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Sample records for 80-year-old japanese community-dwelling

  1. Prevalence of sarcopenia in community-dwelling Japanese older adults.

    PubMed

    Yamada, Minoru; Nishiguchi, Shu; Fukutani, Naoto; Tanigawa, Takanori; Yukutake, Taiki; Kayama, Hiroki; Aoyama, Tomoki; Arai, Hidenori

    2013-12-01

    Sarcopenia, the age-dependent loss of skeletal muscle mass, is highly prevalent among older adults in many countries; however, the prevalence of sarcopenia in healthy Japanese community-dwelling older adults is not well characterized. The aim of this study was to evaluate the prevalence of sarcopenia and to examine the association of sarcopenia with falls and fear of falling in community-dwelling Japanese older adults. This is a cross-sectional study. Healthy men (568) and women (1314) aged 65 to 89 years participated in this research. For all participants, 3 measurements were taken: skeletal muscle mass measurement using bioelectrical impedance, 10 m at a usual walking speed, and handgrip strength. Sarcopenia was defined as the presence of both poor muscle function (low physical performance or low muscle strength) and low muscle mass. The prevalence of sarcopenia, determined using the European Working Group on Sarcopenia in Older People-suggested algorithm, in men and women aged 65 to 89 years was 21.8% and 22.1%, respectively. The prevalence of sarcopenia increased age-dependently, especially in those older than 75 years in both genders. In the young old, the prevalence of sarcopenia was higher in women than in men; however, in those older than 85 years, the prevalence of sarcopenia was lower in women than in men (P < .05). In addition, fall incidents and fear of falling were more prevalent in sarcopenic older adults than in nonsarcopenic older adults (P < .05). These results suggest that sarcopenia is highly prevalent in community-dwelling Japanese older adults and is related to falls and fear of falling. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

  2. Prevalence of Inadequate Nutrient Intake in Japanese Community-Dwelling Older Adults Who Live Alone.

    PubMed

    Nozue, Miho; Ishikawa, Midori; Takemi, Yukari; Kusama, Kaoru; Fukuda, Yoshiharu; Yokoyama, Tetsuji; Nakaya, Tomoki; Nishi, Nobuo; Yoshiba, Kaori; Murayama, Nobuko

    2016-01-01

    Dietary assessment of community-dwelling Japanese older adults who live alone using Dietary Reference Intakes (DRIs) is limited. The present study aimed to estimate the prevalence of inadequate nutrient intake among Japanese community-dwelling older adults by sex and young-old and old-old population groups to identify the most vulnerable groups that need support. A cross-sectional survey was conducted from October 2012 to October 2013 with community-dwelling adults aged 65 y or older who lived alone. Participants were drawn from six cities in four Japanese prefectures. We used two days of dietary survey data to estimate participants' usual intake. The proportion of inadequate intake was assessed using the Estimated Average Requirement (EAR) cut-point method, Tolerable Upper Intake Level, and the tentative dietary goal for preventing life-style related diseases (DG) based on DRIs for Japanese, 2015. Data for 494 participants (162 male, 332 female) over 988 d were examined to assess nutrient intake. We calculated the proportion of inadequate intake between males and females and between young-old and old-old population groups (65-74 y and ≥75 y) using chi-square or Fisher's exact tests. For six nutrients, the estimated proportion of participants with a usual intake below EAR was higher in males than females. In addition, a higher estimated proportion of female participants was within the DG range for the percentage of energy from protein, fat, and carbohydrates, and had a usual intake of two nutrients above DG than males. Our findings showed that among Japanese older adults, males were more vulnerable in terms of inadequate nutrient intake compared with females.

  3. [Individual reminiscence therapy improves self-esteem for Japanese community-dwelling older adults].

    PubMed

    Nomura, Nobutake

    2009-04-01

    This study examined the effects of individual reminiscence therapy in Japanese community-dwelling older adults without dementia. Participants (twenty three men and fifty seven women, mean age = 82.6 yrs) were recruited from a community day-care center. They were randomly assigned to a reminiscence therapy group or a control group. Participants in the reminiscence group completed five or six weekly sessions (30-60 minutes) of individual reminiscence therapy. Participant's depression, life satisfaction, and self-esteem were assessed before and after the sessions. The results showed that the reminiscence group had a significant improvement in self-esteem. Thus individual reminiscence therapy can be a tool to maintain or improve self-esteem for Japanese older adults without dementia.

  4. Arterial stiffness is associated with low skeletal muscle mass in Japanese community-dwelling older adults.

    PubMed

    Sampaio, Ricardo Aurélio Carvalho; Sewo Sampaio, Priscila Yukari; Yamada, Minoru; Yukutake, Taiki; Uchida, Marco Carlos; Tsuboyama, Tadao; Arai, Hidenori

    2014-02-01

    To examine whether arterial stiffness, measured by the cardio-ankle vascular index (CAVI), is associated with skeletal muscle mass index (SMI) in Japanese community-dwelling older adults. Data were collected from 175 participants through questionnaires and specific tests; the data included demographic, lifestyle and health characteristics, body mass index (BMI), and body composition features determined by the bioelectrical impedance analysis, ankle-brachial index, the Mini-Nutritional Assessment, handgrip strength (GS), walking speed and shuttle walking tests (SW), and arterial stiffness determined by the CAVI. Absolute SMI was dichotomized according to the first quintile, which determined low (n = 35) and normal (n = 140) SMI. Participants with low SMI were older (P = 0.01), had more polypharmacy (P = 0.01), a lower BMI (P < 0.001), and fat mass index (P = 0.02), and had a greater risk of malnutrition (P < 0.001) than the normal group. Additionally, they showed poorer physical performance (GS and SW, P = 0.007 and 0.01, respectively) than the normal group. Furthermore, CAVI was associated with SMI even after adjustments (OR 1.82, 95% CI 1.14-2.90, P = 0.01). Our data showed that arterial stiffness is associated with low SMI in community-dwelling older adults, even when adjusting by multiple factors, showing a close interaction of vascular aging and muscle mass decline. © 2014 Japan Geriatrics Society.

  5. 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

  6. Correlation between dental and nutritional status in community-dwelling elderly Japanese.

    PubMed

    Yoshida, Mitsuyoshi; Kikutani, Takeshi; Yoshikawa, Mineka; Tsuga, Kazuhiro; Kimura, Misaka; Akagawa, Yasumasa

    2011-07-01

    The purpose of this study was to clarify the correlation between dental and nutritional status among community-dwelling elderly Japanese people. The subjects were 182 elderly individuals, aged 65-85 years, who voluntarily participated in a health seminar at Kyoto Prefectural University of Medicine. These subjects were divided into two groups according to the occlusion. The subjects in the retained contact group were those who had retained molar occlusion with natural teeth. The lost contact group were those who retained molar occlusion with removable partial dentures. Anthropometric variables such as body mass index (BMI) were collected and dietary intake was assessed using a brief self-administered diet history questionnaire (BDHQ). No statistical difference in BMI or intake of macronutrients was found between these two occlusal groups. The lost contact group reported significantly lower consumption of vegetables and higher consumption of confectionaries (foods rich in sugar) than did the retained contact group (P < 0.05), and therefore had significantly lower intake of vitamin C and dietary fiber (P < 0.05). It can be concluded that natural tooth contact loss in the posterior region affect the intake of vitamins and dietary fiber. . © 2011 Japan Geriatrics Society.

  7. Tri-Axial Accelerometer-Determined Daily Physical Activity and Sedentary Behavior of Suburban Community-Dwelling Older Japanese Adults.

    PubMed

    Chen, Tao; Narazaki, Kenji; Honda, Takanori; Chen, Sanmei; Haeuchi, Yuki; Nofuji, Yu Y; Matsuo, Eri; Kumagai, Shuzo

    2015-09-01

    Knowledge regarding accelerometer-derived physical activity (PA) and sedentary behavior (SED) levels is scarce for Japanese older adults. The aims of this study were therefore to 1) describe levels of PA and SED in Japanese community-dwelling older adults, using tri-axial accelerometer; 2) examine the variation of PA and SED with respect to sex, age, and body mass index (BMI). Participants of this study were from the baseline survey of the Sasaguri Genkimon Study, who were 65 years or older and not certified as those requiring long-term care. PA was assessed objectively for seven consecutive days using tri-axial accelerometer. A total of 1,739 participants (median age: 72 years, men: 38.0%) with valid PA data were included. Overall, participants in the present study spent 54.5% of their waking time being sedentary and 45.5% being active, of which 5.4% was moderate-to-vigorous physical activity (MVPA). Women accumulated more minutes of light physical activity (LPA) and MVPA compared with men. In contrast, men spent more time being sedentary. Mean steps per day did not differ between sexes. Furthermore, participants with higher BMI (BMI ≥25) had lower PA levels, and longer SED compared with those with lower BMI (BMI <). PA levels were lower and SED was longer with age. The present study is the first to demonstrate that the levels of PA and SED differed by sex, age, and BMI in Japanese community-dwelling older adults. In particular, women were more active compared with men, providing unique insight into the current level of PA in older adults. Data presented in the study will enable further investigation of additional determinants of PA and SED in order to develop effective population-based intervention strategies to promote PA and reduce prolonged SED in the Japanese population and possibly other rapidly aging societies. Key pointsAccelerometer, that is capable to assess PA more precisely in large scale epidemiological studies, provides opportunity for improving

  8. Dietary Modification Trial in Community-Dwelling Japanese Elderly: A Pilot Study

    PubMed Central

    Momoki, Chika; Tsuji, Taeko; Shikata, Yukina; Urade, Hana; Morimoto, Hideki; Nakajima, Shinya; Habu, Daiki

    2017-01-01

    Background This study examined the effects of 6-month nutrition education programs for community-dwelling elderly. Methods This study enrolled 50 community-dwelling elderly who regularly visit outpatient clinics. The programs had three goals: salt reduction, increase in dietary fiber, and adequate protein intake. Since it would be difficult for elderly to achieve all goals concurrently, a single goal was chosen by participants themselves. Anthropometric measurements, blood sampling, and assessment of dietary intake were performed at baseline, 3 months, and 6 months. Results The nutrition education program for salt reduction was well accepted by the participants and the amount of daily salt intake showed median value of 9.6 g at baseline, 8.0 g at 3 months and 8.1 g at 6 months (P = 0.005). The amount of dietary fiber intake only slightly increased after taking the nutrition program (median value of 13.4 g at baseline, 15.3 g at 3 months and 15.5 g at 6 months; P = 0.695), because of difficulties in introducing new food options to the diet. After taking the adequate protein intake program, participants showed small decreases in protein (a modification from 1.24 g/kg IBW to 1.20 g/kg IBW) and salt intake (8.2 to 7.3 g) at 3 months, but the effects were not sustained at 6 months. Conclusion This nutrition education program focusing on a single nutrient may serve as a strategy to successfully reduce salt intake and improve systolic blood pressure control in community-dwelling elderly individuals who regularly visit outpatient clinics. In our view, dietary and lifestyle habits should be taken into account as much as possible in nutrition education for elderly individuals. PMID:28611865

  9. 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.

  10. Alcohol drinking status is associated with serum high molecular weight adiponectin in community-dwelling Japanese men.

    PubMed

    Kawamoto, Ryuichi; Tabara, Yasuharu; Kohara, Katsuhiko; Miki, Tetsuro; Ohtsuka, Nobuyuki; Kusunoki, Tomo; Abe, Masanori

    2010-09-30

    Serum high molecular weight (HMW) adiponectin improves insulin sensitivity, and a decreased level of serum HMW adiponectin has been reported as a risk factor for the development of diabetes and coronary heart disease. This association may be further confounded by the alcohol drinking status, which is involved in the development of liver dysfunction. The aim of this study was to determine whether the alcohol drinking status is associated with serum HMW adiponectin levels in community-dwelling Japanese men. A cross-sectional study was carried out in 2002. Study participants without a clinical history of diabetes (747 men aged 60 ± 14 (mean ± standard deviation) (range, 20-89) years) were randomly recruited from a single community at the time of their annual health examination. They were classified into never drinkers, light drinkers (< 1 unit/day), moderate drinkers (1-1.9 units/day), and heavy drinkers (≥ 2 units/day). We examined the effects of alcohol consumption on serum HMW adiponectin. Overall, mean serum HMW adiponectin levels were significantly lower in the group with higher alcohol consumption, and there were inter-group differences in the alcohol drinking status. Moreover, age-adjusted mean serum HMW adiponectin levels were significantly lower in the group with higher alcohol consumption. Multiple linear regression analysis showed that the alcohol drinking status was significantly and independently associated with serum adiponectin as well as age, smoking status, TG, HDL-C, LDL-C, serum ALT, and HOMA-IR. Multivariate-adjusted mean serum HMW adiponectin levels were also significantly lower in the group with higher alcohol consumption. The alcohol drinking status is negatively associated with serum HMW adiponectin levels in Japanese community-dwelling men.

  11. Antihypertensive overtreatment in people 80 years old and older.

    PubMed

    Baena Díez, José Miguel; López Maldonado, Nerea; Navarro Guiu, Elena; Alcayde Claveria, Daniel; García Lareo, Manel; Pérez Orcero, Almudena

    2017-08-31

    To study the proportion of patients older than 80 years old with hypertension and pharmacological overtreatment. Cross-sectional simulation study, including 281 patients older than 80 years old of primary prevention, randomly selected, with good control of hypertension (systolic blood pressure<150mmHg, diastolic blood pressure<90mmHg), treated with a maximum of 3 medications. Overtreatment was considered if at least one medication could be removed and good control persisted, calculating how the blood pressure would raise with Law's meta-analysis, which estimates blood pressure reductions by pre-treatment levels, number and dose of medications. The average age was 85.3 years (64.8% women). A percentage of 33.6 were taking one medication, 46.3% 2 and 22.1% 3, with the most prescribed being thiazides (69.4%), ACE inhibitors (51.3%), ARBs (23.4%), calcium antagonists (21%) and beta blockers (19.6%). Overtreatment was 90.7%, with 2 medications being able to be removed in 63.1% of cases and 3 in 43.1%. Polypharmacy (OR 2.47; 95% CI 1.07-5.69; P=.033) was associated with a greater likely removal of at least one medication. The proportion of patients with overtreatment is high. Changing good control criteria could contribute to a reasoned deprescription. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  12. 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.

  13. Microsurgical reconstruction in patients greater than 80 years old.

    PubMed

    Heidekrueger, Paul I; Heine-Geldern, Albrecht; Ninkovic, Milomir; Herter, Frank; Schmauss, Daniel; Aung, Thiha; Broer, P Niclas

    2016-11-29

    Demographic change implies that the human population is getting older and the elderly are living longer. Consequently, achieving good functional and aesthetic outcomes in microvascular procedures, especially in very old patients with higher incidence of atherosclerosis and vessel calcifications, constitutes a microsurgical challenge. This study evaluates the feasibility of microsurgical procedures in a very old patient cohort. Between 2009 and 2015, 754 patients underwent 838 free flap reconstructions. The patients were divided into two groups according to age in "middle-aged" (<80 years old; n = 711) or "very old" (≥80 years old; n = 43). The series was retrospectively analyzed regarding potential influence of medical comorbidities, surgical and medical complications and outcomes. Between the groups, there was a significant difference regarding comorbidities with a higher prevalence of hypertension (P < 0.0001) and peripheral artery disease (P < 0.0001) in the very old group. However, there was no significant difference regarding the rate of surgical or medical complications, flap failure (middle aged group 43/791 flaps (5.44%) versus very old group 4/47 flaps (8.51%); P = 0.328), and revision rate (117/791 flaps (14.79%) versus 6/47 flaps (12.77%); P = 0.834) between the patient groups during our 3-months follow-up period. Our findings suggest that despite higher rates of patient comorbidities, successful free tissue transfer can also be achieved in a very old population with acceptable risk for complications. © 2016 Wiley Periodicals, Inc.

  14. Hemoglobin is associated with serum high molecular weight adiponectin in Japanese community-dwelling persons.

    PubMed

    Kawamoto, Ryuichi; Tabara, Yasuharu; Kohara, Katsuhiko; Miki, Tetsuro; Kusunoki, Tomo; Takayama, Shuzo; Abe, Masanori

    2011-01-01

    Serum high molecular weight (HMW) adiponectin improves insulin sensitivity, and a decreased level of serum HMW adiponectin has been reported as a risk factor for the development of diabetes and coronary heart disease. This association may be further confounded by the hemoglobin status, which is involved in the development of atherosclerosis. A cross-sectional study was carried out in 2002. Study participants, consisting of 897 men aged 61±14 (mean±standard deviation) years and 1,148 women aged 63±12 years, were randomly recruited from a single community at the time of their annual health examination. Serum HMW adiponectin levels were lowered dose-dependently with an increased hemoglobin level. Stepwise multiple linear regression analyses for serum HMW adiponectin revealed that the hemoglobin status was independently and significantly associated with serum HMW adiponectin levels as well as sex, age, body mass index (BMI), alcohol consumption, total cholesterol, triglycerides, high density lipoprotein cholesterol, antilipidemic medication, uric acid, serum gamma glutamyltransferase, and insulin resistance. Inclusion of hemoglobin levels in the model further increased the coefficient of determination. In stratified analysis, mean serum HMW adiponectin levels were significantly and similarly decreased as hemoglobin levels increased in men, ages ≥ 65 years, BMI < 23.0 kg/m(2), alcohol drinkers, and lower insulin resistance, and there were significant interactions between the two groups for BMI, alcohol consumption and insulin resistance. Hemoglobin status is inversely associated with serum HMW adiponectin levels in community-dwelling persons, especially those aged ≥ 65 years, BMI < 23.0 kg/m(2), alcohol drinkers, and lower insulin resistance groups.

  15. [Homebound status and life space among Japanese community-dwelling elderly in an urban area].

    PubMed

    Murayama, Hiroshi; Shibui, Yu; Kawashima, Takako; Kano, Noriko; Toratani, Akiko; Tachibana, Reiko; Shibuta, Keiko; Fukuda, Yoshiharu; Murashima, Sachiyo

    2011-10-01

    To examine the relationship between homebound status and physical, mental, social and life space factors among community-dwelling elderly in an urban area. A cross-sectional survey was conducted using a mail-in self-administered questionnaire between July and September 2009. The target population comprised 149,991 community residents, aged 65 years and over, living in Setagaya Ward, Tokyo, as of April 2009. "Homebound" was defined as going out (leaving the home) only once a week or less. The respondents were further identified as "type 1" or "type 2" homebound; type 1 included those with a low frequency of outings and low mobility level, and type 2 included those with a low frequency of outings despite having a high mobility level. Questionnaire items encompassed frequency of outings and demographic data, as well as physical, mental, social and life space factors. A total of 103,684 questionnaires were included in the analysis (valid response rate: 69.1%). Among the participants, 3.7% were found to be type 1 homebound and 4.5% were type 2. The older the age group, the higher was the proportion of both types of homebound. Physical and social factors were associated with type 1 homebound, and physical, mental and social factors with type 2. Moreover, regarding the life space factor, poor physical accessibility of the home was associated with type 2 homebound, and less space utilization in daily life was associated with both types. It is important for homebound reduction among the elderly to address the physical, mental and social factors that affect homebound status. In addition, assessing the current home environment and expanding the daily living space could also be strategies to reduce homebound prevalence among the elderly. Collaboration with the housing and public transportation sectors is needed to plan a comprehensive homebound reduction strategy.

  16. Unexplained weight loss in an 80-year-old woman.

    PubMed

    Taylor, Imogen Aleksandra; Gill, Isaac; Harripaul, Azad

    2015-01-23

    An 80-year-old woman presented with long-standing history of weight loss and malnutrition, which had caused her to become reliant on the use of a wheelchair. Her symptoms were initially attributed to her medical comorbidities, however, during admission it became apparent that she had been suffering from depression and had gone on to develop an eating disorder. Eating disorders are most common in young adults but can affect all age groups, including the elderly population. The diagnosis is rarely considered in such patients and easily overlooked, especially when in the presence of chronic conditions and cognitive decline. A pre-existing psychiatric issue, most often depression, may also be present in this age group. There are no current treatment methods targeting patients in this population, who may not respond as effectively to the available strategies directed at young adults. It is important to always consider an eating disorder as a contributor or direct cause of unexplained weight loss in elderly patients.

