (50-69 years old at baseline) who underwent medical check-ups and measurement of PWV, which was standardized for diastolic blood pressure, were recruited and divided into 4 groups according to the PWV values. The average follow-up period was 8.2 years. Mortality from all-causes and from cardiovascular disease significantly increased as PWV increased in the entire follow-up period. Multivariate-adjusted relative risks of all-cause and cardiovascular disease mortality for the highest quartile of PWV (>9.0 m/s) were 1.28 (95% confidence interval (CI) 0.97-1.68) and 1.83 (95%CI 1.02-3.29), respectively, compared with the lowest quartile (<7.5 m/s). An increased PWV can predict cardiovascular mortality in middle-aged and elderly Japanese men.

Optimal energy distribution of carbohydrate intake for Japanese elderly patients with type 2 diabetes: the Japanese Elderly Intervention Trial.

PubMed

Kamada, Chiemi; Yoshimura, Hidenori; Okumura, Ryota; Takahashi, Keiko; Iimuro, Satoshi; Ohashi, Yasuo; Araki, Atsushi; Umegaki, Hiroyuki; Sakurai, Takashi; Yoshimura, Yukio; Ito, Hideki

2012-04-01

In diet therapy for diabetes, optimal energy intake and the energy distribution of macronutrients (protein : fat : carbohydrate [PFC] energy ratio) are important. We aimed to clarify the correlation between the PFC energy ratio and metabolic parameters including glycated hemoglobin A1c (HbA1c) and triglycerides in Japanese elderly patients with type 2 diabetes mellitus aged 65 years or older. Participants were 1173 diabetic patients aged 65 years or older with serum HbA1c level of >/=7.4% enrolled in the Japanese Elderly Diabetes Intervention Trial (J-EDIT). The participants were divided into four groups by the percentage of total energy intake (%E) of carbohydrate (C1: less than 55%E, C2: 55%E or more and less than 60%E, C3: 60%E or more and less than 65%E, and C4: 65%E or more). Relations of %E of carbohydrate to HbA1c and other metabolic parameters, energy intake and nutritional intake were examined. Furthermore, the subjects were divided into four categories by HbA1c levels by quartile method (Q1: less than 7.90%, Q2: 7.90% or more and less than 8.30%, Q3: 8.30% or more and less than 8.80%, Q4: 8.80% or more). Relations of HbA1c to other metabolic parameters, energy intake and nutritional intake were examined. The mean HbA1c levels in the four groups were C1: 8.40%, C2: 8.50%, C3: 8.41% and C4: 8.36% in men, and C1: 8.51%, C2: 8.47%, C3: 8.35% and C4: 8.52% in women, respectively. There were no significant differences and linear trend in HbA1c levels across groups. The mean triglyceride levels were in the range of 122-128 mg/dL in men from C1 to C3, although it was significantly higher in C4 (177 mg/dL). The mean triglyceride levels were in the range of 128-136 mg/dL in women from C1 to C3, although it was significantly higher in Q4 (150 mg/dL). Amounts of protein and fat intakes decreased with an increase of %E of carbohydrate, although amount of carbohydrate intake did not change significantly. As a result, %E of protein and fat, and energy intake decreased

Ankle brachial index values, leg symptoms, and functional performance among community-dwelling older men and women in the lifestyle interventions and independence for elders study

USDA-ARS?s Scientific Manuscript database

The prevalence and significance of low normal and abnormal ankle brachial index (ABI) values in a community dwelling population of sedentary, older individuals is unknown. We describe the prevalence of categories of definite peripheral artery disease (PAD), borderline ABI, low-normal ABI and no PAD...

Characterization of multifocal T2*-weighted MRI hypointensities in the basal ganglia of elderly, community-dwelling subjects☆

PubMed Central

Glatz, Andreas; Valdés Hernández, Maria C.; Kiker, Alexander J.; Bastin, Mark E.; Deary, Ian J.; Wardlaw, Joanna M.

2013-01-01

Multifocal T2*-weighted (T2*w) hypointensities in the basal ganglia, which are believed to arise predominantly from mineralized small vessels and perivascular spaces, have been proposed as a biomarker for cerebral small vessel disease. This study provides baseline data on their appearance on conventional structural MRI for improving and automating current manual segmentation methods. Using a published thresholding method, multifocal T2*w hypointensities were manually segmented from whole brain T2*w volumes acquired from 98 community-dwelling subjects in their early 70s. Connected component analysis was used to derive the average T2*w hypointensity count and load per basal ganglia nucleus, as well as the morphology of their connected components, while nonlinear spatial probability mapping yielded their spatial distribution. T1-weighted (T1w), T2-weighted (T2w) and T2*w intensity distributions of basal ganglia T2*w hypointensities and their appearance on T1w and T2w MRI were investigated to gain further insights into the underlying tissue composition. In 75/98 subjects, on average, 3 T2*w hypointensities with a median total volume per intracranial volume of 50.3 ppm were located in and around the globus pallidus. Individual hypointensities appeared smooth and spherical with a median volume of 12 mm3 and median in-plane area of 4 mm2. Spatial probability maps suggested an association between T2*w hypointensities and the point of entry of lenticulostriate arterioles into the brain parenchyma. T1w and T2w and especially the T2*w intensity distributions of these hypointensities, which were negatively skewed, were generally not normally distributed indicating an underlying inhomogeneous tissue structure. Globus pallidus T2*w hypointensities tended to appear hypo- and isointense on T1w and T2w MRI, whereas those from other structures appeared iso- and hypointense. This pattern could be explained by an increased mineralization of the globus pallidus. In conclusion, the

Construct validity of the Groningen Frailty Indicator established in a large sample of home-dwelling elderly persons: Evidence of stability across age and gender.

PubMed

Peters, L L; Boter, H; Burgerhof, J G M; Slaets, J P J; Buskens, E

2015-09-01

The primary objective of the present study was to evaluate the validity of the Groningen Frailty Indicator (GFI) in a sample of Dutch elderly persons participating in LifeLines, a large population-based cohort study. Additional aims were to assess differences between frail and non-frail elderly and examine which individual characteristics were associated with frailty. By December 2012, 5712 elderly persons were enrolled in LifeLines and complied with the inclusion criteria of the present study. Mann-Whitney U or Kruskal-Wallis tests were used to assess the variability of GFI-scores among elderly subgroups that differed in demographic characteristics, morbidity, obesity, and healthcare utilization. Within subgroups Kruskal-Wallis tests were also used to examine differences in GFI-scores across age groups. Multivariate logistic regression analyses were performed to assess associations between individual characteristics and frailty. The GFI discriminated between subgroups: statistically significantly higher GFI-median scores (interquartile range) were found in e.g. males (1 [0-2]), the oldest old (2 [1-3]), in elderly who were single (1 [0-2]), with lower socio economic status (1 [0-3]), with increasing co-morbidity (2 [1-3]), who were obese (2 [1-3]), and used more healthcare (2 [1-4]). Overall age had an independent and statistically significant association with GFI scores. Compared with the non-frail, frail elderly persons experienced statistically significantly more chronic stress and more social/psychological related problems. In the multivariate logistic regression model, psychological morbidity had the strongest association with frailty. The present study supports the construct validity of the GFI and provides an insight in the characteristics of (non)frail community-dwelling elderly persons participating in LifeLines. Copyright © 2015 Elsevier Inc. All rights reserved.

Study design of J-ELD AF: A multicenter prospective cohort study to investigate the efficacy and safety of apixaban in Japanese elderly patients.

PubMed

Akao, Masaharu; Yamashita, Takeshi; Okumura, Ken

2016-12-01

Apixaban, one of the non-vitamin K antagonist oral anticoagulants, was reported to be effective and safe in stroke prevention in patients with atrial fibrillation (AF) based on the global randomized clinical trial, but data are limited on the efficacy and safety of apixaban in Japanese elderly patients. The J-ELD AF Registry is a large-scale, contemporary observational study, continuously and prospectively registering elderly Japanese patients with AF aged 75 years or older who are currently taking apixaban or the elderly who are to receive apixaban in daily clinical practice, and accumulating the outcomes during one-year follow-up period. In addition to standard baseline characteristics, prothrombin time and anti-Xa activity will be measured to investigate the biomarker characteristics. The primary efficacy endpoints will be stroke and systemic embolism, and the primary safety endpoint will be major bleeding requiring hospitalization. The secondary endpoints in this study will be all-cause death, cardiovascular death, acute myocardial infarction, and the composite of stroke/systemic embolism, cardiovascular death, and acute myocardial infarction. As a primary analysis, the primary/secondary endpoints in the enrolled patients will be totalized for the entire group, and the incidence of events will be described by age, CHADS 2 score, HAS-BLED score, and apixaban dose (5 or 2.5mg bid). The factors that independently predict the incidence of the primary/secondary endpoints will be searched for by Cox regression. The relationship between the biomarkers and the primary/secondary endpoints will also be examined in an explorative manner. This study will provide important information on the efficacy and safety of apixaban in elderly Japanese patients aged 75 years or older, and those of low-dose administration of apixaban (2.5mg bid) for which many of the Japanese elderly are indicated. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights

Effect of structured physical activity on respiratory outcomes in sedentary elderly adults with mobility limitations

USDA-ARS?s Scientific Manuscript database

OBJECTIVES: To evaluate the effect of structured physical activity on respiratory outcomes in community dwelling elderly adults with mobility limitations. DESIGN: Multicenter, randomized trial of physical activity vs health education, with respiratory variables prespecified as tertiary outcomes over...

Elder Abuse: Systematic Review and Implications for Practice.

PubMed

Dong, Xin Qi

2015-06-01

This article is based on the lecture for the 2014 American Geriatrics Society Outstanding Scientific Achievement for Clinical Investigation Award. Elder abuse is a global public health and human rights problem. Evidence suggests that elder abuse is prevalent, predictable, costly, and sometimes fatal. This review will highlight the global epidemiology of elder abuse in terms of its prevalence, risk factors, and consequences in community populations. The global literature in PubMed, MEDLINE, PsycINFO, BIOSIS, Science Direct, and Cochrane Central was searched. Search terms included elder abuse, elder mistreatment, elder maltreatment, prevalence, incidence, risk factors, protective factors, outcomes, and consequences. Studies that existed only as abstracts, case series, or case reports or recruited individuals younger than 60; qualitative studies; and non-English publications were excluded. Tables and figures were created to highlight the findings: the most-detailed analyses to date of the prevalence of elder abuse according to continent, risk and protective factors, graphic presentation of odds ratios and confidence intervals for major risk factors, consequences, and practical suggestions for health professionals in addressing elder abuse. Elder abuse is common in community-dwelling older adults, especially minority older adults. This review identifies important knowledge gaps, such as a lack of consistency in definitions of elder abuse; insufficient research with regard to screening; and etiological, intervention, and prevention research. Concerted efforts from researchers, community organizations, healthcare and legal professionals, social service providers, and policy-makers should be promoted to address the global problem of elder abuse. © 2015, Copyright the Author Journal compilation © 2015, The American Geriatrics Society.

Predicting sarcopenia from functional measures among community-dwelling older adults.

PubMed

Gray, Michelle; Glenn, Jordan M; Binns, Ashley

2016-02-01

Sarcopenia is defined as age-related lean tissue mass (LTM) loss resulting in reduced muscular strength, physical function, and mobility. Up to 33 % of older adults currently are sarcopenic, with likely many more undiagnosed. The purpose of this investigation was to predict sarcopenia status from easily accessible functional measures of community-dwelling older adults. Forty-three community-dwelling older adults (n = 32 females and n = 11 males) participated in the present investigation. Inclusion criteria included ≥65 years of age, mini-mental state examination score ≥24, and no falls within previous 12 months. All subjects completed their appendicular skeletal mass (ASM) assessment via dual-energy X-ray absorptiometry (DXA) and were categorized as either sarcopenic or non-sarcopenic. Physical assessments included 10-m usual walk, hand-grip (HG) strength, 6-min walk, 8-ft up-and-go, 30-s chair stand, 30-s arm curl, and sit-to-stand muscular power. A forward, stepwise multiple regression analysis revealed that age, sex, weight, height, 10-m walk, HG, and sit-to-stand muscular power account for 96.1 % of the variance in ASM. The area under the curve was 0.92 for correctly identifying sarcopenic participants compared to their actual classification. This is the first prediction model used to identify sarcopenia based on parameters of demographic and functional fitness measures in community-dwelling older adults. The ability to accurately identify sarcopenia in older adults is imperative to their quality of life and ability to perform activities of daily living.

The average cost of pressure ulcer management in a community dwelling spinal cord injury population.

PubMed

Chan, Brian C; Nanwa, Natasha; Mittmann, Nicole; Bryant, Dianne; Coyte, Peter C; Houghton, Pamela E

2013-08-01

Pressure ulcers (PUs) are a common secondary complication experienced by community dwelling individuals with spinal cord injury (SCI). There is a paucity of literature on the health economic impact of PU in SCI population from a societal perspective. The objective of this study was to determine the resource use and costs in 2010 Canadian dollars of a community dwelling SCI individual experiencing a PU from a societal perspective. A non-comparative cost analysis was conducted on a cohort of community dwelling SCI individuals from Ontario, Canada. Medical resource use was recorded over the study period. Unit costs associated with these resources were collected from publicly available sources and published literature. Average monthly cost was calculated based on 7-month follow-up. Costs were stratified by age, PU history, severity level, location of SCI, duration of current PU and PU surface area. Sensitivity analyses were also carried out. Among the 12 study participants, total average monthly cost per community dwelling SCI individual with a PU was $4745. Hospital admission costs represented the greatest percentage of the total cost (62%). Sensitivity analysis showed that the total average monthly costs were most sensitive to variations in hospitalisation costs. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

Rural-Urban Differences in Preventable Hospitalizations among Community-Dwelling Veterans with Dementia

ERIC Educational Resources Information Center

Thorpe, Joshua M.; Van Houtven, Courtney H.; Sleath, Betsy L.; Thorpe, Carolyn T.

2010-01-01

Context: Alzheimer's patients living in rural communities may face significant barriers to effective outpatient medical care. Purpose: We sought to examine rural-urban differences in risk for ambulatory care sensitive hospitalizations (ACSH), an indicator of access to outpatient care, in community-dwelling veterans with dementia. Methods: Medicare…

Elder Abuse in American Indian Communities

ERIC Educational Resources Information Center

Anisko, Briana

2009-01-01

Although the many American Indian tribes of the United States are unique in their own customs, languages, and histories, a common thread throughout their traditions and cultural lifestyles is that they are of a culture that reveres the elder in their communities. Elders are the carriers of the culture/history; they are the storytellers, holders of…

Prevalence and factors associated with xerostomia and hyposalivation among community-dwelling older people in Japan.

PubMed

Ohara, Yuki; Hirano, Hirohiko; Yoshida, Hideyo; Obuchi, Shuichi; Ihara, Kazushige; Fujiwara, Yoshinori; Mataki, Shiro

2016-03-01

This study investigated the prevalence and factors associated with xerostomia and hyposalivation among community-dwelling older people. Xerostomia and hyposalivation are common symptoms in the older population. This study included with 894 community-dwelling, Japanese older people (355 men, 539 women; age 65-84 years) who participated in a comprehensive geriatric health examination, which included questionnaires and interviews regarding medical history, medications, Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), depressive condition. The Zung Self-Rating Depression Scale (SDS) was used to evaluate depression. Resting salivary flow rate was evaluated by the modified cotton roll method. In this study, 34.8% of the participants (mean age, 73.5 ± 5.0 years) complained about xerostomia, while the prevalence of hyposalivation was 11.5%. Multiple regression analysis revealed hypnotics use [odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.13-2.61], SDS (OR = 1.05, CI = 1.04-1.07) and TMIG-IC total points (OR = 0.87, CI = 0.76-0.99) to be significantly associated with xerostomia. In contrast, female gender (OR = 2.59, CI = 1.55-4.31) and the use of agents affecting digestive organs (OR = 1.78, CI = 1.11-2.86) were associated with hyposalivation. Our findings showed that the prevalence of xerostomia and hyposalivation were approximately 1 in 3 and 1 in 10 respectively. The factors associated with psychological factors and high-level functional competence, while hyposalivation was associated with medications and gender, as well as systemic and/or metabolic differences. It is important to consider these multidimensional factors associated with xerostomia and hyposalivation. © 2013 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

The burden of community-acquired pneumonia in the elderly: the Spanish EVAN-65 study.

PubMed

Ochoa-Gondar, Olga; Vila-Córcoles, Angel; de Diego, Cinta; Arija, Victoria; Maxenchs, Monica; Grive, Montserrat; Martin, Enrique; Pinyol, Josep L

2008-06-27

Community-acquired pneumonia (CAP) is generally considered a major cause of morbidity and mortality in the elderly. However, population-based data are very limited and its overall burden is unclear. This study assessed incidence and mortality from CAP among Spanish community-dwelling elderly. Prospective cohort study that included 11,240 individuals aged 65 years or older, who were followed from January 2002 until April 2005. Primary endpoints were all-cause CAP (hospitalised and outpatient) and 30-day mortality after the diagnosis. All cases were radiographically proved and validated by checking clinical records. Incidence rate of overall CAP was 14 cases per 1,000 person-year (95% confidence interval: 12.7 to 15.3). Incidence increased dramatically by age (9.9 in people 65-74 years vs 29.4 in people 85 years or older), and it was almost double in men than in women (19.3 vs 10.1). Hospitalisation rate was 75.1%, with a mean length-stay of 10.4 days. Overall 30-days case-fatality rate was 13% (15% in hospitalised and 2% in outpatient cases). CAP remains as a major health problem in older adults. Incidence rates in this study are comparable with rates described in Northern Europe and America, but they largely doubled prior rates reported in other Southern European regions.

Sarcopenia as a predictor of all-cause mortality among community-dwelling older people: A systematic review and meta-analysis.

PubMed

Liu, Ping; Hao, Qiukui; Hai, Shan; Wang, Hui; Cao, Li; Dong, Birong

2017-09-01

The aim of this systematic review and meta-analysis was to examine the association between sarcopenia and all-cause mortality among community-dwelling older people. A systematic review was performed using three electronic databases (EMBASE, MEDLINE and the Cochrane Library) to identify prospective cohort studies from January 2009 to February 2017 examining sarcopenia as a predictor of all-cause mortality among community-dwelling older people. We conducted a pooled analysis of mortality associated with sarcopenia, and subgroup analyses based on measurements of muscle mass and length of follow-up by employing a random-effects model. Sensitivity analyses were performed evaluate the cause of high heterogeneity. In addition, methodological quality, heterogeneity and publication bias were evaluated. Of 1703 studies identified, 6 studies incorporating 7367 individuals were included in the meta-analysis for all-cause mortality. The pooled hazard ratios (HRs) of all-cause mortality from the combination of included studies suggested participants with sarcopenia had a significantly higher rate of mortality (pooled HR 1.60, 95%CI 1.24-2.06, I 2 =27.8%, p=0.216) than participants without sarcopenia. The subgroup analysis for length of follow-up suggested studies with a follow-up period of less than 5 years found a higher risk of all-cause mortality (pooled HR 2.09, 95%CI 1.21-3.60) than studies with a follow-up period of 5 years or more (pooled HR 1.52, 95%CI 1.14-2.01). A subgroup of anthropometric measures was found to identify higher mortality risks (pooled HR 2.26, 95%CI 1.30-3.92) than a subgroup of dual-energy x-ray (DXA) absorptiometry (pooled HR 1.82, 95%CI 1.04-3.18) factors or a subgroup of bioelectrical impedance analysis (BIA) factors (pooled HR 1.31, 95%CI 1.15-1.49). Sarcopenia is a predictor of all-cause mortality among community-dwelling older people. Therefore, it is important to diagnose sarcopenia and to intervene, in order to reduce mortality rates in the

A foot-care program to facilitate self-care by the elderly: a non-randomized intervention study.