  17. Survey of electric bidet toilet use among community dwelling Japanese people and correlates for an itch on the anus.

    PubMed

    Tsunoda, Akira; Takahashi, Tomoko; Arika, Kaori; Kubo, Sachiyo; Tokita, Takeshi; Kameda, Shogo

    2016-11-01

    We conducted a survey to investigate the use of bidet toilets among community dwelling Japanese people and explored the correlates for an itch on the anus. A questionnaire-based survey was conducted among a convenience sample of individuals, who were derived from outpatients and employees of Kameda Medical Center, and students and employees of two technical colleges. A total of 4,963 respondents were evaluated in this study, 55 % of whom used bidet toilets either before or after defecation, and at least 30 % of bidet users washed the anus before defecation, partly to aid defecation. Men rather than women, and older people (aged ≥50 years) rather than younger people used bidets more actively. Logistic regression analysis showed that the correlates for an itch on the anus included male sex, younger age, washing the anus before defecation, warmer water for washing the anus after defecation, and the frequency of fecal leakage. Nearly, one-third of bidet toilet users washed the anus before defecation. An itch on the anus may be associated with the active use of bidets.

  18. Plasma TNF-α Is Associated with Inflammation and Nutrition Status in Community-Dwelling Japanese Elderly.

    PubMed

    Oe, Yukiko; Mochizuki, Kazuki; Miyauchi, Rie; Misaki, Yasumi; Kasezawa, Nobuhiko; Tohyama, Kazushige; Goda, Toshinao

    2015-01-01

    Inflammation has been suggested to play an important role in age-related chronic diseases and disability, and it is associated with nutritional status including obesity and malnutrition. While numerous studies have examined the validity of inflammatory markers in the population studies in Caucasian elderly people, very little information is available for the factors affecting inflammatory markers in Asian elderly people. Among inflammatory markers frequently used for the studies of aging, tumor necrosis factor α (TNF-α) is produced mainly by macrophages, and contributes to production of interleukin-6 (IL-6) and C-reactive protein (CRP), thus directing a chronic inflammatory process in the body. In the present study, we examined the associations between plasma TNF-α level and several factors related to nutrition status, including BMI, albumin, and energy intake in community-dwelling Japanese elderly. We conducted a cross-sectional study of 390 men and women aged 70-86 y (average 73.5 y), who participated in health check-ups. Associations between plasma TNF-α levels, other clinical parameters, and lifestyle factors were analyzed using Spearman's rank correlation coefficient analysis and multiple linear regression analysis. In elderly men, plasma TNF-α level was positively associated with age, white blood cell count, monocyte count, plasma CRP level, serum creatinine, ureic acid, and triacylglycerol levels, and negatively associated with albumin/globulin ratio, eGFR, and serum HDL-cholesterol level. In elderly women, plasma TNF-α level was positively associated with age, plasma CRP level, and serum triacylglycerol level, and negatively associated with serum albumin and HDL-cholesterol levels. The results of this study suggest that plasma TNF-α is associated with inflammation and insulin resistance in both Japanese elderly men and women, and a prominent association of TNF-α with malnutrition status was observed in elderly women.

  19. Association between Functional Capacity Decline and Nutritional Status Based on the Nutrition Screening Initiative Checklist: A 2-Year Cohort Study of Japanese Community-Dwelling Elderly.

    PubMed

    Sugiura, Yumiko; Tanimoto, Yoshimi; Imbe, Ayumi; Inaba, Yuiko; Sakai, Satoshi; Shishikura, Kanako; Tanimoto, Keiji; Hanafusa, Toshiaki

    2016-01-01

    To assess whether nutritional status based on the Nutrition Screening Initiative Checklist is useful for predicting functional capacity decline in community-dwelling Japanese elderly. This two-year observational cohort study included 536 community-dwelling Japanese (65 years and older at baseline) who were independent in both activities and instrumental activities of daily living. Demographic attributes, chronic illness, lifestyle-related habits, nutritional status, functional capacity, and anthropometric measurements were assessed, with decline in functional capacity used as the outcome measure. Subjects were classified into three groups as follows based on the Nutrition Screening Initiative Checklist: low (59.5%), moderate (23.7%), and high (16.8%) nutritional risk. Significant differences were found between nutritional status and the following four baseline variables: age, hypertension, cerebrovascular diseases, and current smoking. However, no significant differences were evident between nutritional status and sex, body mass index, diabetes, drinking habit, or exercise habit. Logistic regression analysis adjusted for age, sex, body mass index, hypertension, cerebrovascular diseases and smoking habit showed that the high nutritional risk group was significantly associated with a decline in both activities of daily living (odds ratio: 4.96; 95% confidence interval (CI): 1.59-15.50) and instrumental activities of daily living (OR: 2.58; 95% CI: 1.31-5.06) compared with the low nutritional risk group. Poor nutritional status based on the Nutrition Screening Initiative Checklist was associated with a decline in functional capacity over a 2-year period in community-dwelling Japanese elderly. These results suggest that the Nutrition Screening Initiative Checklist is a suitable tool for predicting functional capacity decline in community-dwelling elderly.

  20. Interaction between serum uric acid and triglycerides in relation to prehypertension in community-dwelling Japanese adults.

    PubMed

    Kawamoto, Ryuichi; Tabara, Yasuharu; Kohara, Katsuhiko; Kusunoki, Tomo; Abe, Masanori; Miki, Tetsuro

    2014-01-01

    There are few data available on the association between serum uric acid (SUA) levels and blood pressure (BP) categories earlier in the disease continuum, when efforts for its prevention may be applicable. We performed a cross-sectional study to examine the association between SUA and prehypertension in a community-dwelling sample of Japanese adults. Study participants without hypertension aged 19 to 90 years [567 men aged 56 ± 15 (mean ± standard deviation) years and 808 women aged 58 ± 13 years] were recruited for a survey at the community based annual medical check-up. The main outcome was the presence of prehypertension [systolic BP (SBP) 120-139 mmHg and/or diastolic BP (DBP) 80-89 mmHg]. After adjustments by gender and age, both SBP (p<0.001) and DBP (p<0.001) increased significantly and progressively with increasing SUA and triglycerides (TG) as well as body mass index, LDL cholesterol, and fasting plasma glucose (FPG). Compared to those with normotension, the multivariate-adjusted odds ratio (95% confidence interval) for participants with prehypertension was 1.15 (1.05-1.26) for SUA and 3.19 (1.66-6.14) for TG. The interaction between increased SUA and TG was a significant and independent determinant for SBP (β=-2.474, p=0.008), but not for DBP (β=-0.608, p=0.349). Higher SUA levels are associated with prehypertension in participants without hypertriglyceridemia (<150 mg/dL), but not in participants with hypertriglyceridemia (≥ 150 mg/dL). TG levels may modify the association between SUA and prehypertension.

  1. Serum 25-hydroxyvitamin D level and risk of falls in Japanese community-dwelling elderly women: a 1-year follow-up study.

    PubMed

    Shimizu, Y; Kim, H; Yoshida, H; Shimada, H; Suzuki, T

    2015-08-01

    The present prospective follow-up study among 1,393 community-dwelling elderly women aged 75 years or older was conducted to clarify the association between serum 25-hydroxyvitamin D (25(OH)D) level and risk of falls. Lower serum 25(OH)D, particularly level <20 ng/mL, was significantly associated with an increased risk of falls. Serum 25(OH)D level has been revealed to be important factor not only for skeletal health but also for fall prevention among the elderly. Our previous cross-sectional study indicated that low serum 25(OH)D level is associated with inferior physical performance and falls among elderly Japanese women. The present prospective study was designed to clarify the association between serum 25(OH)D level and risk of falls before and after 1 year of follow-up. The community-dwelling elderly women aged 75 years or older (N = 1,393) who participated in a mass health examination were followed 1 year later by a mailed self-administered questionnaire. Responses were obtained from 1,285 subjects (response rate = 92.2%). The incidence of falls at baseline and at 1-year follow-up was 18.8 and 24.4%, respectively. The baseline prevalence of serum 25(OH)D <20 ng/mL was 35.2%. Odds ratios (95% confidence intervals) in the lowest tertile of serum 25(OH)D (<20 ng/mL) compared with those in the highest tertile (≥25 ng/mL) were 1.40 (1.01-1.94) for any falls and 1.47 (0.93-2.32) for recurrent falls vs. no falls adjusted for potential risk factors. Among elderly Japanese women, the lower serum 25(OH)D, particularly level <20 ng/mL, was significantly associated with an increased risk of falls.

  2. 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

  3. Changes in oxidized low-density lipoprotein cholesterol are associated with changes in handgrip strength in Japanese community-dwelling persons.

    PubMed

    Kawamoto, Ryuichi; Kohara, Katsuhiko; Katoh, Tateaki; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Abe, Masanori; Kumagi, Teru; Miki, Tetsuro

    2015-04-01

    Nordic walking (NW), characterized by the use of two walking poles, has positive effects on several muscle groups. Muscle strength and mass decrease with age, and recently, this decrease is defined as sarcopenia. Sarcopenia may be triggered by oxidative stress. We investigated whether changes in the oxidative stress marker, malondialdehyde-modified low-density lipoprotein (MDA-LDL)/LDL-cholesterol (LDL-C) ratio are associated with change in handgrip strength (HGS), which is a useful indicator of sarcopenia, by a 12-week NW exercise among Japanese community-dwelling persons. The present study included 65 women aged 67±7 years and 9 men aged 71±8 years from a rural village. NW exercise of 120 min per week was performed for 12 weeks. Before and at the end of the 12-week intervention, various confounding factors and HGS were measured. 12-week changes in various factors were calculated by subtracting the baseline values from the 12-week values. Changes in HGS and follow-up HGS increased progressively with decreased changes in the MDA-LDL/LDL-C ratio after the 12-week walking exercise (r=-0.32, P=0.006 and r=-0.35, P=0.002, respectively). Multiple linear regression analysis showed that changes in HDL-C (β=0.26, P=0.019) and MDA-LDL/LDL-C ratio (β=-0.32, P=0.004) were significantly and independently associated with changes in HGS. When the data were further stratified by gender, change in the MDA-LDL/LDL-C ratio was significantly and similarly associated with change in HGS in women only. These results suggest that change in MDA-LDL/LDL-C ratio may be a predictor for HGS after a 12-week NW exercise in community-dwelling persons.

  4. 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

  5. Long-Term Effects of a Screening Intervention for Depression on Suicide Rates among Japanese Community-Dwelling Older Adults.

    PubMed

    Oyama, Hirofumi; Sakashita, Tomoe

    2016-04-01

    To explore the long-term impact of a universal screening intervention for depression on suicide rates among older community-dwelling adults, with gender as an effect modifier. Controlled cohort study reporting long-term follow-up of previous research. Two sets of three municipalities in Japan were assigned as intervention and control regions and compared with the surrounding zone and prefecture. Intervention area residents aged 60 years and older (14,291) were invited to participate in a 2-year intervention (2005-2006). Four population-based dynamic cohorts of residents aged 65 years and older (1999-2010) were included as subjects, 6 years before and after the intervention started. At-risk residents within the intervention region (4,918) were invited for a two-step screening program; 2,552 participated in the program linked with care/support services for 2 years. An education program open to the public was held. Changes in suicide from a 6-year baseline to the 2-year intervention and a 4-year follow-up in the intervention region (11,700 adults ≥65 years) were compared with a matched control and two comparison areas using mixed-effects negative binomial regression models. Suicide rates among older adults exposed to screening were compared with those of the control region. Suicide rates in the intervention region decreased by 48%, which was significantly greater than in the three comparison areas. The program's benefits lasted longer for women than men. Screening exposure may be associated with decreased suicide risk over the 4-year follow-up. Universal screening may decrease suicide rates among older adults, with potential gender differences in treatment response. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  6. 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

  7. 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

  8. Cognitive decline predicts long-term care insurance requirement certification in community-dwelling older Japanese adults: a prospective cohort study.

    PubMed

    Nishiguchi, Shu; Yamada, Minoru; Sonoda, Takuya; Kayama, Hiroki; Tanigawa, Takanori; Yukutake, Taiki; Aoyama, Tomoki

    2013-01-01

    The purpose of this prospective cohort study is to examine whether cognitive decline is an independent predictor of new long-term care insurance (LTCI) requirement certifications in Japan. A total of 5,765 community-dwelling older Japanese adults who, at baseline, were independent in terms of their activities of daily living participated in this study and were followed up for 18 months. The outcome measure was the number of new LTCI requirement certifications during the 18-month period of the study. We collected demographic information through questionnaires and assessed cognitive skills with the Cognitive Performance Scale (CPS). The participants were divided into 3 groups according to CPS scores (0, 1, and 2 or greater). During the 18-month period, 399 subjects (6.9%) became newly certified for LTCI services. In a multivariate Cox proportional hazards model, older participants with a CPS score of 1 (adjusted HR: 1.39, 95% CI: 1.08-1.77) and 2 or greater (adjusted HR: 2.27, 95% CI: 1.74-2.96) were significantly more likely to receive an LTCI certification compared to those with a CPS score of 0. Cognitive decline is an independent predictor of new LTCI requirement certifications and the severity of cognitive decline in elderly adults is positively associated with receiving an LTCI requirement certification in Japan.

  9. 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.

  10. Association between objectively measured sleep quality and physical function among community-dwelling oldest old Japanese: A cross-sectional study.

    PubMed

    Kim, Miji; Yoshida, Hideyo; Sasai, Hiroyuki; Kojima, Narumi; Kim, Hunkyung

    2015-08-01

    The present study examined the association between objective measures of sleep quality and performance-based measures of physical function in community-dwelling oldest old Japanese. This cross-sectional study included 207 community-dwelling adults aged 80 years or older (92 men, 115 women; age 83.5 ± 2.6 years [range 80-95 years]). Participants wore an accelerometer (ActiGraph GT3X+) on their non-dominant wrist for 24 h per day over seven consecutive nights. Sleep parameters included total sleep time, sleep efficiency and wake after sleep onset during the night for a week. Performance-based physical function measures were handgrip strength, knee extension strength, and usual and maximum walking speeds. Multivariable linear regression was carried out to determine the associations between weekly sleep parameter averages and physical function measures. Approximately 24% of participants had a total sleep time of less than 6 h a night, and 13% had greater than 8 h a night. Overall, average daily physical activity was 1771.8 ± 520.6 (counts/min/day). In multiple linear regression, sleep efficiency and wake after sleep onset were significantly associated with maximum walking speed (β = 0.277; 95% confidence interval [CI] 0.103 to 0.351 and β = -0.214; 95% CI -0.339 to -0.082, respectively) and usual walking speed (β = 0.200, 95% CI 0.035 to 0.305 and β = -0.174; 95% CI -0.341 to -0.064, respectively), after adjusting for potential confounding factors including daily physical activity. Both sleep qualities were also independently associated with knee extension strength. However, wake after sleep onset was not associated with handgrip strength. Objectively measured sleep quality was associated with physical function in the oldest old. Further research is required to identify the temporality of associations between sleep and physical function. © 2014 Japan Geriatrics Society.

  11. 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.

  12. Examination of useful items for the assessment of fall risk in the community-dwelling elderly Japanese population.

    PubMed

    Demura, Shinichi; Sato, Susumu; Yokoya, Tomohisa; Sato, Toshiro

    2010-05-01

    The aim of this study was to select useful items for assessing fall risk in healthy elderly Japanese individuals. A total of 965 healthy elderly Japanese subjects aged ≥60 years (349 males 70.4 ± 7.1 years, 616 females 69.9 ± 7.1 years) participated in this study. Of these, 16.6% had suffered from a previous fall. We assumed five fall risk factors: symptoms of falling, physical function, disease and physical symptoms, environment, and behavior and character. Eighty-six items were selected to represent these factors. To confirm the component items for each risk factor, we performed factor analysis (principle factor solution and varimax rotation). The high-fall risk response rate was also calculated for each item, and significant differences in this rate were examined between groups of those who had and not had experienced a fall. Useful items were selected using the following criteria: (1) items showing a significant difference in high fall risk response rate between faller and non-faller groups were selected as useful items; (2) items showing low factor loading (<0.4) for any factor were deleted as inappropriate items; (3) the top two items showing a greater amount of the difference in high fall risk response rate among the representative items for each factor. A total of 50 items were selected from each fall risk factor (symptoms of falling, 3 items; physical function, 22 items; disease and physical symptom, 13 items; environment, 4 items; behavior and character, 8 items). Based on our results, the selected items can comprehensively assess the fall risk of a healthy elderly Japanese population. In addition, the assessment items for physical function comprised items of different levels of difficulty, and these are able to gradually and comprehensively assess physical function.

  13. Quality response of even-aged 80-year-old white oak trees after thinning

    Treesearch

    David L. Sonderman

    1984-01-01

    Stem defects were studied over an 18-year period to determine the effect of thinning intensity on quality development of 80-year-old white oak trees. Seventy-nine white oak trees from a thinning study in Kentucky were analyzed from stereo photographs taken in 1960 and 1978. Stem-related defects were measured on the butt 8-foot and second 8-foot sections of each tree....

  14. Environmental and individual correlates of various types of physical activity among community-dwelling middle-aged and elderly Japanese.

    PubMed

    Saito, Yoshinobu; Oguma, Yuko; Inoue, Shigeru; Tanaka, Ayumi; Kobori, Yoshitaka

    2013-05-17

    Recent studies have suggested the importance of the neighborhood environment in determining the specific type of physical activity. However, few studies on this topic have been undertaken in Japan. This study examined the association of three types of physical activity and their associations with individual and neighborhood environmental factors among middle-aged and elderly Japanese. Participants were 2,449 adults aged 40-69 living in Fujisawa city who had undergone health checkups and responded to our survey by mail. Individual factors, the International Physical Activity Questionnaire (long form), and its environmental module acted as inputs to the study. The adjusted odds ratios (ORs) of high levels of moderate-to-vigorous intensity leisure-time physical activity (LTPA), walking for active recreation, and transportation were calculated in relation to individual and neighborhood environmental factors through multiple logistic regression models. Not working and good self-rated health were significantly associated with a higher level of each physical activity outcome. According to the adjusted ORs, higher educational attainment, higher economic status, good access to exercise facilities, and owning motor vehicles were associated with longer LTPA time. However, different sets of factors were associated with longer walking times for recreation and transportation. The results suggest that diverse individual and neighborhood environmental characteristics are associated with different physical activity outcomes. Therefore, customizing environments to become activity-friendly is necessary to increase physical activity effectively among middle-aged and elderly Japanese.

  15. Effects of regular exercise and nutritional guidance on body composition, blood pressure, muscle strength and health-related quality of life in community-dwelling Japanese women.

    PubMed

    Uritani, Daisuke; Matsumoto, Daisuke; Asano, Yasuyo; Yoshizaki, Kyoko; Nishida, Yukiko; Shima, Masayuki

    2013-01-01

    This study aimed to investigate the effects of 6-month regular exercise and nutritional guidance for body composition, blood pressure, muscle strength and health-related quality of life (HRQOL) in community-dwelling Japanese women aged 40-74 years. Participants were divided into an intervention group (n = 48) comprising women registered for health guidance and a control group without intervention (n = 66). The intervention group received 6-month exercise and nutritional guidance to modify lifestyle. Before and after the intervention period, body mass index (BMI), waist circumference, body fat percentage, blood pressure, muscle strength and HRQOL using the 36-item Short-Form Health Survey version 2 (SF-36) questionnaire were measured. At baseline, no significant differences were found between intervention and control groups. Waist circumference decreased significantly in the intervention group (from 82.4 to 79.9 cm) compared to the control group (from 80.5 to 79.7 cm). BMI and body fat percentage also decreased significantly more in the intervention group than in the control group. General health perception, vitality and social functioning in the SF-36 showed significantly greater improvements in the intervention group than in the control group. Six-month regular exercise and nutritional guidance had beneficial effects on body composition and health-related quality of life especially for mental components of SF-36. Based on these findings, our intervention was expected to provide benefits to mental components of HRQOL and facilitate sustained participation and motivation in modify lifestyles. As a result, beneficial effects on body composition might also be sustained. © 2013 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.

  16. The Effects of Aroma Foot Massage on Blood Pressure and Anxiety in Japanese Community-Dwelling Men and Women: A Crossover Randomized Controlled Trial.

    PubMed

    Eguchi, Eri; Funakubo, Narumi; Tomooka, Kiyohide; Ohira, Tetsuya; Ogino, Keiki; Tanigawa, Takeshi

    2016-01-01

    The aim of this study was to investigate the effects of aroma foot massage on blood pressure, anxiety, and health-related quality of life (QOL) in Japanese community-dwelling men and women using a crossover randomized controlled trial. Fifty-seven eligible participants (5 men and 52 women) aged 27 to 72 were randomly divided into 2 intervention groups (group A: n = 29; group B: n = 28) to participate in aroma foot massages 12 times during the 4-week intervention period. Systolic and diastolic blood pressure (SBP and DBP, respectively), heart rate, state anxiety, and health-related QOL were measured at the baseline, 4-week follow-up, and 8-week follow-up. The effects of the aroma foot massage intervention on these factors and the proportion of participants with anxiety were analyzed using a linear mixed-effect model for a crossover design adjusted for participant and period effects. Furthermore, the relationship between the changes in SBP and state anxiety among participants with relieved anxiety was assessed using a linear regression model. Aroma foot massage significantly decreased the mean SBP (p = 0.02), DBP (p = 0.006), and state anxiety (p = 0.003) as well as the proportion of participants with anxiety (p = 0.003). Although it was not statistically significant (p = 0.088), aroma foot massage also increased the score of mental health-related QOL. The change in SBP had a significant and positive correlation with the change in state anxiety (p = 0.01) among participants with relieved anxiety. The self-administered aroma foot massage intervention significantly decreased the mean SBP and DBP as well as the state anxiety score, and tended to increase the mental health-related QOL scores. The results suggest that aroma foot massage may be an easy and effective way to improve mental health and blood pressure. University Hospital Medical Information Network 000014260.

  17. The Effects of Aroma Foot Massage on Blood Pressure and Anxiety in Japanese Community-Dwelling Men and Women: A Crossover Randomized Controlled Trial

    PubMed Central

    Tomooka, Kiyohide; Ohira, Tetsuya; Ogino, Keiki; Tanigawa, Takeshi

    2016-01-01

    Objectives The aim of this study was to investigate the effects of aroma foot massage on blood pressure, anxiety, and health-related quality of life (QOL) in Japanese community-dwelling men and women using a crossover randomized controlled trial. Methods Fifty-seven eligible participants (5 men and 52 women) aged 27 to 72 were randomly divided into 2 intervention groups (group A: n = 29; group B: n = 28) to participate in aroma foot massages 12 times during the 4-week intervention period. Systolic and diastolic blood pressure (SBP and DBP, respectively), heart rate, state anxiety, and health-related QOL were measured at the baseline, 4-week follow-up, and 8-week follow-up. The effects of the aroma foot massage intervention on these factors and the proportion of participants with anxiety were analyzed using a linear mixed-effect model for a crossover design adjusted for participant and period effects. Furthermore, the relationship between the changes in SBP and state anxiety among participants with relieved anxiety was assessed using a linear regression model. Results Aroma foot massage significantly decreased the mean SBP (p = 0.02), DBP (p = 0.006), and state anxiety (p = 0.003) as well as the proportion of participants with anxiety (p = 0.003). Although it was not statistically significant (p = 0.088), aroma foot massage also increased the score of mental health-related QOL. The change in SBP had a significant and positive correlation with the change in state anxiety (p = 0.01) among participants with relieved anxiety. Conclusion The self-administered aroma foot massage intervention significantly decreased the mean SBP and DBP as well as the state anxiety score, and tended to increase the mental health-related QOL scores. The results suggest that aroma foot massage may be an easy and effective way to improve mental health and blood pressure. Trial Registration University Hospital Medical Information Network 000014260 PMID:27010201

  18. Association of spinal inclination with physical performance measures among community-dwelling Japanese women aged 40 years and older.

    PubMed

    Abe, Yasuyo; Aoyagi, Kiyoshi; Tsurumoto, Tadao; Chen, Chih-Yu; Kanagae, Mitsuo; Mizukami, Satoshi; Ye, Zhaojia; Kusano, Yosuke

    2013-10-01

    Spinal inclination assesses spinal posture as a whole. However, the association between spinal inclination and physical performance has not yet been fully elucidated. Therefore, this study aimed to explore the association of spinal inclination with physical performance measures. The participants were 107 Japanese women aged 40-84 years. Spinal posture was assessed as inclination to a perpendicular line by using a computer-assisted device. Increased inclination value means forward inclination of the spine. Physical performance was measured by using the following methods: 6-m walking time, chair stand time, functional reach, Timed Up & Go Test, and grip strength. Information on participants' comorbidities, osteoporosis, knee joint pain, back pain, falls in the previous year, regular exercise and usage of non-steroidal anti-inflammatory drugs (NSAIDs), was also collected. Pearson's correlation analysis showed significant associations between spinal inclination and all of the physical performance measures. Pearson's partial correlation analysis adjusted for age showed significant associations of increased inclination with poor physical functioning in 6-m walking time, chair stand time, functional reach, and Timed Up & Go Test, but not in grip strength. Linear regression analysis adjusted for age, grip strength, number of comorbidities, osteoporosis, knee joint pain, back pain, falls in previous year, regular activity and taking NSAIDs showed that spinal inclination was associated with poor function in 6-m walking time, chair stand time, functional reach and Timed Up & Go Test. Forward spinal inclination was associated with impairment in various physical performance measures. Proper prevention and treatment of underlying disorders should be prompted. © 2012 Japan Geriatrics Society.

  19. Association of food access and neighbor relationships with diet and underweight among community-dwelling older Japanese.

    PubMed

    Nakamura, Hideko; Nakamura, Mieko; Okada, Eisaku; Ojima, Toshiyuki; Kondo, Katsunori

    2017-11-01

    Food access is important for maintaining dietary variety, which predicts underweight. The aim of this study was to examine the association of food access and neighbor relationships with eating and underweight. We analyzed cross-sectional data from 102,869 Japanese individuals aged 65 years or older. The perceived availability of food was assessed using the presence or absence of food stores within 1 km of the home. Level of relationships with neighbors was also assessed. The odds ratios (ORs) and 95% confidence intervals (CIs) for infrequent food intake and underweight were determined using logistic regression analysis. The proportion of men and women having low access to food was 25-30%. Having low food access (OR 1.18; 95% CI, 1.12-1.25 for men and OR 1.26; 95% CI, 1.19-1.33 for women) and a low level of relationship with neighbors (OR 1.38; 95% CI, 1.31-1.45 for men and OR 1.57; 95% CI, 1.48-1.67 for women) was associated with infrequent intake of fruits and vegetables in both sexes. Association between low food access and infrequent intake of fruits and vegetables was higher among men with low levels of neighbor relationship (OR 1.34; 95% CI, 1.23-1.46) than among men with high levels of relationship (OR 1.10; 95% CI, 1.03-1.18). Low perceived availability of food is a risk factor for low dietary variety among older people. Furthermore, high levels of relationship with neighbors may relieve the harmful effect of low food access. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  20. 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.

  1. Fatal lymphomatoid granulomatosis with primary CNS-involvement in an immunocompetent 80-year-old woman

    PubMed Central

    Olmes, David G; Agaimy, Abbas; Kloska, Stephan; Linker, Ralf A

    2014-01-01

    An 80-year-old woman presented with weight loss, fatigue, dizziness and a brain stem lesion. Extensive work-up revealed lymphomatoid granulomatosis (LYG) with primary clinical manifestation in the central nervous system (CNS), a rare Epstein-Barr virus-driven multisystem lymphoproliferative disorder, to be causative for the symptoms. Immunochemotherapy consisting of rituximab and temozolomide was started, but the disease progressed and the patient subsequently died. Histology, diagnostic criteria, differential diagnosis and treatment options for LYG with CNS involvement are discussed. This case demonstrates that LYG with CNS involvement may necessitate more aggressive treatment approaches than combination therapy with rituximab and temozolomide. PMID:25535225

  2. [A 80-year-old woman with delirium after intertrochanteric fracture of femur].

    PubMed

    Piotrowicz, Karolina; Klich-Raczka, Alicja

    2010-01-01

    The aim of this study is to present a case of delirium -the state occurring frequently in elderly patients. A 80-year-old woman was hospitalized in the department of internal diseases for internal medical examinations before scheduled operation of femoral osteosynthesis. In ward, she was given analgesic medicines from the group of non-steroidal anti-inflammatory drugs (NSAID), paracetamole and opioids influencing central nervous system. On the second day after modifying the painkilling treatment (single doses of paracetamole were increased and oral opioid medication was introduced) a quickly progressing (within a few hours) delirium was observed. Its occurrence was ascribed to the application of strong medicines influencing central nervous system. Treatment was modified then; the opioid medicine was replaced with NSAID, which had already been used before, applied intravenously. Subsidence of delirium clinical symptoms and cognitive functions' improvement was observed.

  3. An 80-Year-Old Woman With Progressive Shortness of Breath and a Mediastinal Mass.

    PubMed

    Zider, Alexander; Kamangar, Nader

    2016-07-01

    An 80-year-old woman from Iran presented to our institution for evaluation of insidious onset of dyspnea and progressive hypoxemia. She had a history of hypertension, COPD attributed to secondhand smoke, and an unprovoked pulmonary embolus that was treated with lifelong anticoagulation. In addition, she had a history of latent TB status posttreatment with isoniazid 10 years prior. One year ago, home oxygen therapy was started at 4 L/min via nasal cannula, and because of her decline, her son had brought her to the United States 3 months earlier for medical help. After a contrast-enhanced thoracic CT scan followed by a nondiagnostic thoracentesis, another hospital informed her that she likely had inoperable lung cancer. She presented to our institution for a second opinion. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  4. 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.

  5. ICU Patients Requiring Renal Replacement Therapy Initiation: Fewer Survivors and More Dialysis Dependents From 80 Years Old.

    PubMed

    Commereuc, Morgane; Guérot, Emmanuel; Charles-Nelson, Anais; Constan, Adrien; Katsahian, Sandrine; Schortgen, Frédérique

    2017-08-01

    To assess the role of advanced age on survival and dialysis dependency after initiation of renal replacement therapy for acute kidney injury. Retrospective pooled analysis of prospectively collected data. ICUs of two teaching hospitals in Paris area, France. One thousand five hundred thirty adult patients who required renal replacement therapy initiation in the ICU. None. Survival and post acute kidney injury chronic dialysis dependency were assessed at hospital discharge according to the quintile (Q) of age. The oldest quintile included 289 patients 80 years old and over. Seventy-three percent of included patients had respiratory and hemodynamic supports at renal replacement therapy initiation, similarly distributed across quintiles. Mortality increased with age strata from 63% in Q1 (≤ 52 yr) to 76% in Q5 (≥ 80 yr) (p < 0.001). After adjustment, age did not increase the risk of death up to 80 years. The oldest patients (≥ 80 yr) had a significant higher risk of dying (adjusted odds ratio, 2.59; 95% CI, 1.66-4.03). Dialysis dependency was more frequent among survivors 80 years old or older (30% vs 14%; p = 0.001). Age 80 years old or older was an independent risk for dialysis dependency only for patients with prior advanced chronic kidney disease (p = 0.04). Baseline estimated glomerular filtration rate was the only one predictor of dialysis dependency identified. Patients with advanced age represent a substantial subgroup of patients requiring renal replacement therapy in the ICU. From 80 years, age should be considered as an additional risk of dying over the severity of organ failures. Patients 80 years old or older are likely to recover sufficient renal function allowing renal replacement therapy discontinuation when baseline estimated glomerular filtration rate is above 44 mL/min/1.73 m. At 3 months, only 6% were living at home, dialysis independent.

  6. Associations between serum omega-3 fatty acid levels and cognitive functions among community-dwelling octogenarians in Okinawa, Japan: The KOCOA study

    PubMed Central

    Nishihira, Junko; Tokashiki, Takashi; Higashiuesato, Yasushi; Willcox, Donald Craig; Mattek, Nora; Shinto, Lynne; Ohya, Yusuke; Dodge, Hiroko H.

    2016-01-01

    Background Epidemiological studies have found frequent consumption of fatty fish is protective against cognitive decline. However, the association between circulating omega-3 polyunsaturated fatty acid (PUFA) levels and cognitive functions among the oldest old is not well known. Objective To examine the association between serum PUFA levels and cognitive function among community-dwelling, non-demented elderly aged over 80 years old. Methods The data came from the Keys to Optimal Cognitive Aging (KOCOA) study; an ongoing cohort of relatively healthy volunteers aged over 80 years old, living in Okinawa, Japan. One hundred eighty five participants (mean age 84.1 ± 3.4 years) assessed in 2011 who were free from frank dementia (defined as Clinical Dementia Rating < 1.0) were used for the current cross-sectional study. We examined whether serum omega-3 PUFAs (docosahexaenoic acid [DHA] and eicosapentaenoic acid [EPA]), arachidonic acid (AA), EPA/AA ratio, DHA/AA ratio and DHA+EPA are associated with (1) age and (2) global cognitive function (Japanese MMSE) and executive function (Verbal Fluency Letters). Data was analyzed univariately by t-test and multivariately by cumulative logistic regression models controlling for age, gender, years of education, obesity, hypertension, diabetes, and dyslipidemia. Results Serum DHA levels decreased with increasing age (p = 0.04). Higher global cognitive function was associated with higher levels of serum EPA (p = 0.03) and DHA + EPA (p = 0.03) after controlling for confounders. Conclusions Higher serum EPA and DHA + EPA levels were independently associated with better scores on global cognitive function among the oldest old, free from dementia. Longitudinal follow-up studies are warranted. PMID:26890763

  7. Nutritional intakes in community-dwelling older Japanese adults: high intakes of energy and protein based on high consumption of fish, vegetables and fruits provide sufficient micronutrients.

    PubMed

    Watanabe, Reiko; Hanamori, Kiyoko; Kadoya, Hiroko; Nishimuta, Mamoru; Miyazaki, Hideo

    2004-06-01

    The purpose of this study was to obtain detailed data on the dietary intake of energy, macronutrients, and micronutrients, especially minerals and vitamins, of healthy free-living people over the age of 70 in Japan and to clarify the correlations among nutrient intakes. The survey was conducted in November 2001 for 57 persons (men: 31, women: 26) aged 74 y (born in 1927) living in Niigata City, Japan. A precise weighing method was used to record food intake for three consecutive days. Nutrient intake was calculated based on the Standard Tables of Food Composition in Japan (5th ed.). The intakes of energy and total protein were 44.8+/-7.7 kcal/kg/d and 1.80+/-0.35 g/kg/d for men and 38.1+/-7.6 kcal/ kg/d and 1.51+/-0.26 g/kg/d for women. These values are significantly higher than those proposed by the current Recommended Dietary Allowances (RDAs) and the data by the 2001 National Nutrition Survey in Japan. The energy intake ratios from protein, carbohydrate and fat for men were 16 : 58 : 22, respectively, and the residual part was alcohol. For women, the ratios were 16 : 62 : 22. The proportion of total protein intake that consisted of animal protein was 57.8% for men and 52.8% for women. For both sexes, all of the mean daily intakes of nine minerals and 12 vitamins were higher than those prescribed for elderly Japanese people (> or =70 y) in the RDAs. Significant strong correlations were found between total protein intake and intakes of vitamins D, B2 and B6, as well as niacin and pantothenic acid (p<0.0001). Among the nine minerals, the correlations were very strong between potassium and magnesium, calcium and phosphorus, magnesium and iron, magnesium and copper, iron and copper, and zinc and copper (r's>0.700). For vitamins, strong correlations were found between vitamin A and folic acid, vitamin B2 and pantothenic acid, and folic acid and pantothenic acid. Furthermore, strong relationships were observed between potassium and folic acid, potassium and pantothenic

  8. Effects of exercise and tea catechins on muscle mass, strength and walking ability in community-dwelling elderly Japanese sarcopenic women: a randomized controlled trial.

    PubMed

    Kim, Hunkyung; Suzuki, Takao; Saito, Kyoko; Yoshida, Hideyo; Kojima, Narumi; Kim, Miji; Sudo, Motoki; Yamashiro, Yukari; Tokimitsu, Ichiro

    2013-04-01

    To investigate the effects of exercise and/or tea catechin supplementation on muscle mass, strength and walking ability in elderly Japanese women with sarcopenia. A total of 128 women aged over 75 years were defined as sarcopenic and randomly assigned into four groups: exercise and tea catechin supplementation (n = 32), exercise (n = 32), tea catechin supplementation (n = 32) or health education (n = 32). The exercise group attended a 60-min comprehensive training program twice a week and the tea catechin supplementation group ingested 350 mL of a tea beverage fortified with catechin daily for 3 months. Body composition was determined by bioelectrical impedance analysis. Interview data and functional fitness measurements, such as muscle strength, balance and walking ability, were collected at baseline and after the 3-month intervention. There were significant group × time interactions observed in timed up & go (P < 0.001), usual walking speed (P = 0.007) and maximum walking speed (P < 0.001). The exercise + catechin group showed a significant effect (odds ratio 3.61, 95% confidence interval 1.05-13.66) for changes in the combined variables of leg muscle mass and usual walking speed compared with the health education group. The combination of exercise and tea catechin supplementation had a beneficial effect on physical function measured by walking ability and muscle mass. © 2012 Japan Geriatrics Society.

  9. Validity of maximum isometric tongue pressure as a screening test for physical frailty: Cross-sectional study of Japanese community-dwelling older adults.

    PubMed

    Yamanashi, Hirotomo; Shimizu, Yuji; Higashi, Miho; Koyamatsu, Jun; Sato, Shimpei; Nagayoshi, Mako; Kadota, Koichiro; Kawashiri, Shinya; Tamai, Mami; Takamura, Noboru; Maeda, Takahiro

    2017-09-04

    Maximum isometric tongue pressure (MIP) seems to have a diagnostic value for oral phase dysphagia. The present study aimed to examine the association between MIP and frailty, and to assess the screening validity of MIP for physical frailty. We carried out a cross-sectional study, and enrolled participants aged ≥60 years from Japanese national medical check-ups in 2015 and 2016. The Fried frailty phenotype model was used. We analyzed odds ratios (OR) and 95% confidence intervals (CI) of physical frailty using one standard deviation increments of tongue pressure. Receiver operating characteristic curves were obtained to predict physical frailty using MIP values. Out of 1603 participants, 968 were categorized as non-frail, 605 as pre-frail and 30 as frail. In logistic regression analysis, one standard deviation increment of MIP significantly differentiated frail and pre-frail: the OR for frail with one standard deviation increment in MIP was 0.37 (95% CI 0.26-0.54, P < 0.001), and the OR for pre-frail was 0.63 (95% CI 0.57-0.70, P < 0.001). The area under the receiver operating characteristic curve for predicting frailty with MIP score was as high as 0.776 (95% CI 0.689-0.862). A point of MIP 35 kPa had a sensitivity of 90.0%, specificity of 40.4%, a positive likelihood ratio of 1.5 and a negative likelihood ratio of 0.2 for predicting frailty. MIP performance is independently associated with frailty. MIP also can be used as a simple screening tool for frailty. Geriatr Gerontol Int 2017; ••: ••-••. © 2017 Japan Geriatrics Society.