PubMed

Omote, Shizuko; Watanabe, Arisu; Hiramatsu, Tomoko; Saito, Emiko; Yokogawa, Masami; Okamoto, Rie; Sakakibara, Chiaki; Ichimori, Akie; Kyota, Kaoru; Tsukasaki, Keiko

2017-11-09

We aimed to evaluate a foot-care awareness program designed to improve foot morphology, physical functioning, and fall prevention among the community-dwelling elderly. Eleven independent community-dwelling elderly women (aged 61-83 years) were provided with foot-care advice and shown effective foot-care techniques to perform regularly for 6 months, and compared with a control group of 10 elderly women who did not receive any intervention. Measurements of foot form, functional capacity, subjective foot movement, and physical function were taken at baseline and 6-month follow-up. At follow-up, improvements were seen in the intervention group in foot morphology, subjective foot movement, foot pressure, and balance. In the intervention group, 90% of women had maintained or improved foot form and none of them had fallen during the post-intervention period, compared to the control group where 30% improved foot form (p = 0.0075) and four (40%) of them had fallen. Therefore, a foot-care program may have the potential to prevent falls and improve mobility among the elderly. Trial Registration UMIN-CTR No. UMIN000029632. Date of Registration: October 19, 2017.

Lifestyle and Genetic Predictors of Stiffness Index in Community-dwelling Elderly Korean Men and Women.

PubMed

Park, Kyung-Ae; Park, Yeon-Hwan; Suh, Min-Hee; Choi-Kwon, Smi

2015-09-01

Differing lifestyle, nutritional, and genetic factors may lead to a differing stiffness index (SI) determined by quantitative ultrasound in elderly men and women. The purpose of this study was to determine SI and the gender-specific factors associated with low SI in a Korean elderly cohort. This was a cross-sectional descriptive study identifying the gender-specific factors related to SI in 252 men and women aged 65 years and greater from local senior centers in Seoul, Korea between January and February 2009. The mean SI of elderly men was significantly higher than that of the women's. A multiple regression analysis reveals that age, nutritional status, and physical activity were predictive factors of lower SI in men, whereas age, alcohol consumption, educational level, and genetic polymorphism were predictive factors for elderly women. Low SI was common in both elderly men and women. We found gender differences in factors linked to low SI. In multiple regression analysis, nutritional status and physical activity were more important factors in men, whereas alcohol consumption, educational level, and genetic polymorphism were significant factors predicting low SI in women. Gender-specific modifiable risk factors associated with low SI should be considered when developing osteoporosis prevention programs for the elderly. Copyright © 2015. Published by Elsevier B.V.

Moderating effect of intrinsic religiosity on the relationship between depression and cognitive function among community-dwelling older adults.

PubMed

Foong, Hui Foh; Hamid, Tengku Aizan; Ibrahim, Rahimah; Haron, Sharifah Azizah

2018-04-01

Research has found that depression in later life is associated with cognitive impairment. Thus, the mechanism to reduce the effect of depression on cognitive function is warranted. In this paper, we intend to examine whether intrinsic religiosity mediates the association between depression and cognitive function. The study included 2322 nationally representative community-dwelling elderly in Malaysia, randomly selected through a multi-stage proportional cluster random sampling from Peninsular Malaysia. The elderly were surveyed on socio-demographic information, cognitive function, depression and intrinsic religiosity. A four-step moderated hierarchical regression analysis was employed to test the moderating effect. Statistical analyses were performed using SPSS (version 15.0). Bivariate analyses showed that both depression and intrinsic religiosity had significant relationships with cognitive function. In addition, four-step moderated hierarchical regression analysis revealed that the intrinsic religiosity moderated the association between depression and cognitive function, after controlling for selected socio-demographic characteristics. Intrinsic religiosity might reduce the negative effect of depression on cognitive function. Professionals who are working with depressed older adults should seek ways to improve their intrinsic religiosity as one of the strategies to prevent cognitive impairment.

Factors affecting cognitive function according to gender in community-dwelling elderly individuals

PubMed Central

2017-01-01

OBJECTIVES This study aimed to identify the factors affecting the cognitive function of elderly people in a community by gender. METHODS We obtained 4,878 secondary data of people aged ≥65 years in 2016 at a dementia prevention center in Gyeyang-gu, Incheon. Data were obtained through Mini-Mental Status Examination optimized for screening dementia and a questionnaire. The data were statistically analyzed using analysis of variance, analysis of covariance, and hierarchical regression. RESULTS There were significant differences in cognitive function according to gender, and the differences were significant even when age was controlled, but gender differences disappeared when education was controlled. Age, education, social activities, number of comorbid diseases, and alcohol drinking affected cognitive function through interaction with gender, but interaction with gender disappeared when education was controlled. Regression analysis showed that depression, cohabitant, social activities etc., had a significant impact on both men and women under controlled education and age. In men, the effect of social activities was greater than that of women, and hyperlipidemia had the effect only in women. CONCLUSIONS The differences in gender-related cognitive functions were due to differences in gender education period. The period of education is considered to have a great influence on cognitive function in relation to the economic level, occupation, and social activity. PMID:29141399

Strong influence of dietary intake and physical activity on body fatness in elderly Japanese men: age-associated loss of polygenic resistance against obesity.

PubMed

Tanisawa, Kumpei; Ito, Tomoko; Sun, Xiaomin; Ise, Ryuken; Oshima, Satomi; Cao, Zhen-Bo; Sakamoto, Shizuo; Tanaka, Masashi; Higuchi, Mitsuru

2014-09-01

Genome-wide association studies identified single nucleotide polymorphisms (SNPs) associated with body mass index (BMI) in middle-aged populations; however, it is unclear whether these SNPs are associated with body fatness in elderly people. We examined the association between genetic risk score (GRS) from BMI-associated SNPs and body fatness in elderly Japanese men. We also examined the contribution of GRS, dietary macronutrient intake, and physical activity to body fatness by different age groups. GRS was calculated from 10 BMI-associated SNPs in 84 middle-aged (30-64 years) and 97 elderly (65-79 years) Japanese men; subjects were divided into low, middle, and high GRS groups. Dietary macronutrient intake was assessed using a questionnaire, and physical activity was evaluated using both a questionnaire and an accelerometer. The middle-aged individuals with a high GRS had greater BMI; waist circumference; and total abdominal fat, visceral fat, and subcutaneous fat areas than the middle-aged individuals with low GRS, whereas the indicators were not different between the GRS groups in elderly individuals. Multiple linear regression analysis showed that GRS was the strongest predictor of BMI, total abdominal fat, and visceral fat in the middle-aged group, whereas fat, alcohol, and protein intakes or vigorous-intensity physical activity were more strongly associated with these indicators than was GRS in the elderly group. These results suggest that GRS from BMI-associated SNPs is not predictive of body fatness in elderly Japanese men. The stronger contribution of dietary macronutrient intake and physical activity to body fatness may attenuate the genetic predisposition in elderly men.

Targeting community-dwelling urinary incontinence sufferers: a multi-disciplinary community based model for conservative continence services.

PubMed

St John, Winsome; Wallis, Marianne; James, Heather; McKenzie, Shona; Guyatt, Sheridan

2004-10-01

This paper presents an argument that there is a need to provide services that target community-dwelling incontinence sufferers, and presents a demonstration case study of a multi-disciplinary, community-based conservative model of service delivery: The Waterworx Model. Rationale for approaches taken, implementation of the model, evaluation and lessons learned are discussed. In this paper community-dwelling sufferers of urinary incontinence are identified as an underserved group, and useful information is provided for those wishing to establish services for them. The Waterworx Model of continence service delivery incorporates three interrelated approaches. Firstly, client access is achieved by using community-based services via clinic and home visits, creating referral pathways and active promotion of services. Secondly, multi-disciplinary client care is provided by targeting a specific client group, multi-disciplinary assessment, promoting client self-management and developing client knowledge and health literacy. Finally, interdisciplinary collaboration and linkages is facilitated by developing multidisciplinary assessment tools, using interdisciplinary referrals, staff development, multi-disciplinary management and providing professional education. Implementation of the model achieved greater client access, improvement in urinary incontinence and client satisfaction. Our experiences suggest that those suffering urinary incontinence and living in the community are an underserved group and that continence services should be community focussed, multi-disciplinary, generalist in nature.

Activity Monitors Step Count Accuracy in Community-Dwelling Older Adults.

PubMed

Johnson, Marquell

2015-01-01

Objective: To examine the step count accuracy of activity monitors in community-dwelling older adults. Method : Twenty-nine participants aged 67.70 ± 6.07 participated. Three pedometers and the Actical accelerometer step count functions were compared with actual steps taken during a 200-m walk around an indoor track and during treadmill walking at three different speeds. Results : There was no statistical difference between activity monitors step counts and actual steps during self-selected pace walking. During treadmill walking at 0.67 m∙s -1 , all activity monitors step counts were significantly different from actual steps. During treadmill walking at 0.894m∙s -1 , the Omron HJ-112 pedometer step counts were not significantly different from actual steps. During treadmill walking at 1.12 m∙s -1 , the Yamax SW-200 pedometer steps were significantly different from actual steps. Discussion : Activity monitor selection should be deliberate when examining the walking behaviors of community-dwelling older adults, especially for those who walk at a slower pace.