  10. Predicting death from tumour necrosis factor-alpha and interleukin-6 in 80-year-old people

    PubMed Central

    BRUUNSGAARD, H; LADELUND, S; PEDERSEN, A N; SCHROLL, M; JØRGENSEN, T; PEDERSEN, B K

    2003-01-01

    Ageing is associated with low-grade inflammation and markers such as IL-6 possess prognostic value. Tumour necrosis-alpha (TNF-α) initiates the inflammatory cascade and has been linked to several age-associated disorders. It remains, however, unknown if TNF-α is associated with mortality in old populations. The aim of the present study was to investigate if serum levels of TNF-α were associated with all-cause mortality independently of interleukin (IL)-6 in a prospective study of 333 relatively healthy 80-year-old people. A Cox regression model was used to explore effects of TNF-α and IL-6 on survival in the following 6 years. A total of 133 participants died during this follow-up period. TNF-α was associated with mortality in men, but not in women, whereas low-grade elevations in IL-6 were associated strongly with mortality in both sexes. TNF-α explained only 7% of the variability in IL-6 and effects of the two cytokines were independent of each other as well as of other traditional risk factors for death [smoking, blood pressure, physical exercise, total cholesterol, co-morbidity, body mass index (BMI) and intake of anti-inflammatory drugs]. These findings indicate that at least in old populations chronic elevated levels of TNF-α and IL-6 have different biological functions that trigger age-associated pathology and cause mortality. PMID:12653832

  11. 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 Central

    Kim, Hunkyung; Suzuki, Takao; Kim, Miji; Kojima, Narumi; Ota, Noriyasu; Shimotoyodome, Akira; Hase, Tadashi; Hosoi, Erika; Yoshida, Hideyo

    2015-01-01

    Objective 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. Methods 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. Results 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). Conclusion This study suggests that interventions including exercise

  12. 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

  13. [Prevalence of abdominal aortic aneurysm in a rural population of 65-80 year-old males].

    PubMed

    Salcedo Jódar, L; Alcázar Carmona, P; Tenías Burillo, J M; García Tejada, R

    2014-01-01

    The prevalence of aortic aneurysm (AAA) is reported to be 3.55%-4% in men over 65. But it is not known if this prevalence, resulting from ultrasound measurements made by Family Physicians, can be extrapolated to a rural population. To estimate the prevalence of AAA in a rural population of males aged 65-80 years, using abdominal ultrasound by family physicians, and to identify its association with different cardiovascular risk factors. A cross sectional study was conducted that included males of 65-80 years (n=320) in a rural population of the province of Ciudad Real, Spain. The dependent variable was the presence or not of AAA using ultrasound measurements of the aorta. Those with a diameter greater than or equal to 3cm were considered positive. Explanatory variables were measured; ankle/brachial index (ABI), body mass index (BMI), medical history of high blood pressure (hypertension), diabetes mellitus (DM), dyslipidaemia (DLP), ischemic heart disease, cerebrovascular accidents (CVA), and smoking habits. A bivariate and multivariate analysis of the prevalences was performed, as well as a study of the agreement between observers. The prevalence of AAA in the population was 3.3% (95% CI: 1.1-5.5%. DM and DLP were significantly associated with AAA. The agreement between observers was 0.96 (95% CI; 0.91-0.98). The high prevalence of different cardiovascular risk factors (CVRF) was particularly noteworthy. The prevalence of AAA in 65-80 year-old males in a rural population is similar to that found in the literature. Due to the cross-sectional nature of the study, CVRFs such as hypertension or CVA were not associated with the AAA. A screening program for the early detection of AAA could be introduced into Primary Health Care by family physicians. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  14. Morbidity and disability in 75- and 80-year-old men and women. A five-year follow-up.

    PubMed

    Laukkanen, P; Sakari-Rantala, R; Kauppinen, M; Heikkinen, E

    1997-01-01

    Purpose of this report is to describe the changes that occurred in morbidity, symptoms of illness and disability of 75- and 80-year-old residents of Jyväskylä, Finland, over a five-year period. The study population consisted of the elderly residents of the city of Jyväskylä in central Finland who were born in 1914 and 1910. At baseline (in 1989 and 1990), 355 (92.9%) persons from the younger age group and 262 (91.9%) from the older age group were interviewed and 311 (81.4%) and 230 (80.7%), respectively, took part in the physical examination. At follow-up (in 1994 and 1995), the corresponding numbers were 250 (93.3%) and 148 (88.6%) for the interviews and 217 (81.0%) and 127 (76.0%) for the physical examinations. The prevalence of chronic conditions was determined in connection with the medical examinations on the basis of self-report and the respondent's prescriptions and medical information cards. To measure the occurrence of symptoms, the respondents were asked whether during the past 14 days they had suffered from any of 17 listed symptoms. Functional capacity was assessed in connection with the interview carried out at the respondent's home in terms of needing help in activities of daily living (ADL). In the baseline examinations, subjects were found to have on average 2-3 diseases. During the follow-up the number of diseases and the proportion of people with co-morbidity increased in both age groups. Both men and women had on average 1-2 symptoms that caused them much trouble, and the number of such symptoms increased to some extent during the follow-up. The proportions of those needing help increased during the follow-up in all groups and the increase was most prominent among the women of the older age group. Of those who managed independently with physical ADL (PADL) at baseline, 14.9%-44.9% reported need of help in at least one task at follow-up. The need for help in PADL was greatest with cutting toe-nails, negotiating stairs, moving outdoors, washing

  15. 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.

  16. Assessment of the relationship between the mandibular cortex on panoramic radiographs and the risk of bone fracture and vascular disease in 80-year-olds.

    PubMed

    Okabe, Sachiko; Morimoto, Yasuhiro; Ansai, Toshihiro; Yoshioka, Izumi; Tanaka, Tatsurou; Taguchi, Akira; Kito, Shinji; Wakasugi-Sato, Nao; Oda, Masafumi; Kuroiwa, Hirohito; Ohba, Takeshi; Awano, Shuji; Takata, Yutaka; Takehara, Tadamichi

    2008-09-01

    The objective of this study was to assess cortical measurements on panoramic radiographs in 80-year-old subjects to predict bone fracture and vascular disease risks. The cortical width and shape (normal cortex, mildly to moderately eroded cortex, and severely eroded cortex) were evaluated on 659 panoramic radiographs obtained from 262 men and 397 women, all of whom were 80 years old. At baseline, a general medical examination, including heel bone density, was performed in all subjects. Fractures and vascular disease occurring within 5 years after the baseline examination were determined in 191 subjects and in 108 subjects who died within 5 years after the baseline examination. There were significant correlations between heel bone density and cortical width (r = 0.435, P < .001) and shape (r = 0.231, P < .001). However, cortical measurements on panoramic radiographs were not significantly associated with the occurrence of fractures and vascular disease within 5 years after the baseline examination. Among the elderly, cortical measurements on panoramic radiographs may be associated with bone mineral density and physical activity, but they are not useful markers for the subsequent occurrence of fractures and vascular disease.

  17. Nutritional screening in community dwelling older adults.

    PubMed

    Callen, Bonnie L

    2011-12-01

    The purpose of this study was to test whether a combination of validated tools, one for each of five leading nutritional risk factors, could predict unintentional weight loss in community dwelling older adults. Non-invasive, easily administered nutritional screening tools for community dwelling older adults are few and those that are available are problematic. Convenience samples of 115 adults ≥65 were interviewed. Height, weight and measures of the five nutritional risk factors were collected at interviews 6 months apart. Repeated measures. 91 subjects completing T2 were largely white (95.6%), female (69%), well educated and in good health. Multiple regression was conducted with unintentional weight loss as the dependent variable and depression (the GDS-SF), the Lubben Social Networking Scale, food security, food intake and Independent Activities of Daily Living as the predictor variables. The regression model was statistically significant (F (5, 85) = 0.30852, P = 0.003) with an adjusted r(2) of 0.137. Five validated tools can be administered by nurses or non-professionals to screen for nutritional risk factors leading to unintentional weight loss. Early screening has the potential to identify either nutritional risk or nutritional decline in older adults. © 2010 Blackwell Publishing Ltd.

  18. Spatiotemporal and variability gait data in community-dwelling elderly women from Brazil.

    PubMed

    Kirkwood, Renata N; Gomes, Henrique A; Sampaio, Rosana F; Furtado, Sheyla R C; Moreira, Bruno S

    2016-03-22

    Background Gait is an extremely complex motor task; therefore, gait data should encompass as many gait parameters as possible. Objective To provide reference values for gait measurements obtained from a Brazilian group of community-dwelling elderly females between the ages of 65 and 89 years and to apply the PCA-biplot to yield insight into different walking strategies that might occur during the aging process. Method 305 elderly community-dwelling females living in Brazil were stratified into four age groups: 65-69 years (N=103); 70-74 years (N=95); 75-79 years (N=77); and ≥80 years (N=30). Age, height, and BMI were assessed to describe the characteristics of the groups. Gait spatiotemporal and variability data were obtained using the GAITRite® system. Principal component analysis, followed by MANOVA and the PCA-biplot approach were used to analyze the data. Results 95% CI showed that only three components - rhythm, variability, and support - together explained 74.2% of the total variance in gait that were different among the groups. The older groups (75-79 and ≥80 years) walked with lower than average velocity, cadence, and step length and were above average for the variables stance, step, swing, and double support time and the ≥80 year old group presented the highest gait variability compared to the other groups. Conclusion Aging is associated with decreased gait velocity and cadence and increased stance, step time, and variability, but not associated with changes in base of support. In addition, the PCA-biplot indicates a decline towards decreased rhythm and increased variability with aging.

  19. 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

  20. "Yubi-wakka" (finger-ring) test: A practical self-screening method for sarcopenia, and a predictor of disability and mortality among Japanese community-dwelling older adults.

    PubMed

    Tanaka, Tomoki; Takahashi, Kyo; Akishita, Masahiro; Tsuji, Tetsuo; Iijima, Katsuya

    2017-09-12

    We developed a simple self-screening method, the "Yubi-wakka (finger-ring)" test to assess sarcopenia swiftly. This prospective cohort study aimed to examine the validity of this test as a practical method among community-dwelling older adults for identifying sarcopenia, and for predicting disability and mortality. We followed 1904 older adults, and analyzed associations between this "Yubi-wakka" test result at baseline in 2012 and sarcopenia at baseline, new-onset sarcopenia followed until 2014, and new-certification for the long-term care insurance and mortality followed until 2016. The "Yubi-wakka" test checks whether the maximum non-dominant calf circumference is bigger than the individual's own finger-ring circumference, which is formed by the thumb and forefinger of both hands. We divided participants into three groups, "bigger," "just fits" and "smaller" based on a comparison between the calf and finger-ring circumference. Of 1904 participants (mean age 72.8 ± 5.4 years), 53% were grouped as "bigger," 33% were in "just fits" and 14% were in "smaller." Relative to "bigger," the test results statistically associated with sarcopenia ("just fits" OR 2.4, 95% CI 1.4-4.1 and "smaller" OR 6.6, 95% CI 3.5-13), by multivariate analyses. The test results also increased the risk of new-onset sarcopenia ("just fits" HR 2.1, 95% CI 1.2-3.8 and "smaller" HR 3.4, 95% CI 1.8-6.4). Furthermore, the "smaller" had 2.0- and 3.2-fold increased risks for needing long-term care insurance services and mortality, respectively. The "Yubi-wakka" test is an extremely practical method to identify older adults at risk of sarcopenia, disability and mortality. This test might contribute to increased primary prevention for sarcopenia by serving as an early wake-up call for older adults against becoming sarcopenic. Geriatr Gerontol Int 2017; ••: ••-••. © 2017 Japan Geriatrics Society.

  1. Lung stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer in the very elderly (≥80years old): Extremely safe and effective.

    PubMed

    Kreinbrink, Paul; Blumenfeld, Philip; Tolekidis, George; Sen, Neilayan; Sher, David; Marwaha, Gaurav

    2017-09-01

    Stereotactic body radiotherapy (SBRT) for early-stage non-small-cell lung cancer (NSCLC) is the standard of care in medically inoperable patients. In very elderly patients, previous studies have shown SBRT to offer excellent local control, though with higher toxicities than in younger populations. We report our institutional experience using SBRT in the definitive management of NSCLC in patients ≥80years old. Using an IRB-approved registry of 158 patients treated with definitive-intent lung SBRT for early-stage NSCLC at our institution between 2010 and 2016, 31 consecutively treated patients ≥80years of age were identified. CTCAEv4 scales were prospectively recorded during follow-ups and utilized for toxicity assessments. Kaplan-Meier estimates were utilized for survival analyses. For the 31 patients (with 34 lesions) included, median age was 83 (R: 80-93), median ECOG performance status was 2 (R: 0-3), and median follow-up was 15.8months (R: 3.1-48.3). Median PTV size was 24.0cm(3) (R: 5.83-62.1cm(3)). Median prescription dose was 54Gy in 3 fractions (R: 50-60Gy in 3-8 fractions). Local control was 100% at 1year and 92.3% at 2years. Median survival was 29.1months. There were no grade 2-5 toxicities. Grade 1 toxicities included: fatigue in 5 patients (16.1%), asymptomatic (radiographic) pneumonitis in 12 (38.7%), and dyspnea in 2 (6.5%). Lung SBRT with a BED of ≥100Gy10 for very elderly patients with NSCLC is extremely safe and effective, with inordinately low toxicity rates (zero grade 2-5 toxicities). With stringent dosimetric parameters and planning guidelines, patients ≥80years remain excellent candidates for full-dose SBRT. SBRT for early-stage NSCLC is the accepted standard of care in medically inoperable patients, though in many very elderly patients, dose is either de-intensified or withheld for concern of toxicity in the setting of advanced age and competing risks. In this study of our very elderly (≥80years old) early-stage NSCLC patients, we

  2. Use of the Konno procedure in an 80-year-old woman with aortic stenosis, a narrow left ventricular outflow tract, and a small aortic annulus.

    PubMed

    Misumi, Hiroyasu; Katayama, Yukihiro; Takaji, Kentaro; Oshitomi, Takashi; Uesugi, Hideyuki; Hirayama, Touitsu; Takeuchi, Takamasa

    2014-01-01

    This report describes a technique for repairing an aortic stenosis in an elderly patient with a small aortic annulus and a narrow left ventricular outflow tract. Preoperative echocardiography in an 80-year-old woman showed severe aortic stenosis with a narrow outflow tract: the aortic valve area was 0.48 cm(2), the aortic annular diameter was 14 mm, and the left ventricular outflow tract diameter was 14 mm. The Konno procedure was used to enlarge both the small aortic annulus and the left ventricular outflow tract, and a 19-mm Carpentier-Edwards bioprosthetic valve was implanted. The patient's postoperative course was uneventful. The left ventricular mass decreased from a preoperative value of 236 g to 96 g, 3 years after surgery. Only a few reports have described the use of the Konno operation in adult patients. In the present case, the Konno operation was demonstrated to be a good option for aortic stenosis accompanied by a small aortic annulus and a narrow left ventricular outflow tract, even in an elderly patient.

  3. Validation of a pre-coded food diary used among 60-80 year old men: comparison of self-reported energy intake with objectively recorded energy expenditure.

    PubMed

    Stea, Tonje H; Andersen, Lene F; Paulsen, Gøran; Hetlelid, Ken J; Lohne-Seiler, Hilde; Adnanes, Svanhild; Bjørnsen, Thomas; Salvesen, Svein; Berntsen, Sveinung

    2014-01-01

    To validate energy intake (EI) estimated from a pre-coded food diary (PFD) against energy expenditure (EE) measured with a valid physical activity monitor (SenseWear Pro3 Armband) and to evaluate whether misreporting was associated with overweight/obesity in a group of elderly men. Forty-seven healthy Norwegian men, 60-80 years old, completed the study. As this study was part of a larger intervention study, cross-sectional data were collected at both baseline and post-test. Participants recorded their food intake for four consecutive days using food diaries and wore SenseWear Pro3 Armband (SWA) during the same period. Only participants with complete data sets at both baseline and post-test were included in the study. The group average EI was 17% lower at baseline and 18% lower at post-test compared to measured EE. Mean difference from Bland-Altman plot for EI and EE was -1.5 MJ/day (±1.96 SD: -7.0, 4.0 MJ/day) at baseline and -1.6 MJ/day (-6.6, 3.4 MJ/day) at post-test. The intraclass correlation coefficient (ICC) was 0.30 (95% CI: 0.02, 0.54, p = 0.018) at baseline and 0.34 (0.06, 0.57, p = 0.009) at post-test. Higher values of underreporting was shown among overweight/obese compared to normal weight participants at both baseline and post-test (p≤ 0.001), respectively. The results indicate that the PFD could be a useful tool for estimating energy intake in normal weight elderly men. On the other hand, the PFD seems to be less suitable for estimating energy intake in overweight/obese elderly men.

  4. Age-specific risk factors for incident disability in activities of daily living among middle-aged and elderly community-dwelling Japanese women during an 8-9-year follow up: The Hizen-Oshima study.

    PubMed

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

    2017-07-01

    The purposes of the present study were to investigate risk factors for incident disability in activities of daily living (ADL) among middle-aged and older women, and to determine whether there are differences in risk factors according to age groups. The participants were 264 Japanese women aged 40 years and older. A self-administered questionnaire was used to survey participants about difficulty in carrying out selected basic and instrumental ADL at baseline and at follow up. ADL disability was defined as difficulty carrying out three or more ADL. Information on knee joint or back pain and comorbidities (heart disease, lung disease, stroke or diabetes mellitus) was obtained using a self-administered questionnaire at baseline. Physical performance measurements (grip strength, chair stand time, rapid walking speed and functional reach) were also carried out at baseline. The prevalence of incident ADL disability was 44 (27.5%) in women aged 40-64 years, and 57 (54.8%) in women aged ≥65 years (P < 0.001). Multiple logistic regression analysis showed that decreased grip strength and having pain were significantly associated with a higher risk for incident ADL disability among women aged 40-64 years. For women aged ≥65 years, decreased rapid walking speed, having a comorbidity and having pain were associated with incident ADL disability. The present study showed that a different set of risk factors was associated with incident ADL disability among women aged 40-64 years and women aged ≥65 years. Age-specific screening and intervention strategies are necessary for effective prevention of incident ADL disability. Geriatr Gerontol Int 2017; 17: 1096-1101. © 2016 Japan Geriatrics Society.

  5. 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…

  6. Proactive Coping in Community-Dwelling Older Australians

    ERIC Educational Resources Information Center

    Sougleris, Christina; Ranzijn, Rob

    2011-01-01

    This article reports on a study of older community-dwelling Australian adults which aimed to test whether a relatively unexplored construct, proactive coping, could have a role in purpose in life, personal growth, and life satisfaction. A total of 109 women and 115 men (Mean age = 75.04 yrs, SD = 6.66) completed a questionnaire containing…

  7. 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…

  8. 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…

  9. Proactive Coping in Community-Dwelling Older Australians

    ERIC Educational Resources Information Center

    Sougleris, Christina; Ranzijn, Rob

    2011-01-01

    This article reports on a study of older community-dwelling Australian adults which aimed to test whether a relatively unexplored construct, proactive coping, could have a role in purpose in life, personal growth, and life satisfaction. A total of 109 women and 115 men (Mean age = 75.04 yrs, SD = 6.66) completed a questionnaire containing…

  10. 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

  11. Sarcopenic indices in community-dwelling older adults

    PubMed Central

    Merriwether, Ericka N.; Host, Helen H.; Sinacore, David R.

    2011-01-01

    Background Sarcopenic indices are used to estimate loss of skeletal lean mass and function, and to determine the prevalence of sarcopenia in older adults. It is believed that older women and men with lower skeletal lean mass will be weaker and have more functional limitations. Purpose 1) To classify community-dwelling older adults using two common sarcopenic indices: appendicular lean mass/height2 (ALM/ht2) and skeletal muscle index (SMI), and 2) to determine each indices value as indicators of lower extremity strength and physical function. Methods The sample consisted of 154 community-dwelling older adults (111 women, 43 men; mean age=82.4 SD=3.6 years; mean BMI=25.8 SD=4.4 kg/m2). Each underwent whole-body dual-energy x-ray absorptiometry (DXA) to assess lean mass. The 9-item modified physical performance test (PPT) and s elf-selected walking speed were used to evaluate function. Lower extremity strength was measured bilaterally using isokinetic dynamometry. Results The ALM/ht2 index classified 75 participants (49%) as sarcopenic (SP) and 79 (51%) as non-sarcopenic (NSP). The SMI classified 129 participants (84%) as SP and 25 (16%) as NSP. There were no differences in functional measures between groups by gender using either index after classification. The ALM/ht2 index was more strongly correlated with peak torque of all lower extremity muscle groups (r=.276–.487) compared with the SMI (r=.103–.344). There was no relationship between either sarcopenic index and physical function. Discussion There were marked differences in how two sarcopenic indices classified community-dwelling older adults. Lower extremity strength was lower in older women classified as sarcopenic compared to non-sarcopenic using the ALM/ht2 index, but LE strength was not different in older men. However, no lower extremity strength differences were observed between sarcopenic and non-sarcopenic men or women using the SMI classification. Neither sarcopenic index uniformly identified

  12. Toward a conceptual definition of frail community dwelling older people.

    PubMed

    Gobbens, Robbert J; Luijkx, Katrien G; Wijnen-Sponselee, Maria T; Schols, Jos M

    2010-01-01

    In order to be able to identify frail community-dwelling older people, a reliable and valid definition of the concept of frailty is necessary. The aim of this study was to provide an overview of the literature on conceptual and operational definitions of frailty, and to determine which definitions are most appropriate for identifying frail community-dwelling older people. Therefore, a computerized search was performed in the PubMed database, Web of Science and PsychInfo. A successful definition of frailty reflects a multidimensional approach, makes clear its dynamic state, predicts adverse outcomes, does not include disease, comorbidity or disability, and meets the criterion of practicability. None of the current conceptual and operational definitions meet these criteria. In this article a new integral conceptual definition of frailty is proposed which meets the criteria of a successful definition. Copyright 2010 Mosby, Inc. All rights reserved.

  13. Exercise and Sleep in Community-Dwelling Older Adults

    PubMed Central

    Li, Junxin; Gooneratne, Nalaka

    2016-01-01

    Insomnia and other sleep complaints are highly prevalent in community-dwelling older adults yet often go under detected. Age-related physiological changes may affect sleep, but sleep disturbances and complaints should not be considered normal in this population. Various physiological, psychological, and social consequences have been associated with insomnia and sleep complaints. Treatment options are available so it is imperative to diagnose and treat these individuals to promote healthy aging. Exercise is known to have a wide variety of health benefits, but unfortunately most older adults engage in less exercise with advancing age. This paper describes age-related changes in sleep, clinical correlates of insomnia, consequences of untreated insomnia, and nonpharmacological treatments for insomnia in older adults, with a focus on the relationship between exercise and sleep in community-dwelling older adults with insomnia or sleep complaints. Possible mechanisms explaining the relationship between exercise and sleep are discussed. While the research to date shows promising evidence for exercise as a safe and effective treatment for insomnia and sleep complaints in community-dwelling older adults, future research is needed before exercise can be a first-line treatment for insomnia and sleep complaints in this population. PMID:27088071

  14. Increased gait unsteadiness in community-dwelling elderly fallers

    NASA Technical Reports Server (NTRS)

    Hausdorff, J. M.; Edelberg, H. K.; Mitchell, S. L.; Goldberger, A. L.; Wei, J. Y.

    1997-01-01

    OBJECTIVE: To test the hypothesis that quantitative measures of gait unsteadiness are increased in community-dwelling elderly fallers. STUDY DESIGN: Retrospective, case-control study. SETTING: General community. PARTICIPANTS: Thirty-five community-dwelling elderly subjects older than 70 years of age who were capable of ambulating independently for 6 minutes were categorized as fallers (age, 82.2 +/- 4.9 yrs [mean +/- SD]; n = 18) and nonfallers (age, 76.5 +/- 4.0 yrs; n = 17) based on history; 22 young (age, 24.6 +/- 1.9 yrs), healthy subjects also participated as a second reference group. MAIN OUTCOME MEASURES: Stride-to-stride variability (standard deviation and coefficient of variation) of stride time, stance time, swing time, and percent stance time measured during a 6-minute walk. RESULTS: All measures of gait variability were significantly greater in the elderly fallers compared with both the elderly nonfallers and the young subjects (p < .0002). In contrast, walking speed of the elderly fallers was similar to that of the nonfallers. There were little or no differences in the variability measures of the elderly nonfallers compared with the young subjects. CONCLUSIONS: Stride-to-stride temporal variations of gait are relatively unchanged in community-dwelling elderly nonfallers, but are significantly increased in elderly fallers. Quantitative measurement of gait unsteadiness may be useful in assessing fall risk in the elderly.

  15. Increased gait unsteadiness in community-dwelling elderly fallers

    NASA Technical Reports Server (NTRS)

    Hausdorff, J. M.; Edelberg, H. K.; Mitchell, S. L.; Goldberger, A. L.; Wei, J. Y.

    1997-01-01

    OBJECTIVE: To test the hypothesis that quantitative measures of gait unsteadiness are increased in community-dwelling elderly fallers. STUDY DESIGN: Retrospective, case-control study. SETTING: General community. PARTICIPANTS: Thirty-five community-dwelling elderly subjects older than 70 years of age who were capable of ambulating independently for 6 minutes were categorized as fallers (age, 82.2 +/- 4.9 yrs [mean +/- SD]; n = 18) and nonfallers (age, 76.5 +/- 4.0 yrs; n = 17) based on history; 22 young (age, 24.6 +/- 1.9 yrs), healthy subjects also participated as a second reference group. MAIN OUTCOME MEASURES: Stride-to-stride variability (standard deviation and coefficient of variation) of stride time, stance time, swing time, and percent stance time measured during a 6-minute walk. RESULTS: All measures of gait variability were significantly greater in the elderly fallers compared with both the elderly nonfallers and the young subjects (p < .0002). In contrast, walking speed of the elderly fallers was similar to that of the nonfallers. There were little or no differences in the variability measures of the elderly nonfallers compared with the young subjects. CONCLUSIONS: Stride-to-stride temporal variations of gait are relatively unchanged in community-dwelling elderly nonfallers, but are significantly increased in elderly fallers. Quantitative measurement of gait unsteadiness may be useful in assessing fall risk in the elderly.

  16. Bobble-head doll syndrome in an 80-year-old man, associated with a giant arachnoid cyst of the lamina quadrigemina, treated with endoscopic ventriculocystocisternotomy and cystoperitoneal shunt.

    PubMed

    Olvera-Castro, Jorge Octavio; Morales-Briceño, Hugo; Sandoval-Bonilla, Bayron; Gallardo-Ceja, David; Venegas-Cruz, Miguel Angel; Estrada-Estrada, Eric Misael; Contreras-Mota, Marisol; Guinto-Balanzar, Gerardo; Garcia-Lopez, Rabindranath

    2017-08-01

    Bobble-head doll syndrome (BHDS) is a rare entity, characterized by antero-posterior head bobbing, which is of the type "yes-yes." Less frequently, having a head movement of the type "no-no" is described. We report an unusual case of an 80-year-old man with a cystic mass of the lamina quadrigemina, extending to the posterior fossa. We conclude that ventriculocystocisternotomy associated with a cystoperitoneal shunt is an effective treatment for a symptomatic giant arachnoid cyst in the lamina quadrigemina.

  17. Social Frailty in Community-Dwelling Older Adults as a Risk Factor for Disability.

    PubMed

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

    2015-11-01

    To determine social frailty status using simple questions and to examine the association between social frailty and disability onset among community-dwelling older adults. Prospective cohort study. Japanese community. A total of 4304 adults age ≥65 years living in the community participated in a baseline assessment from 2011 to 2012. They were followed monthly for incident certification of care needs during the 2 years after the baseline assessment. Care-needs certification in the national long-term care insurance system of Japan; a self-reported questionnaire including 7 items to define social frailty status, adjustment for several potential confounders such as demographic characteristics; and Kaplan-Meier survival curves for disability incidence by social frailty. During the 2 years, 144 participants (3.3%) were certified as requiring long-term care insurance in accordance with incident disability. Five of the 7 items in the self-reported questionnaire were significantly associated with disability incidence. In the adjusted model including potential covariates, participants who were defined as having social frailty (≥2/5) (hazard ratio 1.66, 95% confidence interval 1.00-2.74) and prefrailty (=1/5) (hazard ratio 1.53, 95% confidence interval 1.02-2.531), based on 5 items at the baseline assessment, had an increased risk of disability compared with nonfrail participants (=0/5). Social frailty, assessed using simple questions regarding living alone, going out less frequently compared with the prior year, visiting friends sometimes, feeling helpful to friends or family, and talking with someone every day, has a strong impact on the risk of future disability among community-dwelling older people. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  18. Impact of physical frailty on disability in community-dwelling older adults: a prospective cohort study

    PubMed Central

    Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Tsutsumimoto, Kota; Suzuki, Takao

    2015-01-01

    Objective To examine the relationship between physical frailty and risk of disability, and to identify the component(s) of frailty with the most impact on disability in community-dwelling older adults. Design Prospective cohort study. Setting A Japanese community. Participants 4341 older adults aged ≥65 living in the community participated in a baseline assessment from 2011 to 2012 and were followed for 2 years. Main outcome measures Care-needs certification in the national long-term care insurance (LTCI) system of Japan, type of physical frailty (robust, prefrail, frail) and subitems (slowness, weakness, exhaustion, low activity, weight loss), adjusted for several potential confounders such as demographic characteristics, analysed with Kaplan-Meier survival curves for incidence of disability by frailty phenotype. Results During the 2-year follow-up period, 168 participants (3.9%) began using the LTCI system for incidence of disability. Participants classified as frail (HR 4.65, 95% CI 2.63 to 8.22) or prefrail (2.52, 1.56 to 4.07) at the baseline assessment had an increased risk of disability incidence compared with robust participants. Analyses for subitems of frailty showed that slowness (2.32, 1.62 to 3.33), weakness (1.90, 1.35 to 2.68) and weight loss (1.61, 1.13 to 2.31) were related to increased risk of disability incidence. In stratified analyses, participants who were classified as frail and who had lower cognitive function had the highest percentage (30.3%) of disability incidence during the 2 years after baseline assessment. Conclusions Physical frailty, even being prefrail, had a strong impact on the risk of future disability. Some components of frailty, such as slowness, weakness and weight loss, are strongly associated with incident disability in community-dwelling older adults. PMID:26338685

  19. Standing from the Floor in Community-Dwelling Older Adults.

    PubMed

    Klima, Dennis Wayne; Anderson, Catherine; Samrah, Dina; Patel, Dipal; Chui, Kevin; Newton, Roberta

    2016-04-01

    While considerable research has targeted physical performance in older adults, less is known about the ability to rise from the floor among community-dwelling elders. The purposes of the study were to (1) examine physical performance correlates of timed supine to stand performance and (2) identify the predominant motor pattern used to complete floor rise. Fifty-three community-dwelling adults over the age of 60 (x = 78.5 ± 8.5; 36 [68%] females) performed a timed supine to stand test and physical performance assessments. Forty-eight subjects (90.6%) demonstrated an initial roll with asymmetrical squat sequence when rising to stand. Supine to stand performance time was significantly correlated with all physical performance tests, including gait speed (r = -.61; p < .001), grip strength (r = -.30; p < .05), and Timed Up and Go (TUG) performance (r = .71; p < .001). Forty-eight percent of the variance in rise time (p < .001) was attributed to TUG velocity. Findings serve to enhance both functional performance assessment and floor rise interventions.

  20. [Cardiac rehabilitation: beyond 80 year-old?].

    PubMed

    Sandu-Marinescu, O; Falconnet, C; Saber, H; Ellegaard, B; Perrenoud, J J

    2005-11-02

    The prevalence of heart failure increases with age. Although the benefit of cardiac rehabilitation has been well demonstrated, in particular for what concerns improved effort tolerance, data in the geriatric population is scarce. A supervised inpatient cardiac rehabilitation program has started in September 2004 at the Hôpital de gériatrie in Geneva. By March 2005, 34 out of 50 participants (mean age of 87 years) had completed the program. The results showed a significant increase in the distance walked at the 6-minute test (+ 68,5 m, P<0,001) and a decreased level of anxiety that facilitated the return home. It will be necessary to evaluate the impact of these encouraging results on the readmission rate and on the longterm functional capacity.

  1. Sarcopenia: Prevalence and associated factors based on different suggested definitions in community-dwelling older adults.

    PubMed

    Kim, Hunkyung; Hirano, Hirohiko; Edahiro, Ayako; Ohara, Yuki; Watanabe, Yutaka; Kojima, Narumi; Kim, Miji; Hosoi, Erika; Yoshida, Yuko; Yoshida, Hideyo; Shinkai, Shoji

    2016-03-01

    The age-related loss of muscle mass and/or strength and performance, sarcopenia, has been associated with geriatric syndromes, morbidity and mortality. Although sarcopenia has been researched for many years, currently there is a lack of consensus on its definition. Some studies define sarcopenia as low muscle mass alone, whereas other studies have recently combined low muscle mass, strength and physical performance suggested by the European Working Group on Sarcopenia in Older People, as well as the Asian Working Group for Sarcopenia. The arbitrary use of various available sarcopenia definitions within the literature can cause discrepancies in the prevalence and associated risk factors. The application of population-specific cut-off values in any sample population can be problematic, particularly among different ethnicities. Using commonly used cut-off points to define sarcopenia, including solely muscle mass and combined definitions, on a community-dwelling elderly Japanese population, the prevalence of sarcopenia ranged from 2.5 to 28.0% in men and 2.3 to 11.7% in women, with muscle mass measured by dual-energy X-ray absorptiometry, and 7.1-98.0% in men and 19.8-88.0% in women measured by bioelectrical impedance analysis. Body mass index was the most prominent related factor for sarcopenia across the definitions in this Japanese sample. However, other associated hematological and chronic condition factors varied depending on the definition.

  2. A Randomized, Double-Blind, Placebo-Controlled Phase II Trial Investigating the Safety and Immunogenicity of Modified Vaccinia Ankara Smallpox Vaccine (MVA-BN®) in 56-80-Year-Old Subjects

    PubMed Central

    Greenberg, Richard N.; Hay, Christine M.; Stapleton, Jack T.; Marbury, Thomas C.; Wagner, Eva; Kreitmeir, Eva; von Krempelhuber, Alfred; Young, Philip; Nichols, Richard; Meyer, Thomas P.; Weigl, Josef; Virgin, Garth; Arndtz-Wiedemann, Nathaly; Chaplin, Paul

    2016-01-01

    Background Modified Vaccinia Ankara MVA-BN® is a live, highly attenuated, viral vaccine under advanced development as a non-replicating smallpox vaccine. In this Phase II trial, the safety and immunogenicity of Modified Vaccinia Ankara MVA-BN® (MVA) was assessed in a 56–80 years old population. Methods MVA with a virus titer of 1 x 108 TCID50/dose was administered via subcutaneous injection to 56–80 year old vaccinia-experienced subjects (N = 120). Subjects received either two injections of MVA (MM group) or one injection of Placebo and one injection of MVA (PM group) four weeks apart. Safety was evaluated by assessment of adverse events (AE), focused physical exams, electrocardiogram recordings and safety laboratories. Solicited AEs consisted of a set of pre-defined expected local reactions (erythema, swelling, pain, pruritus, and induration) and systemic symptoms (body temperature, headache, myalgia, nausea and fatigue) and were recorded on a memory aid for an 8-day period following each injection. The immunogenicity of the vaccine was evaluated in terms of humoral immune responses measured with a vaccinia-specific enzyme-linked immunosorbent assay (ELISA) and a plaque reduction neutralization test (PRNT) before and at different time points after vaccination. Results Vaccinations were well tolerated by all subjects. No serious adverse event related to MVA and no case of myopericarditis was reported. The overall incidence of unsolicited AEs was similar in both groups. For both groups immunogenicity responses two weeks after the final vaccination (i.e. Visit 4) were as follows: Seroconversion (SC) rates (doubling of titers from baseline) in vaccine specific antibody titers measured by ELISA were 83.3% in Group MM and 82.8% in Group PM (difference 0.6% with 95% exact CI [-13.8%, 15.0%]), and 90.0% for Group MM and 77.6% for Group PM measured by PRNT (difference 12.4% with 95% CI of [-1.1%, 27.0%]). Geometric mean titers (GMT) measured by ELISA two weeks after

  3. 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…

  4. 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…

  5. Dressing and grooming: preferences of community-dwelling older adults.

    PubMed

    Cohen-Mansfield, Jiska; Jensen, Barbara

    2007-02-01

    This study explored dressing and grooming habits and preferences of older adults. Fifty-eight community-dwelling older persons (mean age = 80 years) in suburban Maryland responded to the Self-maintenance Habits and Preferences in Elderly (SHAPE) questionnaire. There was a large variability in preferences, and all items were very important for at least some of the participants. Women attributed higher levels of importance to dressing and grooming than did men. Importance ratings increased with level of education and were higher for unmarried persons, but were not related to age or need for assistance with instrumental activities of daily living (IADLs). On an individual basis, this information can be used to suggest items for interventions or to structure a personal care environment. Alternately, it can be used in the aggregate as a guideline for designing programs of care to reflect the preferences of a majority of older persons.

  6. Sarcopenia as a Risk Factor for Cognitive Deterioration in Community-Dwelling Older Adults: A 1-Year Prospective Study.

    PubMed

    Nishiguchi, Shu; Yamada, Minoru; Shirooka, Hidehiko; Nozaki, Yuma; Fukutani, Naoto; Tashiro, Yuto; Hirata, Hinako; Yamaguchi, Moe; Tasaka, Seishiro; Matsushita, Tomofumi; Matsubara, Keisuke; Tsuboyama, Tadao; Aoyama, Tomoki

    2016-04-01

    The purpose of this 1-year prospective study was to determine whether sarcopenia is an independent risk factor of cognitive deterioration in community-dwelling older adults. One-year prospective study. Japanese community. A total of 131 community-dwelling older adults aged 65 years and older participated in this study. We defined sarcopenia using the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia, and the participants were classified into the sarcopenia and normal groups according to this definition. The participants' cognitive functions were assessed using the Mini-Mental State Examination (MMSE) during pre- and postdata collection (after 1 year). The rate of change in pre- and post-MMSE scores during the follow-up term was significantly different between the 2 groups (normal group, -0.32 ± 8.39%; sarcopenia group, -5.86 ± 5.16%; P = .002). The analysis of covariance, adjusted for demographic data and the pre-MMSE scores, showed a significant change in the MMSE scores between the normal and sarcopenia group (F = 9.30, P = .003). Furthermore, in the multivariate logistic regression analysis, the cognitive function was significantly more likely to deteriorate (defined as a loss of at least 2 points of MMSE) in the sarcopenia group during the follow-up term (odds ratio: 7.86, 95% confidence interval: 1.53-40.5). Sarcopenia was identified as an independent risk factor of cognitive deterioration in community-dwelling older adults during the 1-year study period. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  7. 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

  8. Association between sarcopenia and higher-level functional capacity in daily living in community-dwelling elderly subjects in Japan.

    PubMed

    Tanimoto, Yoshimi; Watanabe, Misuzu; Sun, Wei; Sugiura, Yumiko; Tsuda, Yuko; Kimura, Motoshi; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Kono, Koichi

    2012-01-01

    This study aimed to determine the association between sarcopenia, defined by muscle mass, muscle strength, and physical performance, and higher-level functional capacity in community-dwelling Japanese elderly people. Subjects were 1158 elderly, community-dwelling Japanese people aged 65 or older. We used bioelectrical impedance analysis to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance. Sarcopenia was characterized by low muscle mass, plus low muscle strength or low physical performance. Subjects without low muscle mass, low muscle strength, and low physical performance were classified as "normal." Examination of higher-level functional capacity was performed using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The TMIG-IC is a 13-item questionnaire completed by the subject; it contains five questions on self-maintenance and four questions each on intellectual activity and social role. Sarcopenia was identified in 11.3% and 10.7% of men and women, respectively. The percentage of disability for instrumental activities of daily living (IADL) was 39.0% in men with sarcopenia and 30.6% in women with sarcopenia. After adjustment for age, in men, sarcopenia was significantly associated with IADL disability compared with intermediate and normal subjects. In women, sarcopenia was significantly associated with every subscale of the TMIG-IC disability compared with intermediate and normal subjects. This study revealed that sarcopenia, defined by muscle mass, muscle strength, and physical performance, had a significant association with disability in higher-level functional capacity in elderly Japanese subjects. Interventions to prevent sarcopenia may prevent higher-level functional disability among elderly people. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Tofu intake is associated with poor cognitive performance among community-dwelling elderly in China.