Cross-cultural comparisons of the Mini-mental State Examination between Japanese and U.S. cohorts

PubMed Central

Meguro, Kenichi; Ishii, Hiroshi; Yamaguchi, Satoshi; Saxton, Judith A.; Ganguli, Mary

2009-01-01

Background The Mini-mental State Examination (MMSE) is widely used in Japan and the U.S.A. for cognitive screening in the clinical setting and in epidemiological studies. A previous Japanese community study reported distributions of the MMSE total score very similar to that of the U.S.A. Methods Data were obtained from the Monongahela Valley Independent Elder's Study (MoVIES), a representative sample of community-dwelling elderly people aged 65 and older living near Pittsburgh, U.S.A., and from the Tajiri Project, with similar aims in Tajiri, Japan. We examined item-by-item distributions of the MMSE between two cohorts, comparing (1) percentage of correct answers for each item within each cohort, and (2) relative difficulty of each item measured by Item Characteristic Curve analysis (ICC), which estimates log odds of obtaining a correct answer adjusted for the remaining MMSE items, demographic variables (age, gender, education) and interactions of demographic variables and cohort. Results Median MMSE scores were very similar between the two samples within the same education groups. However, the relative difficulty of each item differed substantially between the two cohorts. Specifically, recall and auditory comprehension were easier for the Tajiri group, but reading comprehension and sentence construction were easier for the MoVIES group. Conclusions Our results reaffirm the importance of validation and examination of thresholds in each cohort to be studied when a common instrument is used as a dementia screening tool or for defining cognitive impairment. PMID:18925977

Lower physical activity, but not excessive calorie intake, is associated with metabolic syndrome in elderly with type 2 diabetes mellitus: the Japanese Elderly Diabetes Intervention Trial.

PubMed

Iijima, Katsuya; Iimuro, Satoshi; Ohashi, Yasuo; Sakurai, Takashi; Umegaki, Hiroyuki; Araki, Atsushi; Yoshimura, Yukio; Ouchi, Yasuyoshi; Ito, Hideki

2012-04-01

A decline in physical activity has been shown to be associated with metabolic syndrome (MetS), leading to cardiovascular events. However, this is difficult to manage well in the elderly with multiple atherosclerotic risk factors. In this study, we investigated the correlation between physical activity and clinical parameters in the presence and absence of MetS in Japanese elderly subjects with type 2 diabetes mellitus (T2DM). In addition, we determined which factor, calorie intake or physical activity, mainly contributes to the prevalence of MetS. Cross-sectional analysis of 846 consecutive Japanese elderly (408 men and 438 women, mean age 68.7 years) was carried out at the time of enrolment (2000-2002) in the Japanese Elderly Diabetes Intervention Trial. Their level of physical activity was evaluated using the Baecke questionnaire, consisting of three components: work, sports and leisure. Total activity score (TAS) as the sum of each activity score was divided into four quartiles (Q1 to Q4). After adjustment for age and sex, there was a positive association of TAS with high-density lipoprotein cholesterol, although no significant correlation between other lipid parameters and TAS was found. In addition, fasting plasma glucose, insulin level and physical measurements, such as waist circumference, waist/hip ratio and body mass index, were inversely associated with TAS. Although no correlation between TAS and cognitive function Mini-Mental State Examination was found, TAS was positively associated with instrumental ADL and negatively associated with geriatric depression score (GDS), suggesting that a decline in physical activity in the elderly is associated with depressed mood rather than a decline of cognitive function. Total calorie intake appeared to increase according to TAS; however, this did not reach statistical significance. In a subanalysis comparing the presence and absence of MetS, the TAS grade in the MetS group was significantly lower than that in the

Age-associated striatal dopaminergic denervation and falls in community-dwelling subjects

PubMed Central

Bohnen, Nicolaas I.; Muller, Martijn L. T. M.; Kuwabara, Hiroto; Cham, Rakié; Constantine, Gregory M.; Studenski, Stephanie A.

2016-01-01

Older adults have a high prevalence of gait and balance disturbances and falls. Normal aging is associated with significant striatal dopaminergic denervation, which might be a previously unrecognized additional contributor to geriatric falls. This study investigated the relationship between the severity of age-associated striatal dopaminergic denervation (AASDD) and falls in community-dwelling subjects. Community-dwelling subjects who did not have a clinical diagnosis to explain falls (n = 77: 43 female, 34 male; mean age 61.4 +/− 16.4; range 20–85) completed clinical assessment and brain dopamine transporter (DAT) [11C]beta-CFT (2-beta-carbomethoxy-3beta-(4-fluorophenyl) tropane) positron emission tomography imaging followed by 6 months of prospective fall monitoring using diaries. Results showed a significant inverse relationship between striatal DAT activity and age (r = −0.82, p < 0.001). A total of 26 subjects (33.8%) reported at least one fall, with 5 subjects (6.5%) reporting two or more falls. While no significant difference was noted in striatal DAT activity between nonfallers (n = 51) and fallers (n = 26; f = 0.02, not significant), striatal DAT activity was modestly reduced in the small subgroup of recurrent fallers compared with the other subjects (f = 5.07, p < 0.05). Findings indicate that AASDD does not explain isolated self-reported falls in community-dwelling subjects. However, it may be a contributing factor in the small subgroup of subjects with recurrent falls. PMID:20157861

Comparisons of social interaction and activities of daily living between long-term care facility and community-dwelling stroke patients.

PubMed

Yoon, Jeong-Ae; Park, Se-Gwan; Roh, Hyo-Lyun

2015-10-01

[Purpose] This study was conducted to compare the correlation between social interaction and activities of daily living (ADL) between community-dwelling and long-term care facility stroke patients. [Subjects and Methods] The Subjects were 65 chronic stroke patients (32 facility-residing, 33 community-dwelling). The Evaluation Social Interaction (ESI) tool was used to evaluate social interaction and the Assessment of Motor and Process Skills (AMPS) measure was used to evaluate ADL. [Results] Both social interaction and ADL were higher in community-dwelling than facility-residing stroke patients. There was a correlation between ESI and ADL for both motor and process skills among facility-residing patients, while only ADL process skills and ESI correlated among community-dwelling patients. In a partial correlation analysis using ADL motor and process skills as control variables, only process skills correlated with ESI. [Conclusion] For rehabilitation of stroke patients, an extended treatment process that combines ADL and social activities is likely to be required. Furthermore, treatment programs and institutional systems that can improve social interaction and promote health maintenance for community-dwelling and facility-residing chronic stroke patients are needed throughout the rehabilitation process.

Association Between Social Participation and 3-Year Change in Instrumental Activities of Daily Living in Community-Dwelling Elderly Adults.

PubMed

Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

2017-01-01

To investigate whether social participation (SP) in older adults is associated with ability to perform instrumental activities of daily living (IADLs). Prospective cohort study. Two local municipalities of Nara, Japan. Individuals aged 65 to 96 (n = 2,774 male, n = 3,586 female) free of IADL disability at baseline. SP and IADLs were assessed using self-administered questionnaires. SP was categorized into five types and assessed using the number and type of social activities. IADLs were evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression analysis stratified according to sex was used to examine change in IADLs according to SP, with nonparticipation as a reference. During the 3-year follow-up, 13.6% of men and 9.0% of women reported IADL decline. After adjusting for age, family structure, body mass index, pension, occupation, medical treatment, self-rated health, drinking, smoking, depression, cognitive function, and activities of daily living, participation in various social activities was inversely associated with change in IADLs in women but not men. Participation in the following types of social activities had significant inverse associations with IADL disability: hobby clubs (odds ratio (OR) = 0.68, 95% confidence interval (CI) = 0.49-0.94) for men and local events (OR = 0.68, 95% CI = 0.48-0.95), hobby clubs (OR = 0.53, 95% CI = 0.36-0.79), senior citizen clubs (OR = 0.74, 95% CI = 0.56-0.97), and volunteer groups (OR = 0.56, 95% CI = 0.32-0.99) for women. Participation in a variety of different types of social activities was associated with change in IADLs over the 3 years of this study in women, and participation in hobby clubs was associated with change in IADLs in men and women. Recommending that community-dwelling elderly adults participate in social activities appropriate for their sex may promote successful aging. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics

Association of Trajectories of Higher-Level Functional Capacity with Mortality and Medical and Long-Term Care Costs Among Community-Dwelling Older Japanese.

PubMed

Taniguchi, Yu; Kitamura, Akihiko; Nofuji, Yu; Ishizaki, Tatsuro; Seino, Satoshi; Yokoyama, Yuri; Shinozaki, Tomohiro; Murayama, Hiroshi; Mitsutake, Seigo; Amano, Hidenori; Nishi, Mariko; Matsuyama, Yutaka; Fujiwara, Yoshinori; Shinkai, Shoji

2018-03-26

Higher-level functional capacity is crucial component for independent living in later life. We used repeated-measures analysis to identify aging trajectories in higher-level functional capacity. We then determined whether these trajectories were associated with all-cause mortality and examined differences in medical and long-term care costs between trajectories among community-dwelling older Japanese. 2,675 adults aged 65-90 years participated in annual geriatric health assessments and biennial health monitoring surveys during the period from October 2001 through August 2011. The average number of follow-up assessments was 4.0, and the total number of observations was 10,609. Higher-level functional capacity, which correspond to the fourth and fifth sublevels of Lawton's hierarchical model, was assessed with the Tokyo Metropolitan Institute of Gerontology-Index of Competence (TMIG-IC). We identified four distinct trajectory patterns (high-stable, late-onset decreasing, early-onset decreasing, and low-decreasing) on the TMIG-IC through age 65-90 years. As compared with the high-stable trajectory group, participants in the late-onset decreasing, early-onset decreasing, and low-decreasing TMIG-IC trajectory groups had adjusted hazard ratios for mortality of 1.22 (95% confidence interval: 1.01-1.47), 1.90 (1.53-2.36), and 2.87 (2.14-3.84), respectively. Participants with high-stable and late-onset decreasing higher-level functional capacity trajectories had lower mean monthly medical costs and long-term care costs. In contrast, mean total costs were higher for those with low-decreasing trajectories, after excluding the large increase in such costs at the end of life. People with a low-decreasing aging trajectory in higher-level functional capacity had higher risks of death and had high monthly total costs.