    PubMed

    Xu, Xin; Xiao, Shifu; Rahardjo, Tri Budi; Hogervorst, Eef

    2015-01-01

    Tofu is a soy product which is commonly consumed in Asian countries, such as China and Indonesia. Several studies found negative associations of high tofu consumption with cognitive function in older Asian populations. However, the effect of tofu on cognitive function remains disputed as it was not found in Western populations. In the present study, the effect of weekly tofu intake on cognitive performance was investigated in an observational cross sectional study of 517 Chinese elderly from Shanghai. Similar to earlier studies, results showed that a higher weekly intake of tofu was associated with worse memory performance using the Hopkins Verbal Learning Test (β = -0.10, p = 0.01) after controlling for age, gender, education, being vegetarian, and weekly intake of fruit/juice, green vegetables, and orange/red vegetables. Furthermore, among older elderly (≥68 years of age), high tofu intake increased the risk of cognitive impairment indicative of dementia (OR = 1.27, 95% CI = 0.99-1.64, p = 0.04), after adjusting for all covariates. Consumption of meat and green vegetables independently also reduced risk of dementia. To conclude, high intake of tofu was negatively related to cognitive performance among community-dwelling elderly in China. Similar findings were reported in Indonesia and in Japanese Americans in the US. These findings suggest that the effect of tofu on cognition in elderly should be further investigated.

  10. Documentation of Advance Care Planning for Community-Dwelling Elders

    PubMed Central

    Yung, Victoria Y.; Walling, Anne M.; Min, Lillian; Wenger, Neil S.

    2010-01-01

    Abstract Background Advance planning for end-of-life care has gained acceptance, but actual end-of-life care is often incongruent with patients' previously stated goals. We assessed the flow of advance care planning information from patients to medical records in a community sample of older adults to better understand why advance care planning is not more successful. Methods Our study used structured interview and medical record data from community-dwelling older patients in two previous studies: Assessing Care of Vulnerable Elders (ACOVE)-1 (245 patients age ≥65 years and screened for high risk of death/functional decline in 1998–1999) and ACOVE-2 (566 patients age ≥75 who screened positive for falls/mobility disorders, incontinence, and/or dementia in 2002–2003). We compared interview data on patients' preferences, advance directives, and surrogate decision-makers with findings from the medical record. Results In ACOVE-1, 38% of surveyed patients had thought about limiting the aggressiveness of medical care; 24% of surveyed patients stated that they had spoken to their doctor about this. The vast majority of patients (88%–93%) preferred to die rather than remain permanently in a coma, on a ventilator, or tube fed. Regardless of patients' specific preferences, 15%–22% of patients had preference information in their medical record. Among patients who reported that they had completed an advance directive and had given it to their health-care provider, 15% (ACOVE-1) and 47% (ACOVE-2) had advance directive information in the medical record. Among patients who had not completed an advance directive but had given surrogate decision-maker information to their provider, 0% (ACOVE-1) and 16% (ACOVE-2) had documentation of a surrogate decision-maker in the medical record. Conclusions Community-dwelling elders' preferences for end-of-life care are not consistent with documentation in their medical records. Electronic health records and standardized data

  11. 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

  12. Neighborhood Environment and Falls among Community-Dwelling Older Adults.

    PubMed

    Nicklett, Emily Joy; Lohman, Matthew C; Smith, Matthew Lee

    2017-02-10

    Background: Falls present a major challenge to active aging, but the relationship between neighborhood factors and falls is poorly understood. This study examined the relationship between fall events and neighborhood factors, including neighborhood social cohesion (sense of belonging, trust, friendliness, and helpfulness) and physical environment (vandalism/graffiti, rubbish, vacant/deserted houses, and perceived safety walking home at night). Methods: Data were analyzed from 9259 participants over four biennial waves (2006-2012) of the Health and Retirement Study (HRS), a nationally representative sample of adults aged 65 and older in the United States. Results: In models adjusting for demographic and health-related covariates, a one-unit increase in neighborhood social cohesion was associated with 4% lower odds of experiencing a single fall (odds ratio (OR): 0.96, 95% confidence interval (CI): 0.93-0.99) and 6% lower odds of experiencing multiple falls (OR: 0.94, 95% CI: 0.90-0.98). A one-unit increase in the physical environment scale was associated with 4% lower odds of experiencing a single fall (OR: 0.96, 95% CI: 0.93-0.99) and with 5% lower odds of experiencing multiple falls (OR: 0.95, 95% CI: 0.91-1.00) in adjusted models. Conclusions: The physical and social neighborhood environment may affect fall risk among community-dwelling older adults. Findings support the ongoing need for evidence-based fall prevention programming in community and clinical settings.

  13. Analyzing wheelchair mobility patterns of community-dwelling older adults.

    PubMed

    Karmarkar, Amol M; Cooper, Rory A; Wang, Hongwu; Kelleher, Annmarie; Cooper, Rosemarie

    2011-01-01

    This study determined and compared wheelchair mobility patterns for older adults during an organized sporting event and within their community. In July 2008, 39 veterans participating in the 28th National Veterans Wheelchair Games (Omaha, Nebraska) completed the study. Of these, 26 were manual wheelchair and 13 were power wheelchair users. We collected wheelchair-related mobility data using wheelchair data-logging devices. Participants were significantly more active using manual wheelchairs during the games than when using their wheelchairs in their homes in terms of distance traveled (4,466.2 vs 1,367.4 m, p < 0.001) and average speed of propulsion (0.76 vs 0.64 m/s, p < 0.001). The trend was the same for power wheelchair users, with respect to distance (7,306.2 vs 3,450.5 m, p = 0.004) and average speed (0.9 vs 0.7 m/s, p = 0.002). This study demonstrates an objective method of evaluating wheelchair use in community-dwelling older adults.

  14. Gait variability in community dwelling adults with Alzheimer disease.

    PubMed

    Webster, Kate E; Merory, John R; Wittwer, Joanne E

    2006-01-01

    Studies have shown that measures of gait variability are associated with falling in older adults. However, few studies have measured gait variability in people with Alzheimer disease, despite the high incidence of falls in Alzheimer disease. The purpose of this study was to compare gait variability of community-dwelling older adults with Alzheimer disease and control subjects at various walking speeds. Ten subjects with mild-moderate Alzheimer disease and ten matched control subjects underwent gait analysis using an electronic walkway. Participants were required to walk at self-selected slow, preferred, and fast speeds. Stride length and step width variability were determined using the coefficient of variation. Results showed that stride length variability was significantly greater in the Alzheimer disease group compared with the control group at all speeds. In both groups, increases in walking speed were significantly correlated with decreases in stride length variability. Step width variability was significantly reduced in the Alzheimer disease group compared with the control group at slow speed only. In conclusion, there is an increase in stride length variability in Alzheimer disease at all walking speeds that may contribute to the increased incidence of falls in Alzheimer disease.

  15. Measures of Functional Status in Community-Dwelling Elders

    PubMed Central

    Sherman, Scott E.; Reuben, David

    1998-01-01

    OBJECTIVE To evaluate two performance-based measures of functional status and assess their correlation with self-report measures. DESIGN Cross-sectional study. PARTICIPANTS Of the 363 community-dwelling elders enrolled in a trial of comprehensive geriatric assessment who participated, all had at least one of four target conditions (urinary incontinence, depression, impaired functional status, or history of falling). MEASUREMENTS Two performance-based measures, National Institute on Aging (NIA) Battery, and Physical Performance Test (PPT), and three self-report functional status measures, basic and intermediate activities of daily living and the Short-Form-36 (SF–36) physical functioning subscale, were used. Measures of restricted activity days, patient satisfaction and perceived efficacy were also used. MAIN RESULTS All measures were internally consistent. There was a high correlation between the NIA and PPT (κ = 0.71), while correlations between the performance-based and self-report measures ranged from 0.37 to 0.50. When patients with values above the median on the two performance-based measures were compared with those below, there were significant differences (p≤ .0001) for age, number of medications, and the physical function, pain, general health, and physical role function SF-36 subscales. CONCLUSIONS Performance-based measures correlated highly with each other and moderately with questionnaire-based measures. Performance-based measures also had construct validity and did not suffer from floor or ceiling effects. PMID:9844079

  16. 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.

  17. Effects on balance, falls, and bone mineral density of a home-based exercise program without home visits in community-dwelling elderly women: a randomized controlled trial.

    PubMed

    Kamide, Naoto; Shiba, Yoshitaka; Shibata, Hiroshi

    2009-01-01

    The aim of the present study was to investigate the effects of home-based exercise without home visits on physical function, falls, and bone mineral density in community-dwelling elderly women. Sixty community-dwelling, elderly (> or =65 years of age) women were recruited from a Japanese community. Subjects were randomly assigned to a home-based exercise group or a control group. The subjects assigned to the home-based exercise group performed home-based exercise without home visits 3 times per week for 6 months in their homes. Assessments of physical function and bone mineral density were carried out before and after intervention in both groups. Muscle strength, gait velocity, the timed up and go test (TUGT), single leg stance time, the bend reach performance test, and reaction time were measured to assess physical function. The patients' history of falls was also assessed before and after the 12-month follow-up. To determine bone mineral density, the speed of sound (SOS) at the right calcaneus was measured using a quantitative ultrasound device. There were no significant differences between the two groups in baseline characteristics. 82.6% of subjects completed the prescribed exercise program in the home-based exercise group. Compared to the control group, TUGT improved significantly (p<0.05) in the home-based exercise group. Home-based exercise without home visits can be adopted for community-dwelling elderly women, particularly since no specific place or instructor is needed.

  18. Risk for falls among community-dwelling older people: systematic literature review.

    PubMed

    Sousa, Luís Manuel Mota; Marques-Vieira, Cristina Maria Alves; Caldevilla, Maria Nilza Guimarães Nogueira de; Henriques, Cristina Maria Alves Dias; Severino, Sandy Silva Pedro; Caldeira, Sílvia Maria Alves

    2017-02-23

    To identify the risk factors for falls of the community-dwelling elderly in order to update the Taxonomy II of NANDA International. A systematic literature review based on research using the following platforms: EBSCOHost®, CINAHL and MEDLINE, from December 2010 to December 2014. The descriptors used were (Fall* OR Accidental Fall) AND (Community Dwelling OR Community Health Services OR Primary health care) AND (Risk OR Risk Assessment OR Fall Risk Factors) AND (Fall* OR Accidental Fall) AND (Community Dwelling OR older) AND Nurs* AND Fall Risk Factors. The sample comprised 62 studies and 50 risk factors have been identified. Of these risk factors, only 38 are already listed in the classification. Two new categories of risk factors are proposed: psychological and socio-economical. New fall risk factors for the community-dwelling elderly have been identified, which can contribute to the updating of this nursing diagnosis of the Taxonomy II of NANDA International.

  19. 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.

  20. Neighborhood Environment and Falls among Community-Dwelling Older Adults

    PubMed Central

    Nicklett, Emily Joy; Lohman, Matthew C.; Smith, Matthew Lee

    2017-01-01

    Background: Falls present a major challenge to active aging, but the relationship between neighborhood factors and falls is poorly understood. This study examined the relationship between fall events and neighborhood factors, including neighborhood social cohesion (sense of belonging, trust, friendliness, and helpfulness) and physical environment (vandalism/graffiti, rubbish, vacant/deserted houses, and perceived safety walking home at night). Methods: Data were analyzed from 9259 participants over four biennial waves (2006–2012) of the Health and Retirement Study (HRS), a nationally representative sample of adults aged 65 and older in the United States. Results: In models adjusting for demographic and health-related covariates, a one-unit increase in neighborhood social cohesion was associated with 4% lower odds of experiencing a single fall (odds ratio (OR): 0.96, 95% confidence interval (CI): 0.93–0.99) and 6% lower odds of experiencing multiple falls (OR: 0.94, 95% CI: 0.90–0.98). A one-unit increase in the physical environment scale was associated with 4% lower odds of experiencing a single fall (OR: 0.96, 95% CI: 0.93–0.99) and with 5% lower odds of experiencing multiple falls (OR: 0.95, 95% CI: 0.91–1.00) in adjusted models. Conclusions: The physical and social neighborhood environment may affect fall risk among community-dwelling older adults. Findings support the ongoing need for evidence-based fall prevention programming in community and clinical settings. PMID:28208598

  1. Risk factors of falls in community dwelling active elderly.

    PubMed

    Tuunainen, Eeva; Rasku, Jyrki; Jäntti, Pirkko; Pyykkö, Ilmari

    2014-02-01

    To search for measures to describe and relate to accidental falls in community dwelling elderly. A EuroQol EQ-5D questionnaire based on a patient's otoneurological case history provided a general health related quality of life measure, a fall history for the last 3 months and force platform measures for 96 active elderly from a pensioner organization. On average, the elderly experienced 0.3 falls over the preceding three months. A fall was seen to cause a significant deterioration in the quality of life and vertigo and caused fear of falling. The postural instability correlated with falls. Vertigo was present among 42% and was most commonly characterized as episodic and rotatory in factorial analysis items relating to vertigo correlated to falls and balance complaints. Four factors were identified and three of these correlated with falls. Vestibular failure correlated to a fall occurring when a person was rising up; Movement intolerance correlated with falls due to slips and trips, and Near-syncope factor correlated to falls for other reasons. In posturography, the variable measuring critical time describing the memory based "closed loop" control of postural stability carried a risk for accidental fall with an odds ratio of 6. The variable measuring zero crossing velocity showed a high rate of velocity change around the neutral position of stance. Vertigo and poor postural stability were the major reasons for falls in the active elderly. In ageing, postural control is shifted towards open loop control (visual, proprioception, exteroception and vestibular) instead of closed loop control and is a factor that contributes to a fall. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Effects of Cardiopulmonary Bypass on Mediastinal Drainage and the Use of Blood Products in the Intensive Care Unit in 60- to 80-Year-Old Patients Who Have Undergone Coronary Artery Bypass Grafting

    PubMed Central

    Aygün, Fatih; Özülkü, Mehmet; Günday, Murat

    2015-01-01

    OBJECTIVE The present study consisted of patients who underwent on-pump coronary artery bypass grafting (CABG) and off-pump CABG and investigated effect of using cardiopulmonary bypass (CPB) on the amount of postoperative drainage and blood products, red blood cell (RBC), free frozen plasma (FFP) given in the intensive care unit in 60-80-year-old patients who underwent CABG. METHODS The present study comprises a total of 174 patients who have undergone coronary artery bypass graft (off-pump or on-pump CABG) surgery in our clinic in between 2012-2015 year. RESULTS It was observed that the amount of drainage in the first 24 postoperative hours was lower in the on-pump CABG group (Group 1) when compared to off-pump group (Group 2) (Group 1 vs. Group 2; 703.5±253.8 ml vs. 719.6±209.4 ml; P =0.716). However, the amount of drainage in the second 24 hours was statistically significantly lower in the off-pump CABG group (Group 1 vs. Group 2; 259.8±170.6 ml vs. 190.1±129.1 ml; P =0.016). With regard to the amount of overall drainage, no statistically significant difference was observed between the two groups. Group 1 needed RBC transfusion higher than Group 2 (Group 1 vs. Group 2; 2.2±1.3 bag vs. 1.2±0.9 bag; P <0.001). CONCLUSION We can say that CPB influences the amount of second 24-hour drainage which indexed body surface area. In addition, CPB decreases hct, hb, thrombocyte count in ICU arrived, after 24 hours in postoperative period. Reduced thrombocyte counting effect can be appeared after 48 hours in the postoperative period of CPB. PMID:26934397

  3. Hypoactive sexual desire dysfunction in community-dwelling older women.

    PubMed

    Zeleke, Berihun M; Bell, Robin J; Billah, Baki; Davis, Susan R

    2017-04-01

    To determine the prevalence of hypoactive sexual desire dysfunction (HSDD) and its associated factors in women aged 65 to 79 years. A questionnaire-based, cross-sectional study was conducted amongst community-dwelling older women. Participants were recruited between April and August 2014 from a national database based on electoral rolls. Sexual function and sexual distress were assessed by the Female Sexual Function Index and the Female Sexual Distress Scale-Revised, respectively. HSDD was defined as the presence of both low sexual desire and sexually related personal distress. The mean ± SD age of the 1,548 women was 71 ± 3.4 years and 52.6% were partnered. Among the participants, 88.0% (95% confidence interval [CI], 86.3%-89.6%) had low sexual desire, 15.5% (95% CI, 13.8%-17.4%) had sexually related personal distress, and 13.6% (95% CI, 11.9%-15.4%) had HSDD. The HSDD was more common among partnered than among unpartnered women (23.7% vs 5.9%; P < 0.001). Being partnered (adjusted odds ratio [AOR] = 4.21; 95% CI, 2.50-7.07), having vaginal dryness during intercourse (AOR = 2.37; 95% CI, 1.58-3.55), having symptomatic pelvic floor dysfunction (AOR = 1.92; 95% CI, 1.29-2.92), and having moderate-to-severe depressive symptoms (AOR = 4.15; 95% CI, 2.16-7.96) were independently associated with having HSDD. In a subanalysis, HSDD was more common among sexually active than sexually inactive women (31.5% vs 17.3%; P < 0.001). Furthermore, 32% (95% CI, 27.7%-38.3%) of partnered sexually active women had HSDD, as did 22% (95% CI, 11.5%-37.8%) of unpartnered sexually active women. HSDD is common and associated with potentially modifiable risk factors in older women. It should not be assumed that unpartnered older women are sexually inactive or are not distressed by low sexual desire.

  4. [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

  5. [Incidence of bicycle-related accidents and subsequent injury in community-dwelling older adults: understanding potential accidents].

    PubMed

    Sakurai, Ryota; Kawai, Hisashi; Fukaya, Taro; Yoshida, Hideyo; Kim, Hunkyung; Hirano, Hirohiko; Suzuki, Hiroyuki; Obuchi, Shuichi; Fujiwara, Yoshinori

    2015-01-01

    This study investigated 1) the incidence of bicycle-related accidents and subsequent injuries and 2) the number of injuries (accidents) reported to the police (i.e., examining the number of potential accidents) among community-dwelling Japanese older adults, after examining the percentage of those who were regular cyclists. Based on local resident registration, we mailed questionnaires to 7083 community-dwelling older adults. The questionnaire included questions about the incidence of bicycle-related accidents and subsequent injury within a year, the degree of injury and presence or absence of reporting that injury (bicycle-related accident) to the police. For the bicycle-related accident, we asked regarding both riding and pedestrian accidents (i.e., accidents caused by a bicycle when walking). Excluding the blank responses (n=3539, 50.0%), the targets for analysis were 3098 older adults in riding accidents and 2861 older adults in pedestrian accidents. The results showed that 63.0% of older adults (n=1953) routinely rode a bicycle. Among them, 9.4% (n=184) experienced riding accidents, and 3.4% (n=98) experienced pedestrian accidents caused by a bicycle. For the riding accidents, 76.1% (n=140) had some injuries, and for the pedestrian accidents, 55.1% (n=54) had some injuries. Furthermore, in 70.2% (n=59) and 76.9% (n=20) of riding and pedestrian accidents, respectively, those who went to the hospital for treatment of their injury (i.e., injury requiring treatment) did not report the accident to the police. The present study revealed that there are many potential bicycle-related accidents in older adults. This suggests that there may be a large gap in the national survey data between reported bicycle-related accidents and the actual number of incidents in older adults.

  6. Forgiveness, Ego-Integrity, and Depressive Symptoms in Community-Dwelling and Residential Elderly Adults.

    PubMed

    Dezutter, Jessie; Toussaint, Loren; Leijssen, Mia

    2016-09-01

    This study aimed first, to investigate the relation between forgivingness and depressive symptoms in elderly individuals and second, to explore whether the developmental task of integrity/despair is a possible underlying process in this relation. Both aims were studied in a sample of community-dwelling elderly individuals as well as in a sample of residential elderly individuals. Community-dwelling elderly individuals (n = 280, M = 75.98 years) and residential elderly individuals (n = 205, M = 83.20 years) in Belgium filled out questionnaires on forgivingness, depressive symptoms, and the developmental task of integrity/despair. Structural equation modeling was used to test the mediational role of integrity/despair in the relation between forgivingness and depression in both samples. Furthermore, multigroup analyses tested the convergence of the mediational models in the community-dwelling elderly individuals and the residential elderly individuals. Forgivingness and depression were negatively associated in both residential elderly individuals and community-dwelling elderly individuals. The developmental task of finding integrity and avoiding despair showed to be a significant mediator in this relationship. Framed within a life-span perspective, we showed that the developmental task of finding a balance between integrity and despair is an important intrapersonal mechanism through which forgivingness is related with depressed feelings for residential as well as community-dwelling elderly individuals. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Effect of the Japanese preventive-care version of the Minimum Data Set--Home Care on the health-related behaviors of community-dwelling, frail older adults and skills of preventive-care managers: a quasi-experimental study conducted in Japan.

    PubMed

    Igarashi, Ayumi; Ikegami, Naoki; Yamada, Yukari; Yamamoto-Mitani, Noriko

    2009-09-01

    To determine whether the Japanese preventive-care version of the Minimum Data Set-Home Care improves the health-related behaviors of older adults and the skills of preventive-care managers. Municipal preventive-care managers were instructed on the use of the Japanese preventive-care version of the Minimum Data Set--Home Care and asked to employ it in their interactions with clients during the intervention period (intervention group). The health-related behaviors of older adults (maintenance of self-care and consumption of a balanced diet) were assessed by self-rating methods. The skills of the preventive-care managers were assessed by considering the number of and variations in the needs of the clients, as reflected in the care plans formulated by the managers. The clients' self-care levels were higher in the intervention group than in the control group (P < 0.05). A greater number of needs, as reflected in the care plans, were noted in the intervention group than in the control group (P < 0.05), and the variation in the assessed needs was greater in the former than in the latter. This study suggests that the Japanese preventive-care version of the Minimum Data Set--Home Care may improve the skills of preventive-care managers, and consequently, the health-related behaviors of frail older clients.

  8. Analysis of dysphagia risk using the modified dysphagia risk assessment for the community-dwelling elderly

    PubMed Central

    Byeon, Haewon

    2016-01-01

    [Purpose] The elderly are susceptible to dysphagia, and complications can be minimized if high-risk groups are screened in early stages and properly rehabilitated. This study provides basic material for the early detection and prevention of dysphagia by investigating the risks of dysphagia and related factors in community-dwelling elders. [Subjects and Methods] Participants included 325 community-dwelling elderly people aged 65 or older. The modified dysphagia risk assessment for the community-dwelling elderly was used to assess dysphagia risk. [Results] Approximately 52.6% (n=171) of participants belonged to the high-risk group for dysphagia. After adjusting for confounding variables, people aged 75+, who used dentures, and who needed partial help in daily living had a significantly higher risk of dysphagia. [Conclusion] It is necessary to develop guidelines for dysphagia for early detection and rehabilitation. PMID:27799680

  9. Dietary protein intake in community-dwelling, frail, and institutionalized elderly people: scope for improvement.

    PubMed

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

    2012-03-01

    Adequate dietary protein intake is required to postpone and treat sarcopenia in elderly people. Insight into dietary protein intake in this heterogeneous population segment is needed to locate dietary inadequacies and to identify target populations and feeding strategies for dietary interventions. Therefore, we assessed dietary protein intake, distribution of protein intake throughout the day, and the use of protein-containing food sources in community-dwelling, frail, and institutionalized elderly people in the Netherlands. Secondary analyses were carried out using dietary data collected from studies among community-dwelling, frail, and institutionalized elderly people to evaluate protein intake characteristics. Dietary protein intake averaged 1.1 ± 0.3 g/kg-bw/day in community-dwelling, 1.0 ± 0.3 g/kg-bw/day in frail, and 0.8 ± 0.3 g/kg-bw/day in institutionalized elderly men. Similar protein intakes were found in women. Ten percent of the community-dwelling and frail elderly and 35% of the institutionalized elderly people showed a protein intake below the estimated average requirement (0.7 g/kg-bw/day). Protein intake was particularly low at breakfast in community-dwelling (10 ± 10 g), frail (8 ± 5 g), and institutionalized elderly people (12 ± 6 g) with bread and dairy products as predominant protein sources. Whereas daily protein intake is generally well above the recommended dietary allowance in community-dwelling and frail elderly people, a significant proportion of institutionalized elderly showed an intake below the current protein requirement, making them an important target population for dietary interventions. Particularly at breakfast, there is scope for improving protein intake.

  10. 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…

  11. 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…

  12. The Effects of a 12-Week Walking Program on Community-Dwelling Older Adults

    ERIC Educational Resources Information Center

    Cheng, Shun-Ping; Tsai, Tzu-I; Lii, Yun-Kung; Yu, Shu; Chou, Chen-Liang; Chen, I-Ju

    2009-01-01

    Walking is a popular and easily accessible form of physical activity. However, walking instruction for older adults is based on the evidence gathered from younger populations. This study evaluated walking conditions, strength, balance, and subjective health status after a 12-week walking-training program in community-dwelling adults greater than…

  13. The Effects of a 12-Week Walking Program on Community-Dwelling Older Adults

    ERIC Educational Resources Information Center

    Cheng, Shun-Ping; Tsai, Tzu-I; Lii, Yun-Kung; Yu, Shu; Chou, Chen-Liang; Chen, I-Ju

    2009-01-01

    Walking is a popular and easily accessible form of physical activity. However, walking instruction for older adults is based on the evidence gathered from younger populations. This study evaluated walking conditions, strength, balance, and subjective health status after a 12-week walking-training program in community-dwelling adults greater than…

  14. Hospitalization Rates of Nursing Home Residents and Community-Dwelling Seniors in British Columbia

    ERIC Educational Resources Information Center

    Ronald, Lisa A.; McGregor, Margaret J.; McGrail, Kimberlyn M.; Tate, Robert B.; Broemling, Anne-Marie

    2008-01-01

    The overall use of acute care services by nursing home (NH) residents in Canada has not been well documented. Our objectives were to identify the major causes of hospitalization among NH facility residents and to compare rates to those of community-dwelling seniors. A retrospective cohort was defined using population-level health administrative…

  15. 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…

  16. Test-retest reliability of the safe driving behavior measure for community-dwelling elderly drivers.

    PubMed

    Song, Chiang-Soon; Lee, Joo-Hyun; Han, Sang-Woo

    2016-06-01

    [Purpose] The Safe Driving Behavior Measure (SDBM) is a self-report measurement tools that assesses the safe-driving behaviors of the elderly. The purpose of this study was to evaluate the test-retest reliability of the SDBM among community-dwelling elderly drivers. [Subjects and Methods] A total of sixty-one community-dwelling elderly were enrolled to investigate the reliability of the SDBM. The SDBM was assessed in two sessions that were conducted three days apart in a quiet and well-organized assessment room. That test-retest reliability of overall scores and three domain scores of the SDBM were statistically evaluated using intraclass correlation coefficients [ICC (2.1)]. Pearson correlation coefficients were used to quantify bivariate associations among the three domains of the SDBM. [Results] The SDBM demonstrated excellent rest-retest reliability for community-dwelling elderly drivers. The Cronbach alpha coefficients of the three domains of person-vehicle (0.979), person-environment (0.944), and person-vehicle-environment (0.971) of the SDBM indicate high internal consistency. [Conclusion] The results of this study suggest that the SDBM is a reliable measure for evaluating the safe- driving of automobiles by community-dwelling elderly, and is adequate for detecting changes in scores in clinical settings.

  17. Hospitalization Rates of Nursing Home Residents and Community-Dwelling Seniors in British Columbia

    ERIC Educational Resources Information Center

    Ronald, Lisa A.; McGregor, Margaret J.; McGrail, Kimberlyn M.; Tate, Robert B.; Broemling, Anne-Marie

    2008-01-01

    The overall use of acute care services by nursing home (NH) residents in Canada has not been well documented. Our objectives were to identify the major causes of hospitalization among NH facility residents and to compare rates to those of community-dwelling seniors. A retrospective cohort was defined using population-level health administrative…

  18. Wheelchair Use among Community-Dwelling Older Adults: Prevalence and Risk Factors in a National Sample

    ERIC Educational Resources Information Center

    Clarke, Philippa; Colantonio, Angela

    2005-01-01

    Older adults are the largest group of wheelchair users yet there are no peer-reviewed studies on the national profile of older wheelchair users in Canada. We investigated the characteristics of wheelchair users in a national sample of community-dwelling older adults from the Canadian Study of Health and Aging (CSHA-2). Questions on the use of…

  19. Wheelchair Use among Community-Dwelling Older Adults: Prevalence and Risk Factors in a National Sample

    ERIC Educational Resources Information Center

    Clarke, Philippa; Colantonio, Angela

    2005-01-01

    Older adults are the largest group of wheelchair users yet there are no peer-reviewed studies on the national profile of older wheelchair users in Canada. We investigated the characteristics of wheelchair users in a national sample of community-dwelling older adults from the Canadian Study of Health and Aging (CSHA-2). Questions on the use of…

  20. Self-Reported versus Professionally Assessed Functional Limitations in Community-Dwelling Very Old Individuals

    ERIC Educational Resources Information Center

    Carlsson, Gunilla; Haak, Maria; Nygren, Carita; Iwarsson, Susanne

    2012-01-01

    The objective of this study was to examine the relationship between self-reported and professionally assessed functional limitations in community-dwelling very old individuals. In total, 306 single-living adults aged 81-90 years were included in this cross-sectional study. The main outcome measure was the presence and absence of self-reported and…

  1. Determinants of Perceived Physical Environment Barriers among Community-Dwelling Elderly in Taiwan.

    PubMed

    Lien, W-C; Chang, J-H; Guo, N-W; Lin, Y-C; Hsieh, P-C; Kuan, T-S

    2015-05-01

    To test the hypothesis that mobility, activities of daily living, and the interaction between them can play a key role in determining perceived physical environment barriers among community-dwelling elderly. Cross-sectional. Community. One hundred and ninety-seven community-dwelling elderly with more than 7 points on the Short Portable Mental State Questionnaire and less than 7 points on the Geriatric Depression Scale (15 items). None. Time Get-up and Go test (TUG), the subscales of basic activity of daily living (BADL)/instrumental activities of daily living (IADL) of the Hierarchy of Care Required (HCR), and the physical/structural subscale of the Craig Hospital Inventory of Environmental Factors in Community-dwelling Elderly in Taiwan were used to measure mobility, activities of daily living and perceived physical environment barriers, respectively. Hierarchical linear regression analyses were used to test the study hypothesis. Significant and positive relations were found to exist between perceived physical environment barriers and (1) the TUG time (β=.300, p<.05), and (2) the IADL score for the HCR (β=.322, p<.05), respectively. A significant and negative relation existed between perceived physical environment barriers and the interaction term (the TUG time and the IADL score for the HCR) (β=-.211, p<.05). Mobility, IADL and the interaction between them are found to be significant determinants of perceived physical environment barriers in the community-dwelling elderly under consideration. Strategies targeting the enhancement of mobility among community-dwelling elderly are suggested to lead to improvements in the degree to which physical environment barriers are perceived. This beneficial effect could be greater in the case of elderly individuals with better IADL function.

  2. The pleasurable recreational activities among community-dwelling older adults.

    PubMed

    Onishi, Joji; Masuda, Yuichiro; Suzuki, Yusuke; Gotoh, Tadao; Kawamura, Takashi; Iguchi, Akihisa

    2006-01-01

    This study aimed to clarify what pleasurable recreational activities older adults like to participate in, and to investigate the relationship between those activities and quality of life (QOL). Questionnaires were delivered to older residents (65 years and above) in a Japanese rural area. The residents' background information, the amount of pleasure for various activities, and the QOL were surveyed. The QOL was evaluated by the revised Philadelphia Geriatric Center (PGC) morale scale. The amount of pleasure taken in a majority of the activities, such as conversation with family or neighbors showed a significant association with the happiness score, but only a few activities showed significant association between the revised PGC morale scale and the amount of pleasure. The multiple regression analyses indicated that the amount of pleasure in exercise, the difficulty in managing finances, and amount of pleasure taken in watching TV were significant variables for predicting the happiness score. The results indicated that the amount of pleasure older adults experienced when engaging in activities such as conversation with family or neighbors showed significant association with the older adults' happiness. These results may be helpful in understanding contributions of various activities to the perception of pleasure in older adults.

  3. 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.

  4. Comparison of segmental multifrequency bioelectrical impedance analysis with dual-energy X-ray absorptiometry for the assessment of body composition in a community-dwelling older population.

    PubMed

    Kim, Miji; Shinkai, Shoji; Murayama, Hiroshi; Mori, Seijiro

    2015-08-01

    The purpose of the present study was to examine the agreement of segmental multifrequency bioelectrical impedance analysis (SMF-BIA) for the assessment of whole-body and appendicular fat mass (FM) and lean soft tissue mass (LSTM) compared with dual-energy X-ray absorptiometry (DXA) in a community-dwelling Japanese older population. The study population included 551 community-dwelling Japanese older adults (241 men and 310 women) aged between 65 and 87 years. Agreement between SMF-BIA and DXA for whole-body and appendicular body composition was assessed using simple linear regression and Bland-Altman analysis. High coefficients of determination (R(2)) were observed for whole-body FM (R(2) = 0.91, standard error of estimate [SEE] = 1.4 kg in men and R(2) = 0.94, SEE = 1.2 kg in women) between SMF-BIA and DXA. The R(2) coefficient for whole-body LSTM was higher in men (R(2) = 0.88, SEE = 1.9 kg) than in women (R(2) = 0.83, SEE = 1.5 kg). There was systematic bias with overestimation of whole-body FM and underestimation of whole-body LSTM by SMF-BIA. Proportional bias was noted for measurement of whole-body FM and LSTM in both men and women, but there was no proportional bias between the two methods for measurement of appendicular LSTM (r = 0.05, P = 0.428 and r = -0.10, P = 0.070 for men and women, respectively). SMF-BIA is a good alternative for estimating the whole-body and appendicular FM and LSTM in a community-dwelling Japanese older population, although it overestimated FM and underestimated LSTM when validated against DXA. © 2014 Japan Geriatrics Society.

  5. Changes in social interaction over 20 years and the effects of community resources use among community-dwelling elderly persons.

    PubMed

    Watanabe, Kumi; Tanaka, Emiko; Wu, Bailiang; Kobayashi, Zyunko; Mochizuki, Yukiko; Kim, Yeon; Watanabe, Taeko; Okumura, Rika; Ito, Sumio; Anme, Tokie

    2017-01-01

    Objectives Recently, social isolation has been reported to be a critical problem among Japanese elderly persons. However, few studies have compared social interaction in the past and the present or investigated its predictive factors. This study aimed to clarify the transitional changes in social interaction over 20 years and explore the factors related to social interaction focusing on the use of community resources.Methods The participants were community-dwelling elderly persons aged 65 years and over. A survey was conducted 8 times from 1994 to 2014 in the suburban area of Tobishima, Japan. The Index of Social Interaction Scale was used and each subscale and the total score were calculated. Subsequently, the 2014 scores were compared with the 1994 scores using the Wilcoxon rank sum test. Logistic regression analysis was conducted to clarify the factors related to social interaction, focusing on the association between the use of community resources (local elderly management center, health care center, health promotion facility, library) in 2011 and social interaction 3 years later. Age, gender, disease, and mobility were also entered into the model as control variables.Results Comparing social interaction in 1994 and 2014, total scores were found to have significantly increased in all age groups. Independence scores significantly increased in the overall group and in females aged 75-84. Curiosity scores also increased in both males and females. These results show that social interaction has increased over 2 decades. In addition, the use of local elderly management and health care centers, and health promotion facilities was associated with total social interaction scores 3 years later.Conclusion The current study clarified changes in social interaction, both comprehensively and for each of its aspects, among community-dwelling elderly adults. Increasing social isolation has been reported in recent years; however, the current study showed that social

  6. Outcomes of a multicomponent physical activity program for sedentary, community-dwelling older adults.

    PubMed

    Toto, Pamela E; Raina, Ketki D; Holm, Margo B; Schlenk, Elizabeth A; Rubinstein, Elaine N; Rogers, Joan C

    2012-07-01

    This single-group repeated-measures pilot study evaluated the effects of a 10-wk, multicomponent, best-practice exercise program on physical activity, performance of activities of daily living (ADLs), physical performance, and depression in community-dwelling older adults from low-income households (N = 15). Comparison of pretest and posttest scores using a one-tailed paired-samples t test showed improvement (p < .05) for 2 of 3 ADL domains on the Activity Measure-Post Acute Care and for 6 physical-performance measures of the Senior Fitness Test. Repeated-measures ANOVA revealed significant main effects for 3 of 8 physical activity measures using the Yale Physical Activity Scale. Retention rate was 78.9%, and the adherence rate for group sessions was 89.7%. Results suggest that participation in a multicomponent, best-practice physical activity program may positively affect sedentary, community-dwelling older adults' physical activity, ADL performance, and physical performance.

  7. Body Composition Outcomes of a Qigong Intervention Among Community-Dwelling Aging Adults.

    PubMed

    Chang, Mei-Ying; Chen, Hsiao-Yu

    2016-12-01

    Aging causes various changes in body composition, which are critical implications for health and physical functioning in aging adults. The aim of this study was to explore the body composition outcomes of a qigong intervention among community-dwelling aging adults. This was a quasi-experimental study in which 90 participants were recruited. Forty-eight participants (experimental group) attended a 30-min qigong program 3 times per week for 12 weeks, whereas 42 participants (control group) continued performing their usual daily activities. The experimental group achieved a greater reduction in the fat mass percentage at the posttest, and exhibited increased fat-free mass, lean body mass percentage, and lean body mass to fat mass ratio compared with the controls. No difference between the two groups in body mass index, fat mass, and lean body mass was observed. These results indicated that the qigong intervention showed beneficial outcomes of body composition among community-dwelling aging adults.

  8. Lack of anticipated support for care for community-dwelling older adults.

    PubMed

    Oliveira, Déborah Cristina de; Neri, Anita Liberalesso; D'Elboux, Maria José

    2016-06-01

    to identify the factors associated with lack of anticipated support for care for community-dwelling older adults. this study presents comparison and logistic regression analyses of data from 671 individuals who took part of the multicentric study entitled "Frailty in older Brazilians" - a quantitative, epidemiologic and transversal investigation carried out between 2008 and 2009. the subjective evaluation of anticipated support for care for community-dwelling older adults was a good indicator of risk for lack of anticipated support for care in women, older adults who live alone and those with poor self-rated health. it is necessary to reflect upon the formal support system currently available for older people in Brazil, considering that those who most frequently presented lack of anticipated support for care are an increasing population. The study also highlights the importance of using subjective methods for the evaluation of the adequacy of older adults' support network.

  9. Zero-Inflated Poisson Modeling of Fall Risk Factors in Community-Dwelling Older Adults.

    PubMed

    Jung, Dukyoo; Kang, Younhee; Kim, Mi Young; Ma, Rye-Won; Bhandari, Pratibha

    2016-02-01

    The aim of this study was to identify risk factors for falls among community-dwelling older adults. The study used a cross-sectional descriptive design. Self-report questionnaires were used to collect data from 658 community-dwelling older adults and were analyzed using logistic and zero-inflated Poisson (ZIP) regression. Perceived health status was a significant factor in the count model, and fall efficacy emerged as a significant predictor in the logistic models. The findings suggest that fall efficacy is important for predicting not only faller and nonfaller status but also fall counts in older adults who may or may not have experienced a previous fall. The fall predictors identified in this study--perceived health status and fall efficacy--indicate the need for fall-prevention programs tailored to address both the physical and psychological issues unique to older adults.

  10. Rates of depression and participation in senior centre activities in community-dwelling older persons.

    PubMed

    Fulbright, S A

    2010-06-01

    The purpose of this study was to determine the role that senior citizen centres play in decreasing depression in community-dwelling older persons. A quantitative cross-sectional design was utilized. A questionnaire was used to determine demographic and lifestyle data. The dependent variable, depression symptoms, was measured using the 15-point Geriatric Depression Scale. Eighty-eight per cent stated that they attend for the friends and social support. Second, the study demonstrated that community-dwelling older persons can have those needs fulfilled at the senior centres. Ninety-four per cent of them have made close friends at their centres. Ninety-four per cent stated that their lives had improved since attending the senior centre. Eighty-six per cent felt they had made friends on whom they could rely when needed.

  11. The Quality of Pain Treatment in Community-Dwelling Persons with Dementia

    PubMed Central

    Li, Jiwen; Snow, A. Lynn; Wilson, Nancy; Stanley, Melinda A.; Morgan, Robert O.; Sansgiry, Shubhada; Kunik, Mark E.