Relational coordination between community health nurses and other professionals in delivering care to community-dwelling frail people.

PubMed

Cramm, Jane Murray; Hoeijmakers, Marjan; Nieboer, Anna Petra

2014-03-01

The first aim of this study was to investigate whether relational coordination is higher between primary care professionals and community health nurses than among other professionals. The second aim of this study was to investigate the relationship between different levels of relational coordination and primary care professionals' satisfaction with the care delivery of community health nurses. Community health nursing is based on the notion that all activities should respond to frail people's needs in a coordinated way, together with other professionals. Relational coordination is therefore important for the effective health-care delivery by these nurses. This cross-sectional study was performed among 167 professionals (n = 323, response rate 52%) who regularly worked with community health nurses. The results showed a higher degree of relational coordination with community health nurses than with other primary care professionals. Multilevel analyses revealed that professionals' satisfaction with the care delivered by community health nurses was influenced positively by relational coordination. Enhancing relational coordination between community health nurses and other primary care professionals in the neighborhood may improve the delivery of care to community-dwelling frail people. Comprehensive care delivery to community-dwelling frail people requires strong connections between all health and social care professionals. Community health nurses may be an important factor in strengthening these connections. © 2013 John Wiley & Sons Ltd.

Systematic Literature Review of Randomized Control Trials Assessing the Effectiveness of Nutrition Interventions in Community-Dwelling Older Adults

ERIC Educational Resources Information Center

Bandayrel, Kristofer; Wong, Sharon

2011-01-01

Objective: Nutrition interventions may play an important role in maintaining the health and quality of life in community-dwelling older adults. To the authors' knowledge, no systematic literature review has been conducted on the effectiveness of nutrition interventions in the community-dwelling older adult population. Design: Systematic literature…

Does smart home technology prevent falls in community-dwelling older adults: a literature review.

PubMed

Pietrzak, Eva; Cotea, Cristina; Pullman, Stephen

2014-01-01

Falls in older Australians are an increasingly costly public health issue, driving the development of novel modes of intervention, especially those that rely on computer-driven technologies. The aim of this paper was to gain an understanding of the state of the art of research on smart homes and computer-based monitoring technologies to prevent and detect falls in the community-dwelling elderly. Cochrane, Medline, Embase and Google databases were searched for articles on fall prevention in the elderly using pre-specified search terms. Additional papers were searched for in the reference lists of relevant reviews and by the process of 'snowballing'. Only studies that investigated outcomes related to falling such as fall prevention and detection, change in participants' fear of falling and attitudes towards monitoring technology were included. Nine papers fulfilled the inclusion criteria. The following outcomes were observed: (1) older adults' attitudes towards fall detectors and smart home technology are generally positive; (2) privacy concerns and intrusiveness of technology were perceived as less important to participants than their perception of health needs and (3) unfriendly and age-inappropriate design of the interface may be one of the deciding factors in not using the technology. So far, there is little evidence that using smart home technology may assist in fall prevention or detection, but there are some indications that it may increase older adults' confidence and sense of security, thus possibly enabling aging in place.

Behavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors

PubMed Central

2008-01-01

Executive Summary In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry’s newly released Aging at Home Strategy. After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person’s transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report. Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series. Aging in the Community: Summary of Evidence-Based Analyses Prevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based Analysis Behavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based Analysis Caregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based Analysis Social Isolation in Community-Dwelling Seniors: An Evidence-Based Analysis The Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) Objective To assess the effectiveness of behavioural interventions for the treatment and management of urinary incontinence (UI) in community-dwelling seniors. Clinical Need: Target Population and Condition Urinary incontinence defined as “the complaint of any involuntary leakage of urine” was identified as 1 of the key predictors in a senior’s transition from independent

Classifying MCI Subtypes in Community-Dwelling Elderly Using Cross-Sectional and Longitudinal MRI-Based Biomarkers

PubMed Central

Guan, Hao; Liu, Tao; Jiang, Jiyang; Tao, Dacheng; Zhang, Jicong; Niu, Haijun; Zhu, Wanlin; Wang, Yilong; Cheng, Jian; Kochan, Nicole A.; Brodaty, Henry; Sachdev, Perminder; Wen, Wei

2017-01-01

Amnestic MCI (aMCI) and non-amnestic MCI (naMCI) are considered to differ in etiology and outcome. Accurately classifying MCI into meaningful subtypes would enable early intervention with targeted treatment. In this study, we employed structural magnetic resonance imaging (MRI) for MCI subtype classification. This was carried out in a sample of 184 community-dwelling individuals (aged 73–85 years). Cortical surface based measurements were computed from longitudinal and cross-sectional scans. By introducing a feature selection algorithm, we identified a set of discriminative features, and further investigated the temporal patterns of these features. A voting classifier was trained and evaluated via 10 iterations of cross-validation. The best classification accuracies achieved were: 77% (naMCI vs. aMCI), 81% (aMCI vs. cognitively normal (CN)) and 70% (naMCI vs. CN). The best results for differentiating aMCI from naMCI were achieved with baseline features. Hippocampus, amygdala and frontal pole were found to be most discriminative for classifying MCI subtypes. Additionally, we observed the dynamics of classification of several MRI biomarkers. Learning the dynamics of atrophy may aid in the development of better biomarkers, as it may track the progression of cognitive impairment. PMID:29085292

Disrespect and Isolation: Elder Abuse in Chinese Communities

ERIC Educational Resources Information Center

Tam, Sandra; Neysmith, Sheila

2006-01-01

Based on a qualitative study of home care workers, this paper aims to understand elder abuse of Chinese Canadians. The findings show disrespect is the key form elder abuse takes in the Chinese community. As a culturally specific form of abuse, disrespect remains invisible under categories of elder abuse derived from a Western cultural perspective.…

An analysis of the impact of cell phone use on depressive symptoms among Japanese elders.

PubMed

Minagawa, Yuka; Saito, Yasuhiko

2014-01-01

There has been increasing interest in the impact of information and communication technologies, such as the computer and Internet, on physical and mental health status, but relatively little is known about the health effects of using cell phones. This study investigates how cell phone usage is associated with levels of depressive symptoms among Japanese men and women aged 65 years and older. We focus on social relationships, particularly intergenerational relationships between older parents and adult children, as a possible mediator in the association of cell phone use with late-life depressive symptoms. We therefore hypothesize that using cell phones contributes to the psychological well-being of older adults primarily through encouraging social relationships. We used 4 waves of data from the Nihon University Japanese Longitudinal Study of Aging (2001-2009) to analyze the impact of cell phone use on depressive symptoms. RESULTS are based on ordinary least squares regression analyses. Although the use of cell phones was related to lower levels of depressive symptoms among elderly Japanese people, controlling for sociodemographic characteristics and physical health conditions wiped out the effects for men. In contrast, the protective effects of using cell phones persisted among women, even net of all controls. Moreover, the impact of using cell phones was not explained by filial relationship measures, suggesting that cell phone use influences the mental health of older women independently of social engagement. Among the many advantages brought about by recent technological developments, cell phones appear to be an important contributor to the psychological well-being of Japanese elders. Researchers and policy makers should prioritize access to new technologies for older adults. © 2014 S. Karger AG, Basel.

Perceived loneliness and general cognitive status in community-dwelling older adults: the moderating influence of depression.

PubMed

Lam, Charlene L M; Yu, Junhong; Lee, Tatia M C

2017-09-01

The relationship between depression, loneliness, and cognitive functioning among the elderly is not well understood in the literature. In the present study, we tested the moderating influence of depressive symptoms on loneliness and cognitive functioning. We recruited 100 community-dwelling older adults in Hong Kong. Demographic information, perceived loneliness, depressed mood, and general cognitive status were assessed. Results indicated that married participants reported lower levels of perceived loneliness (t (96) = 2.26, p = .03). We found a significant moderating effect of depressive symptoms on the relationship between perceived loneliness and general cognitive status (B = -.05, p = .002). Perceived loneliness correlated negatively with general cognitive status only in participants with higher levels of depressed mood (B = -.16, p = .01). Together, these findings suggest that perceived loneliness combined with depressed mood is related to poorer general cognitive status in older adults. The implications of these findings are discussed.

Smoking increases risk for cognitive decline among community-dwelling older Mexican Americans

PubMed Central

Collins, Nicole; Sachs-Ericsson, Natalie; Preacher, Kristopher J.; Sheffield, Kristin M.; Markides, Kyriakos

2011-01-01

Objectives Few studies have investigated smoking and cognitive decline among older Mexican Americans. In the current study we explore the relationship between smoking status and cognitive changes over time in a large sample of community-dwelling older adults of Mexican descent. Design Latent growth curve analyses were used to examine the decreasing growth in the number of correct responses on a test of cognitive functioning with increasing age (7 years with 4 data collection points). Setting In-home interviews were obtained from participants residing in the Southwest United States. Participants Participants were community-dwelling older Mexican Americans. Measurements Cognitive functioning was assessed at each of the 4 data collection points with the Mini-Mental Status Examination. Participants’ self-reports of health functioning and smoking status were obtained at baseline. Results With the inclusion of health variables and other control variables, the effect of smoking status on cognitive functioning was significant such that the decrease in the number of correct responses over time was greater for smokers than for non-smokers. Conclusions Smoking increases risk for cognitive decline among community-dwelling older Mexican Americans. There are numerous health benefits in quitting smoking, even for older adults who have been smoking for many years. Further efforts to ensure that smoking cessation and prevention programs are targeted toward Hispanics are necessary. PMID:20104052

Alternating Motion Rate to Distinguish Elderly People With History of Pneumonia.

PubMed

Kera, Takeshi; Edahiro, Ayako; Hirano, Hirohiko; Kawai, Hisashi; Yoshida, Hideyo; Kojima, Motonaga; Fujiwara, Yoshinori; Ihara, Kazushige; Obuchi, Shuichi

2016-12-01

Under the hypothesis that elderly people in the community may have deficient oropharyngeal dysfunction, the purpose of this case-control study was to compare oral and physical characteristics in elderly people with and without a history of pneumonia and to identify factors distinguishing them. In 2014, we examined 1,311 elderly people who agreed to participate in a longitudinal and intervention study for the community-dwelling elderly. We looked at such physical characteristics as body composition, grip power, gait, and balance and at oropharyngeal characteristics, such as alternating motion rate (AMR) in speech and the repetitive saliva-swallowing test (RSST). The subjects were also asked about past history of pneumonia and other morbid conditions. From that information, we extracted 24 subjects reporting to have had pneumonia within the previous 5 y as well as 172 other subjects who matched the pneumonia subjects with respect to age, sex, and number of other morbidities to form 2 groups for comparisons. We also subjected the data to a logistic regression analysis, with having or not having pneumonia as the dependent variable, oral and physical characteristics as independent variables, and age and sex as covariates. No significant differences were seen in physical characteristics between the 2 groups. Among the oropharyngeal characteristics, AMR was significantly lower in the pneumonia subjects (P = .005, effect size = 0.20), whereas RSST exhibited no significant difference between the 2 groups. Logistic regression revealed AMR to be the only factor related to pneumonia (P = .002, odds ratio 0.169, 95% CI 0.056-0.508). In community-dwelling elderly people, association of pneumonia with skilled tongue control (AMR) rather than with swallowing (RSST) prompts a reexamination of what constitutes being at risk for pneumonia. Copyright © 2016 by Daedalus Enterprises.

Community Options for Elders.

ERIC Educational Resources Information Center

Poulsen, Joyce G.

This paper describes the Winnebago County (Wisconsin) Community Options Program, begun in January, 1982, which provides for a comprehensive assessment of all elderly persons within the target area who are at risk of becoming institutionalized. The paper focuses on the planning activities for the first year of the pilot program including community…

[Active and healthy living in old age--results from a representative survey of community-dwelling senior citizens in Hamburg].

PubMed

Dapp, Ulrike; Lorentz, Ch; Laub, S; Anders, J; von Renteln-Kruse, W; Minder, Ch; Dirksen-Fischer, M

2009-06-01

The majority of community-dwelling people 60 years and older are independent and live actively. However, there is little information about elderly persons' views on aging, health and health promotion. Therefore, an anonymous, written questionnaire survey was performed in a representative sample of inhabitants from a section of the city of Hamburg, 60 years and older; 5 year intervals, 14 subsamples according to 7 age groups of females and males. Questionnaires from 950 participants (29% response) could be evaluated: mean age 71.5 years, 58% women, 34% living alone, 5% with professional healthcare needs as indicated by status according to German nursing care insurance. Senior citizens' positive attitudes towards aging and health were predominant: 69% of respondents felt young, 85% worried about loss of autonomy in old age. The results provide evidence indicating potential for improving health-promoting lifestyles in parts of the older population by evaluating and strengthening older persons' competencies and by considering their concerns seriously. These results provide valuable information for future plans in the public-health sector in the city of Hamburg where particular health-promoting actions for elderly persons will be considered.

Factors that allow elderly individuals to stay at home with their families using the Japanese long-term care insurance system.

PubMed

Oyama, Yumiko; Tamiya, Nanako; Kashiwagi, Masayo; Sato, Mikiya; Ohwaki, Kazuhiro; Yano, Eiji

2013-07-01

This study examined the factors that allow elderly individuals to stay at home continuously by considering the roles of the family caregiver, the use of services and characteristics of the elderly individual. We analyzed 432 elderly individuals living at home with family. The outcome was that participants remained at home continuously over a 24-month period. The participants were stratified into two care-needs levels, and then multiple logistic regression analyses were carried out to examine relationships between staying at home and the Japanese version of the Zarit Burden Interview (J-ZBI), public Long-term Care Insurance (LTCI) service use, family caregivers' characteristics and elderly peoples' characteristics. Low scores on the J-ZBI were related to outcome in both care-needs subgroups (low care-needs subgroup: OR 2.11; 95% CI 1.31-3.43, high care-needs subgroup: OR 5.03; 95% CI 1.04-31.1). Regarding LTCI services, the use of home-visit nursing (HN) service was related to staying at home continuously in the high care-needs group (OR 37.39; 95% CI 3.31-879.1). Alleviation of caregiver' burden was essential for continuous stay at home of elderly people regardless of care-needs levels. Also, the HN service was founded as the relevant LTCI service factor for staying at home continuously. The HN service use might affect the outcome when we consider the causal relationship. Therefore, the policy for the promotion of HN service use will be important to achieve the ultimate goal of LTCI, which is to allow elderly people to live in their communities for as long as possible. © 2012 Japan Geriatrics Society.

The factors associated with a self-perceived hearing handicap in elderly people with hearing impairment--results from a community-based study.

PubMed

Chang, Hsin-Pin; Ho, Chin-Yu; Chou, Pesus

2009-10-01

Elderly persons with a physiologic hearing deficit (hearing impairment) are not necessarily socially or emotionally disturbed by the deficit in everyday life (hearing handicap). The self-perception of a hearing handicap in elderly people is a key element in seeking consultation for a hearing impairment or using hearing aids. Thus, it is important to determine the factors associated with the self-perception of a hearing handicap. The aims of the present study were to report the relation between a hearing impairment and the self-perception of a hearing handicap, and the factors associated with a self-perceived hearing handicap among a group of randomly recruited, community-dwelling elderly persons, aged 65 yr and older, in Taipei, Taiwan. A cross-sectional survey of community-dwelling elderly persons aged 65 yr and older (N = 1220) participating in an annual general purpose geriatric health examination in 2005 in Taipei. Pure-tone audiometry and a questionnaire including the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) were administered, after obtaining the subject's consent to participate in the study. Demographic information, lifestyle, self-report health status, and biochemical data were also collected. There was a moderate association (gamma(s) = 0.52) between hearing impairment and self-perceived handicap. Only 21.4% of the study subjects with moderate to profound hearing impairment (M4 >or=41 dB HL, N = 555) perceived themselves as hearing-handicapped (HHIE-S total score >or=10). Besides hearing level, marital status (widowed) and self-perceived general health (bad or neutral) were factors that are significantly associated with a self-perceived hearing handicap among elderly subjects with moderate to profound hearing impairment. For study subjects with moderate to profound hearing impairment (M4 >or=41 dB HL), 5.0% of those with HHIE-S <10 and 45.4% of those with HHIE-S >or=10 used or felt that they required hearing aids (chi2 test, p

Mail-Based Intervention for Sarcopenia Prevention Increased Anabolic Hormone and Skeletal Muscle Mass in Community-Dwelling Japanese Older Adults: The INE (Intervention by Nutrition and Exercise) Study.

PubMed

Yamada, Minoru; Nishiguchi, Shu; Fukutani, Naoto; Aoyama, Tomoki; Arai, Hidenori

2015-08-01

The aim of the Intervention by Nutrition and Exercise (INE) study was to investigate the effects of a mail-based intervention for sarcopenia prevention on muscle mass and anabolic hormones in community-dwelling older adults. A cluster-randomized controlled trial. This trial recruited community-dwelling adults aged 65 years and older in Japan. The 227 participants were cluster randomized into a walking and nutrition (W/N) group (n = 79), a walking (W) group (n = 71), and a control (C) group (n = 77). We analyzed the physical and biochemical measurements in this substudy. Six months of mail-based intervention (a pedometer-based walking program and nutritional supplementation). The skeletal muscle mass index (SMI) using the bioelectrical impedance data acquisition system, biochemical measurements, such as those of insulinlike growth factor (IGF-1), dehydroepiandrosterone sulfate (DHEA-S), and 25-hydroxy vitamin D (25[OH]D), as well as frailty, were assessed by the Cardiovascular Health Study criteria. Participants in the W/N and W groups had significantly greater improvements in SMI, IGF-1, and 25(OH)D (P < .05) than those in the C group. Participants in the W/N group had significantly greater improvements in DHEA-S (P < .05) than in the other groups. These effects were more pronounced in frail, older adults. These results suggest that the mail-based walking intervention of the remote monitoring type for sarcopenia prevention can increase anabolic hormone levels and SMI in community-dwelling older adults, particularly in those who are frail. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Decline in cognitive function and risk of elder self-neglect: finding from the Chicago Health Aging Project.

PubMed

Dong, XinQi; Simon, Melissa A; Wilson, Robert S; Mendes de Leon, Carlos F; Rajan, K Bharat; Evans, Denis A

2010-12-01

To examine the longitudinal association between decline in cognitive function and risk of elder self-neglect in a community-dwelling population. Prospective population-based study. Geographically defined community in Chicago. Community-dwelling subjects reported to the social services agency from 1993 to 2005 for self-neglect who also participated in the Chicago Health Aging Project (CHAP). Of the 5,519 participants in CHAP, 1,017 were reported to social services agency for suspected elder self-neglect from 1993 to 2005. Social services agency identified reported elder self-neglect. The primary predictor was decline in cognitive function assessed using the Mini-Mental State Examination (MMSE), the Symbol Digit Modalities Test (Executive Function), and immediate and delayed recall of the East Boston Memory Test (Episodic Memory). An index of global cognitive function scores was derived by averaging z-scores of all tests. Outcome of interest was elder self-neglect. Logistic and linear regression models were used to assess these longitudinal associations. After adjusting for potential confounding factors, decline in global cognitive function, MMSE score, and episodic memory were not independently associated with greater risk of reported and confirmed elder self-neglect. Decline in executive function was associated with greater risk of reported and confirmed elder self-neglect. Decline in global cognitive function was associated with greater risk of greater self-neglect severity (parameter estimate=0.76, standard error=0.31, P=.01). Decline in executive function was associated with risk of reported and confirmed elder self-neglect. Decline in global cognitive function was associated with risk of greater self-neglect severity. © 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.

Muscle quality, aerobic fitness and fat mass predict lower-extremity physical function in community-dwelling older adults.

PubMed

Misic, Mark M; Rosengren, Karl S; Woods, Jeffrey A; Evans, Ellen M

2007-01-01

Muscle mass, strength and fitness play a role in lower-extremity physical function (LEPF) in older adults; however, the relationships remain inadequately characterized. This study aimed to examine the relationships between leg mineral free lean mass (MFLM(LEG)), leg muscle quality (leg strength normalized for MFLM(LEG)), adiposity, aerobic fitness and LEPF in community-dwelling healthy elderly subjects. Fifty-five older adults (69.3 +/- 5.5 years, 36 females, 19 males) were assessed for leg strength using an isokinetic dynamometer, body composition by dual energy X-ray absorptiometry and aerobic fitness via a treadmill maximal oxygen consumption test. LEPF was assessed using computerized dynamic posturography and stair ascent/descent, a timed up-and-go task and a 7-meter walk with and without an obstacle. Muscle strength, muscle quality and aerobic fitness were similarly correlated with static LEPF tests (r range 0.27-0.40, p < 0.05); however, the strength of the independent predictors was not robust with explained variance ranging from 9 to 16%. Muscle quality was the strongest correlate of all dynamic LEPF tests (r range 0.54-0.65, p < 0.001). Using stepwise linear regression analysis, muscle quality was the strongest independent predictor of dynamic physical function explaining 29-42% of the variance (p < 0.001), whereas aerobic fitness or body fat mass explained 5-6% of the variance (p < 0.05) depending on performance measure. Muscle quality is the most important predictor, and aerobic fitness and fat mass are secondary predictors of LEPF in community-dwelling older adults. These findings support the importance of exercise, especially strength training, for optimal body composition, and maintenance of strength and physical function in older adults.

Neuroticism (not depressive symptoms) predicts memory complaints in some community-dwelling older adults.

PubMed

Merema, Matt R; Speelman, Craig P; Foster, Jonathan K; Kaczmarek, Elizabeth A

2013-08-01

To examine whether depressive symptoms are useful predictors of subjective memory complaints in community-dwelling older adults, beyond the predictive utility already provided by memory performance and characteristics of personality. Using hierarchical regression, we examined the relationship between depressive symptoms and subjective memory complaints, controlling for age, gender, education, memory performance, conscientiousness, and neuroticism. Community-dwelling older adults aged 66 to 90 years (N = 177) who responded to a newspaper advertisement for a memory study in Perth, Western Australia. The General Frequency of Forgetting scale (for memory complaints), Depression Anxiety Stress Scales (for depressive symptoms), NEO-Five Factor Inventory (for conscientiousness and neuroticism), and the Visual Reproduction and Logical Memory subtests from the Wechsler Memory Scale-4th Edition (for visual and verbal memory). The hierarchical regression analysis indicated that while depressive symptoms significantly predicted memory complaints after variance associated with age, gender, education, memory performance, and conscientiousness was partialled out, they accounted for almost none of the variance in complaints when neuroticism was partialled out. The well-established relationship between depression and memory complaints may exist in some community-dwelling older adult populations only on account of the manner in which both are associated with neuroticism. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Community-Level Social Capital and Psychological Distress among the Elderly in Japan: A Population-Based Study

PubMed Central

Kobayashi, Tomoko; Suzuki, Etsuji; Noguchi, Masayuki; Kawachi, Ichiro; Takao, Soshi

2015-01-01

Despite accumulating evidence, previous studies have not clearly separated the contribution of community-level social capital on mental health from that of individual-level social support. We examined the association between community-level social capital and psychological distress in a sample of older Japanese individuals, taking into account the effects of individual-level social capital and social support. We collected data via a cross-sectional survey among all residents aged ≥65 in three rural municipalities in Okayama Prefecture. We measured two components of social capital in the questionnaire: perceptions of trust and reciprocity in the community. Community-level social capital was obtained by aggregating individual responses and calculating the proportion of subjects reporting mistrust and lack of reciprocity. Psychological distress was assessed by the Kessler Psychological Distress scale. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) for psychological distress using two-level Poisson regression models (9,761 individuals nested within 35 communities). The prevalence of psychological distress was 39.8%. Low community-level social capital was associated with psychological distress, even after controlling for individual-level social support, age, sex, educational attainment, frequency of alcohol consumption, smoking status, body mass index, marital status, socioeconomic status, and number of cohabiters. The adjusted RRs per 10% increase of the proportion of mistrust and lack of reciprocity in the communities were 1.23 (95% CI: 1.01–1.51) and 1.12 (95% CI: 1.02–1.24), respectively. Lower levels of community-level social capital are associated with psychological distress among the Japanese elderly population, even after adjusting for individual-level perceptions of social capital and social support. PMID:26550997

Activity Monitors Step Count Accuracy in Community-Dwelling Older Adults

PubMed Central

2015-01-01

Objective: To examine the step count accuracy of activity monitors in community-dwelling older adults. Method: Twenty-nine participants aged 67.70 ± 6.07 participated. Three pedometers and the Actical accelerometer step count functions were compared with actual steps taken during a 200-m walk around an indoor track and during treadmill walking at three different speeds. Results: There was no statistical difference between activity monitors step counts and actual steps during self-selected pace walking. During treadmill walking at 0.67 m∙s−1, all activity monitors step counts were significantly different from actual steps. During treadmill walking at 0.894m∙s−1, the Omron HJ-112 pedometer step counts were not significantly different from actual steps. During treadmill walking at 1.12 m∙s−1, the Yamax SW-200 pedometer steps were significantly different from actual steps. Discussion: Activity monitor selection should be deliberate when examining the walking behaviors of community-dwelling older adults, especially for those who walk at a slower pace. PMID:28138464

Gender-specific hip fracture risk in community-dwelling and institutionalized seniors age 65 years and older.

PubMed

Finsterwald, M; Sidelnikov, E; Orav, E J; Dawson-Hughes, B; Theiler, R; Egli, A; Platz, A; Simmen, H P; Meier, C; Grob, D; Beck, S; Stähelin, H B; Bischoff-Ferrari, H A

2014-01-01

In this study of acute hip fracture patients, we show that hip fracture rates differ by gender between community-dwelling seniors and seniors residing in nursing homes. While women have a significantly higher rate of hip fracture among the community-dwelling seniors, men have a significantly higher rate among nursing home residents. Differences in gender-specific hip fracture risk between community-dwelling and institutionalized seniors have not been well established, and seasonality of hip fracture risk has been controversial. We analyzed detailed data from 1,084 hip fracture patients age 65 years and older admitted to one large hospital center in Zurich, Switzerland. In a sensitivity analysis, we extend to de-personalized data from 1,265 hip fracture patients from the other two large hospital centers in Zurich within the same time frame (total n = 2,349). The denominators were person-times accumulated by the Zurich population in the corresponding age/gender/type of dwelling stratum in each calendar season for the period of the study. In the primary analysis of 1,084 hip fracture patients (mean age 85.1 years; 78% women): Among community-dwelling seniors, the risk of hip fracture was twofold higher among women compared with men (RR = 2.16; 95% CI, 1.74-2.69) independent of age, season, number of comorbidities, and cognitive function; among institutionalized seniors, the risk of hip fracture was 26% lower among women compared with men (RR = 0.77; 95% CI: 0.63-0.95) adjusting for the same confounders. In the sensitivity analysis of 2,349 hip fracture patients (mean age 85.0 years, 76% women), this pattern remained largely unchanged. There is no seasonal swing in hip fracture incidence. We confirm for seniors living in the community that women have a higher risk of hip fracture than men. However, among institutionalized seniors, men are at higher risk for hip fracture.

Elder Abuse in Japan

ERIC Educational Resources Information Center

Arai, Mizuho

2006-01-01

Perceptions of elder abuse were examined in Japanese women (n =100) and men (n =46). Japanese women and men both emphasized physical aggression, followed by neglect and blaming, when giving examples of extremely abusive behavior. Physical aggression was also the most frequently mentioned type of moderate elder abuse, followed by neglect, economic…

Effectiveness of seasonal influenza vaccination in community-dwelling elderly people: an individual participant data meta-analysis of test-negative design case-control studies.

PubMed

Darvishian, Maryam; van den Heuvel, Edwin R; Bissielo, Ange; Castilla, Jesus; Cohen, Cheryl; Englund, Helene; Gefenaite, Giedre; Huang, Wan-Ting; la Bastide-van Gemert, Sacha; Martinez-Baz, Iván; McAnerney, Johanna M; Ntshoe, Genevie M; Suzuki, Motoi; Turner, Nikki; Hak, Eelko

2017-03-01

Several aggregate data meta-analyses have provided estimates of the effectiveness of influenza vaccination in community-dwelling elderly people. However, these studies ignored the effects of patient-level confounders such as sex, age, and chronic diseases that could bias effectiveness estimates. We aimed to assess the confounder-adjusted effectiveness of influenza vaccines on laboratory-confirmed influenza among elderly people by conducting a global individual participant data meta-analysis. In this individual participant data meta-analysis, we considered studies included in a previously conducted aggregate data meta-analysis that included test-negative design case-control studies published up to July 13, 2014. We contacted all authors of the included studies on Dec 1, 2014, to request individual participant data. Patients were excluded if their unique identifier was missing, their vaccination status was unknown, their outcome status was unknown, or they had had suspected influenza infection more than once in the same influenza season. Cases were patients with influenza-like illness symptoms who tested positive for at least one of A H1N1, A H1N1 pdm09, A H3N2, or B viruses; controls were patients with influenza-like illness symptoms who tested negative for these virus types or subtypes. Influenza vaccine effectiveness against overall and subtype-specific laboratory-confirmed influenza were the primary and secondary outcomes. We used a generalised linear mixed model to calculate adjusted vaccine effectiveness according to vaccine match to the circulating strains of influenza virus and intensity of the virus activity (epidemic or non-epidemic). Vaccine effectiveness was defined as the relative reduction in risk of laboratory-confirmed influenza in vaccinated patients compared with unvaccinated patients. We did subgroup analyses to estimate vaccine effectiveness according to hemisphere, age category, and health status. We received 23 of the 53 datasets included in the

Assertive community treatment for elderly people with severe mental illness.

PubMed

Stobbe, Jolanda; Mulder, Niels C L; Roosenschoon, Bert-Jan; Depla, Marja; Kroon, Hans

2010-10-19

Adults aged 65 and older with severe mental illnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mental illnesses patients, no special form of it is available for the elderly. A special assertive community treatment team for the elderly is developed in Rotterdam, the Netherlands and tested for its effectiveness. We will use a randomized controlled trial design to compare the effects of assertive community treatment for the elderly with those of care as usual. Primary outcome measures will be the number of dropouts, the number of patients engaged in care and patient's psychiatric symptoms, somatic symptoms, and social functioning. Secondary outcome measures are the number of unmet needs, the subjective quality of life and patients' satisfaction. Other secondary outcomes include the number of crisis contacts, rates of voluntary and involuntary admission, and length of stay. Inclusion criteria are aged 65 plus, the presence of a mental disorder, a lack of motivation for treatment and at least four suspected problems with functioning (addiction, somatic problems, daily living activities, housing etc.). If patients meet the inclusion criteria, they will be randomly allocated to either assertive community treatment for the elderly or care as usual. Trained assessors will use mainly observational instruments at the following time points: at baseline, after 9 and 18 months. This study will help establish whether assertive community treatment for the elderly produces better results than care as usual in elderly people with severe mental illnesses who are difficult to engage. When assertive community treatment for the elderly proves valuable in these respects, it can be tested and implemented more widely, and mechanisms for its effects investigated. The Netherlands National Trial Register NTR1620.

Interventions to improve social determinants of health among elderly ethnic minority groups: a review.

PubMed

Pool, Michelle S; Agyemang, Charles O; Smalbrugge, Martin

2017-12-01

Like the European general population, ethnic minorities are aging. In this group, important social determinants of health (social participation, social isolation and loneliness) that lead to negative health outcomes frequently occur. Interventions targeting these determinants may decrease negative health outcomes. The goal of this article was to identify effective interventions that improve social participation, and minimise social isolation and loneliness in community dwelling elderly ethnic minorities. An electronic database (PubMed) was systematically searched using an extensive search strategy, for intervention studies in English, French, Dutch of German, without time limit. Additional articles were found using references. Articles were included if they studied an intervention aimed to improve social participation or minimise social isolation or loneliness and were focusing on community dwelling elderly ethnic minorities. Data regarding studies characteristics and results were extracted. Six studies (three randomized controlled trials, three non-controlled intervention studies) were included in the review. All studies were group-based interventions and had a theoretical basis. Five out of six studies showed improvement on a social participation, -isolation or loneliness outcome. Type of intervention included volunteering-, educational- and physical activities. In three studies active participation of the participant was required, these interventions were not more effective than other interventions. Some interventions improved the included social determinants of health in community dwelling elderly ethnic minorities. Investment in further development and implementation of these interventions may help to improve social determinants of health in these populations. It is necessary to evaluate these interventions in the European setting. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Development of the Japanese DOLOPLUS-2: a pain assessment scale for the elderly with Alzheimer's disease.

PubMed

Ando, Chiaki; Hishinuma, Michiko

2010-09-01

Pain assessment in non-communicative patients relies primarily on observation scales. The DOLOPLUS-2 is a behavioral pain assessment scale for the elderly with impaired verbal communication. It rates five somatic items, two psychomotor items, and three psychosocial items as indicators of pain. The aims of the present study were to develop a Japanese version of the DOLOPLUS-2 and to apply it to elderly patients with Alzheimer's disease (AD). The translated instrument was evaluated with reference to Japanese patients with AD experiencing pain during post-surgery rehabilitation for hip fractures and who were unable to use any self-reported pain measures. After translation and back-translation, 21 registered nurses tested 'Version 1' of the pain assessment scale on three patients. The ratings of the nurses and researcher were compared and the number of matching scores determined. Semistructured interviews were conducted with the nurses and patient case studies were recorded. The results of the interviews provided the basis for the development of 'Version 2' of the scale, which was then tested with six patients and 31 nurses using the same procedures as for the testing of Version 1. The intraclass correlation coefficient for inter-rater reliability for the Version 2 administrators was 0.90 (P < 0.001), with a 95% confidence interval of 0.88-0.92; the degree of agreement by items (0.67-0.90) was excellent. Nurses' comments for Version 1 revealed that it was 'difficult to use' and that 'some Japanese expressions and explanations needed improvement'. In contrast, the nurses' comments on Version 2 indicated that there were no problems. Analysis of patient case studies in Version 2 indicated that pain scores were high only when the patients clearly would have had pain, such as when they started with full weight bearing. On the basis of these results, we developed a final version of the Japanese DOLOPLUS-2. The findings of the present study suggest that Version 2 of the

Antidepressant Use and Recurrent Falls in Community-Dwelling Older Adults: Findings From the Health ABC Study.

PubMed

Marcum, Zachary A; Perera, Subashan; Thorpe, Joshua M; Switzer, Galen E; Castle, Nicholas G; Strotmeyer, Elsa S; Simonsick, Eleanor M; Ayonayon, Hilsa N; Phillips, Caroline L; Rubin, Susan; Zucker-Levin, Audrey R; Bauer, Douglas C; Shorr, Ronald I; Kang, Yihuang; Gray, Shelly L; Hanlon, Joseph T

2016-07-01

Few studies have compared the risk of recurrent falls across various antidepressant agents-using detailed dosage and duration data-among community-dwelling older adults, including those who have a history of a fall/fracture. To examine the association of antidepressant use with recurrent falls, including among those with a history of falls/fractures, in community-dwelling elders. This was a longitudinal analysis of 2948 participants with data collected via interview at year 1 from the Health, Aging and Body Composition study and followed through year 7 (1997-2004). Any antidepressant medication use was self-reported at years 1, 2, 3, 5, and 6 and further categorized as (1) selective serotonin reuptake inhibitors (SSRIs), (2) tricyclic antidepressants, and (3) others. Dosage and duration were examined. The outcome was recurrent falls (≥2) in the ensuing 12-month period following each medication data collection. Using multivariable generalized estimating equations models, we observed a 48% greater likelihood of recurrent falls in antidepressant users compared with nonusers (adjusted odds ratio [AOR] = 1.48; 95% CI = 1.12-1.96). Increased likelihood was also found among those taking SSRIs (AOR = 1.62; 95% CI = 1.15-2.28), with short duration of use (AOR = 1.47; 95% CI = 1.04-2.00), and taking moderate dosages (AOR = 1.59; 95% CI = 1.15-2.18), all compared with no antidepressant use. Stratified analysis revealed an increased likelihood among users with a baseline history of falls/fractures compared with nonusers (AOR = 1.83; 95% CI = 1.28-2.63). Antidepressant use overall, SSRI use, short duration of use, and moderate dosage were associated with recurrent falls. Those with a history of falls/fractures also had an increased likelihood of recurrent falls. © The Author(s) 2016.

Dynamical Properties of Postural Control in Obese Community-Dwelling Older Adults †.

PubMed

Frames, Christopher W; Soangra, Rahul; Lockhart, Thurmon E; Lach, John; Ha, Dong Sam; Roberto, Karen A; Lieberman, Abraham

2018-05-24

Postural control is a key aspect in preventing falls. The aim of this study was to determine if obesity affected balance in community-dwelling older adults and serve as an indicator of fall risk. The participants were randomly assigned to receive a comprehensive geriatric assessment followed by a longitudinal assessment of their fall history. The standing postural balance was measured for 98 participants with a Body Mass Index (BMI) ranging from 18 to 63 kg/m², using a force plate and an inertial measurement unit affixed at the sternum. Participants' fall history was recorded over 2 years and participants with at least one fall in the prior year were classified as fallers. The results suggest that body weight/BMI is an additional risk factor for falling in elderly persons and may be an important marker for fall risk. The linear variables of postural analysis suggest that the obese fallers have significantly higher sway area and sway ranges, along with higher root mean square and standard deviation of time series. Additionally, it was found that obese fallers have lower complexity of anterior-posterior center of pressure time series. Future studies should examine more closely the combined effect of aging and obesity on dynamic balance.

The Effects of Aroma Foot Massage on Blood Pressure and Anxiety in Japanese Community-Dwelling Men and Women: A Crossover Randomized Controlled Trial.