    2015-01-01

    Background/Aims Despite pervasive and debilitating pain among elders, it is underassessed and undertreated; and cognitive impairment can add challenges. We assessed the quality of pain care for community-dwelling elderly patients with dementia. Methods We phone interviewed 203 Veterans Affairs primary care outpatients with dementia and pain and reviewed medical records to score 15 quality indicators of pain assessment and management. Results Pain assessment was documented for 98%, and a standard pain scale was used for 94%. Modified pain scales were rarely used. Though 70% self-reported pain of ‘quite bad’ or worse, charts documented no pain in 64%. When pain was identified, treatment was offered to 80%; but only 59% had a follow-up assessment within 6 months. Nonpharmacological interventions were underused. Conclusion Community-dwelling elders with dementia are underdiagnosed and undertreated for pain.

  12. Prefrailty in community-dwelling older adults is associated with nutrition status.

    PubMed

    Chang, Shu-Fang; Lin, Pei-Ling

    2016-02-01

    This study investigated the differences of demographic characteristics and nutrition status between prefrail and nonfrail older adults. Meanwhile, the factors related to the nutrition status of community-dwelling older adults were also studied. The World Health Organisation has actively developed prevention programmes to address geriatric frailty. However, few previous studies have focused on the relationship between prefrailty and nutrition status. This study adopted a cross-sectional and correlational research design. Community-dwelling older adults were recruited for this study. The participants' nutrition status was assessed using the Mini-Nutritional Assessment tool, and their frailty status was evaluated based on the Study of Osteoporotic Fractures indicators. The Study of Osteoporotic Fractures criteria comprise the following three items: >5% loss in total body weight within one year; inability to rise five times from a chair without assistance and a self-reported lack of energy. Inclusion criteria were age ≥65 years, living independently at home and exhibiting neither mental impairment nor acute disease. Data were gathered from 152 participants; most were men, lived alone and had a level of education lower than elementary school. Multiple linear regressions were used to evaluate the association between variables and nutritional status, the results of which revealed that prefrailty and body mass index were independently related to the participants' nutrition status. The results showed that nutritional assessment can be employed with community-dwelling older adults. In particular, prefrailty and body mass index were key factors that affected nutritional status in older adults. Community nurses must understand the risk factors related to nutritional status in community-dwelling older people. If nurses use this approach, prefrail older adults are likely to experience improved confidence in maintaining their health and a decreased incidence of frailty and

  13. [Relationship between the nutritional status and the oral function among community-dwelling dependent elderly persons].

    PubMed

    Morisaki, Naoko; Miura, Hiroko; Hara, Shuichi

    2015-01-01

    We herein examined the relationship between the nutritional status and the oral function among community-dwelling dependent elderly persons. The subjects included 218 community-dwelling dependent elderly persons. The data were collected via questionnaires, including information regarding age, sex, the level of care required, nutritional status and swallowing function. We used the Mini Nutritional Assessment-Short Form (MNA-SF) to measure the nutritional status and the Dysphagia Risk Assessment for the Community-dwelling Elderly (DRACE) to evaluate the swallowing function. The tongue pressure and the labial closure force were measured using a tongue pressure measurement system (JMS Co. Ltd., Hiroshima, Japan) and the Lip de Cum (Cosmo-Instruments Co, Ltd, Tokyo, Japan). The mean MNA-SF score was 10.07±2.58. The mean DRACE score was 4.39±3.80. The mean tongue pressure was 23.89±10.61 kPa. The mean labial closure force was 10.17±6.04 N. The results of bivariate regression analyses showed that there was a poor correlation between the MNA-SF and the DRACE, tongue pressure and labial closure force. Furthermore, the multiple regression analysis with the MNA-SF as the dependent variable revealed a correlation between the DRACE and labial closure force (p<0.01, R(2)=0.02). Our results suggest that the nutritional status is significantly related to the swallowing function and labial closure force among community-dwelling dependent elderly persons.

  14. Costs of Malnutrition in Institutionalized and Community-Dwelling Older Adults: A Systematic Review.

    PubMed

    Abizanda, Pedro; Sinclair, Alan; Barcons, Núria; Lizán, Luis; Rodríguez-Mañas, Leocadio

    2016-01-01

    The aim of this study was to assess health economics evidence published to date on malnutrition costs in institutionalized or community-dwelling older adults. A systematic search of the literature published until December 2013 was performed using standard literature, international and national electronic databases, including MedLine/PubMed, Cochrane Library, ISI WOK, SCOPUS, MEDES, IBECS, and Google Scholar. Publications identified referred to the economic burden and use of medical resources associated with malnutrition (or risk of malnutrition) in institutionalized or community-dwelling older adults, written in either English or Spanish. Costs were updated to 2014 (€). A total of 9 studies of 46 initially retrieved met the preestablished criteria and were submitted to thorough scrutiny. All publications reviewed involved studies conducted in Europe, and the results regarding the contents of all the studies showed that total costs associated with malnutrition in institutionalized and community-dwelling older adults were considerably higher than those of well-nourished ones, mainly due to a higher use of health care resources (GP consultations, hospitalizations, health care monitoring, and treatments). Interventions to reduce the prevalence of malnutrition, such as the use of oral nutritional supplements, showed an important decrease in-hospital admissions and medical visits. Malnutrition is associated with higher health care costs in institutionalized or community-dwelling older adults. The adoption of nutritional interventions, such as oral nutritional supplements, may have an important impact in reducing annual health care costs per patient. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  15. 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

  16. [Detection of memory impairment among community-dwelling elderly by using the Rivermead Behavioural Memory Test].

    PubMed

    Shinagawa, Shunichiro; Toyota, Yasutaka; Matsumoto, Teruhisa; Sonobe, Naomi; Adachi, Hiroyoshi; Mori, Takaaki; Ishikawa, Tomohisa; Fukuhara, Ryuji; Ikeda, Manabu

    2010-06-01

    The aim of this study was to use the Rivermead Behavioural Memory Test (RBMT) to evaluate everyday memory impairment among community-dwelling elderly who had normal cognitive function and performed daily activities normally but displayed memory impairments,and to diagnose the condition as either mild cognitive impairment or dementia. Among the 1,290 community-dwelling elderly persons who participated in the study, 72 subjects scored higher than 24 on the Mini-Mental State Examination (MMSE): these subjects performed daily activities normally, but their family members reported that they showed memory impairments. Fifty-two subjects completed RBMT, Clinical Dementia Rating, and brain computed tomography, and a final diagnosis was established. The mean standard profile score was 15.1+/-5.0 and mean screening score was 6.4+/-3.0. RBMT score was correlated with the MMSE score. Nine of the subjects were diagnosed with dementia and 26 of them were found to be normal. RBMT achieved 100% sensitivity and specificity with regard to the differentiation of subjects with Alzheimer's disease. However, some subjects were diagnosed with dementia even though their RBMT score was higher than the cut-off score. RBMT was useful in detecting memory impairments of AD subjects in community-based surveys. However, some subjects were diagnosed with dementia because of the existence of other cognitive impairments among community-dwelling elderly.

  17. Multicomponent exercise for physical fitness of community-dwelling elderly women.

    PubMed

    Kang, Soonhee; Hwang, Sujin; Klein, Aimee B; Kim, Seok Hun

    2015-03-01

    [Purpose] The purpose of this study was to identify whether a 4-week multicomponent exercise program could improve the level of physical fitness of community-dwelling elderly women. [Subjects and Methods] Twenty-two healthy community-dwelling elderly women were randomly allocated to either an experimental or a control group. Experimental subjects performed a multicomponent exercise program that consisted of balance, strengthening, and stretching exercises for 4 weeks, whereas the control subjects did not perform any specific exercise. The subjects' level of physical fitness was assessed prior to and after training using the Senior Fitness Test which assesses muscle strength, flexibility, dynamic balance/agility, aerobic endurance, and body composition. [Results] Subjects in the experimental group showed significant improvements in lower and upper body strength, lower and upper body flexibility, dynamic balance/agility following training, but not in aerobic endurance or body composition. Significant group differences were shown in lower and upper body strength, lower body flexibility, and dynamic balance/agility. [Conclusion] The results suggest that a multicomponent training program that consists of balance, strengthening, and stretching exercises is a relevant intervention for the improvement of the level of physical fitness of community-dwelling elderly women.

  18. Influence of whole body vibration platform frequency on neuromuscular performance of community-dwelling older adults.

    PubMed

    Furness, Trentham P; Maschette, Wayne E

    2009-08-01

    The purpose of this study was to progressively overload vibration platform frequency to describe sea-saw whole body vibration influence on neuromuscular performance of community-dwelling older adults. Seventy-three community-dwelling older adults (aged 72 +/- 8 years) were randomly assigned to 4 groups (zero, one, 2, and 3 whole body vibration sessions per week). Quantifiers of neuromuscular performance such as the 5-Chair Stands test, the Timed Up and Go (TUG) test, and the Tinetti test were recorded. Furthermore, Health-related quality of life was qualified with the SF-36 Health Survey. A 6-week whole body vibration intervention significantly improved the quantifiers of neuromuscular performance in a community-dwelling older adult sample. Whole body vibration was shown to significantly reduce time taken to complete the 5-Chair Stands test (p < 0.05) and the TUG test (p < 0.05). Tinetti test scores significantly improved (p < 0.05). as did all components of health-related quality of life (p < 0.05). Overall, progressively overloaded frequency elicited more beneficial improvement for the 3 whole body vibration sessions per week group. It was concluded that progressively overloaded frequency was effective in improving quantifiable measures of neuromuscular performance in the sample and that practitioners may confidently prescribe 3 whole body vibration sessions per week with more precise knowledge of the effects of whole body vibration on neuromuscular performance and health-related quality-of-life effects.

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

    PubMed Central

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

    2016-01-01

    Study Objectives: To examine the association between markers of sleep-disordered breathing (SDB) and white matter hyperintensity (WMH) volume in an elderly, multiethnic, community-dwelling cohort. Methods: 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. Results: 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). Conclusions: 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. Citation: Rostanski SK, Zimmerman ME, Schupf N, Manly JJ, Westwood AJ, Brickman AM, Gu Y. Sleep disordered breathing and white matter hyperintensities in community-dwelling elders. SLEEP 2016;39(4):785–791. PMID:27071695

  20. Topical Decolonization Does Not Eradicate the Skin Microbiota of Community-Dwelling or Hospitalized Adults

    PubMed Central

    Hogan, Patrick G.; Wallace, Meghan A.; Deych, Elena; Shannon, William; Warren, David K.

    2016-01-01

    Topical antimicrobials are often employed for decolonization and infection prevention and may alter the endogenous microbiota of the skin. The objective of this study was to compare the microbial communities and levels of richness and diversity in community-dwelling subjects and intensive care unit (ICU) patients before and after the use of topical decolonization protocols. We enrolled 15 adults at risk for Staphylococcus aureus infection. Community subjects (n = 8) underwent a 5-day decolonization protocol (twice daily intranasal mupirocin and daily dilute bleach-water baths), and ICU patients (n = 7) received daily chlorhexidine baths. Swab samples were collected from 5 anatomic sites immediately before and again after decolonization. A variety of culture media and incubation environments were used to recover bacteria and fungi; isolates were identified using matrix-assisted laser desorption ionization–time of flight mass spectrometry. Overall, 174 unique organisms were recovered. Unique communities of organisms were recovered from the community-dwelling and hospitalized cohorts. In the community-dwelling cohort, microbial richness and diversity did not differ significantly between collections across time points, although the number of body sites colonized with S. aureus decreased significantly over time (P = 0.004). Within the hospitalized cohort, richness and diversity decreased over time compared to those for the enrollment sampling (from enrollment to final sampling, P = 0.01 for both richness and diversity). Topical antimicrobials reduced the burden of S. aureus while preserving other components of the skin and nasal microbiota. PMID:27671074

  1. Exercise Intervention for Anti-Sarcopenia in Community-Dwelling Older People

    PubMed Central

    Miyazaki, Ryo; Takeshima, Taro; Kotani, Kazuhiko

    2016-01-01

    Sarcopenia is an age-related health problem in general communities. Effective exercise programs against sarcopenia remain necessary for community-dwelling older people. In order to summarize the available knowledge on this subject, we collected English articles from a MEDLINE/Pubmed database examining the effects of exercise interventions on sarcopenia-related outcome measures in community-dwelling older people. When nine articles, including eight randomized controlled trials, were reviewed, most studies demonstrated significant improvements in some outcome measures. Indeed, a significant improvement in the muscle mass in one study, muscle strength in two studies and physical performance in two studies was reported among five studies using exercise (E) alone. A significant improvement in the muscle mass in two studies, muscle strength in one study and physical performance in two studies was also reported among four studies using exercise plus nutritional supplementation (EN). Notably, the EN studies appeared to have less extensive exercise interventions than the E studies. One EN study further exhibited significant improvements in all outcome measures. Collectively, exercise could be used as anti-sarcopenic strategies and nutritional interventions when combined with exercise might play a compensated or perhaps a comprehensive role among community-dwelling older people. Limited studies exist and more studies are required for the optimum programs in the community settings. PMID:27829949

  2. Association of day length and weather conditions with physical activity levels in older community dwelling people.

    PubMed

    Witham, Miles D; Donnan, Peter T; Vadiveloo, Thenmalar; Sniehotta, Falko F; Crombie, Iain K; Feng, Zhiqiang; McMurdo, Marion E T

    2014-01-01

    Weather is a potentially important determinant of physical activity. Little work has been done examining the relationship between weather and physical activity, and potential modifiers of any relationship in older people. We therefore examined the relationship between weather and physical activity in a cohort of older community-dwelling people. We analysed prospectively collected cross-sectional activity data from community-dwelling people aged 65 and over in the Physical Activity Cohort Scotland. We correlated seven day triaxial accelerometry data with daily weather data (temperature, day length, sunshine, snow, rain), and a series of potential effect modifiers were tested in mixed models: environmental variables (urban vs rural dwelling, percentage of green space), psychological variables (anxiety, depression, perceived behavioural control), social variables (number of close contacts) and health status measured using the SF-36 questionnaire. 547 participants, mean age 78.5 years, were included in this analysis. Higher minimum daily temperature and longer day length were associated with higher activity levels; these associations remained robust to adjustment for other significant associates of activity: age, perceived behavioural control, number of social contacts and physical function. Of the potential effect modifier variables, only urban vs rural dwelling and the SF-36 measure of social functioning enhanced the association between day length and activity; no variable modified the association between minimum temperature and activity. In older community dwelling people, minimum temperature and day length were associated with objectively measured activity. There was little evidence for moderation of these associations through potentially modifiable health, environmental, social or psychological variables.

  3. The Relationship of Sleep Duration with Obesity and Sarcopenia in Community-Dwelling Older Adults.

    PubMed

    Chien, Meng-Yueh; Wang, Li-Ying; Chen, Hsi-Chung

    2015-01-01

    Numerous studies have reported the relationship between sleep duration and obesity in elderly adults; however, little is known about the relationship of sleep duration and sarcopenia. We examined the relationship of sleep duration with obesity and sarcopenia in community-dwelling older adults. A total of 488 community-dwelling adults (224 men and 264 women) aged ≥65 years were included in the analysis. Self-reported sleep duration and anthropometric data were collected. Skeletal muscle mass was estimated using the predicted equation from a bioelectrical impedance analysis measurement. Obesity and sarcopenia were defined according to the body mass index and the skeletal muscle mass index, respectively. The association between sleep duration and sarcopenia exhibited a U shape in older adults. Compared to adults with 6-8 h of sleep, adults with <6 h of sleep had a nearly 3-fold increased likelihood of sarcopenia (odds ratio, OR: 2.76, 95% confidence interval, CI: 1.28-5.96), while adults with ≥8 h of sleep had a nearly 2-fold increased risk of sarcopenia (OR: 1.89, 95% CI: 1.01-3.54). Older adults with a sleep duration <6 h were more prone to obesity (OR: 2.15, 95% CI: 1.08-4.30). After gender stratification, the association between obesity and short sleep duration was more robust in women. There were significant associations of sleep duration with either obesity or sarcopenia in community-dwelling older adults. Gender differences in these associations were also observed.

  4. Multicomponent exercise for physical fitness of community-dwelling elderly women

    PubMed Central

    Kang, Soonhee; Hwang, Sujin; Klein, Aimee B.; Kim, Seok Hun

    2015-01-01

    [Purpose] The purpose of this study was to identify whether a 4-week multicomponent exercise program could improve the level of physical fitness of community-dwelling elderly women. [Subjects and Methods] Twenty-two healthy community-dwelling elderly women were randomly allocated to either an experimental or a control group. Experimental subjects performed a multicomponent exercise program that consisted of balance, strengthening, and stretching exercises for 4 weeks, whereas the control subjects did not perform any specific exercise. The subjects’ level of physical fitness was assessed prior to and after training using the Senior Fitness Test which assesses muscle strength, flexibility, dynamic balance/agility, aerobic endurance, and body composition. [Results] Subjects in the experimental group showed significant improvements in lower and upper body strength, lower and upper body flexibility, dynamic balance/agility following training, but not in aerobic endurance or body composition. Significant group differences were shown in lower and upper body strength, lower body flexibility, and dynamic balance/agility. [Conclusion] The results suggest that a multicomponent training program that consists of balance, strengthening, and stretching exercises is a relevant intervention for the improvement of the level of physical fitness of community-dwelling elderly women. PMID:25931757

  5. 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

  6. Determinants of the utilization of dental services in a community-dwelling elderly Japanese population.

    PubMed

    Ohi, Takashi; Sai, Motoyuki; Kikuchi, Masahiko; Hattori, Yoshinori; Tsuboi, Akito; Hozawa, Atsushi; Ohmori-Matsuda, Kaori; Tsuji, Ichiro; Watanabe, Makoto

    2009-07-01

    Oral health care is not only an effective strategy for the prevention, early diagnosis, and treatment of orofacial disease and disorders, but also an essential component of general health promotion programs. The current study aimed to identify the determinants of the utilization of dental services in an elderly population in Japan. A community-based comprehensive geriatric assessment, including the measurements of physical, mental, and social functioning, was conducted among elderly people aged >or= 70 years residing in a suburban area of Sendai, Japan. Oral health status and functioning, their impact on the quality of life, and dental utilization were also surveyed. Of the 1,170 participants, 418 subjects who had specific treatment needs for dental problems and reported irregular dental attendance were recommended a dental visit, and 1 year later, their compliance with the recommendation was assessed by using questionnaire. Multiple logistic regression analysis demonstrated that a higher number of remaining teeth and the use of removable dentures were significant predictors of dental utilization within 1 year. Regular utilization was associated with a higher number of remaining teeth, younger age, presence of systemic disease, absence of depressive symptoms, and higher educational attainment. Conversely, non-compliance with the treatment recommendations was associated with fewer remaining teeth, smoking, and non-utilization of dental services during the previous year. The differences in the determinants of dental attendance behavior, which may be partially associated with the insurance coverage for dental services, suggest the need for specific strategies for oral health promotion for different behavior of dental utilization.

  7. Relationship between chewing ability and sarcopenia in Japanese community-dwelling older adults.

    PubMed

    Murakami, Masaharu; Hirano, Hirohiko; Watanabe, Yutaka; Sakai, Katsuhiko; Kim, Hunkyoung; Katakura, Akira

    2015-08-01

    It has been reported that if nutrient intake is unbalanced, muscle mass, muscle strength and physical performance declines, and therefore it is important to maintain chewing ability to keep a balanced nutrient intake. However, the relationship between chewing ability and sarcopenia has not been previously reported. Therefore, the present study investigated the relationship between chewing ability and sarcopenia in addition to known sarcopenia-related factors. We examined 761 participants (average age 73.0 ± 5.1 years), who lived in the Itabashi city of Tokyo. Our research was designed to examine the relationship between chewing ability and sarcopenia. We carried out regression analysis to analyze the relationship with sarcopenia-related factors with consideration of the age of the participants. The 761 participants were divided into two groups in terms of the stage of sarcopenia according to whether there was a deterioration of muscle strength or physical performance. Furthermore, we carried out logistic regression analyses on the value as a dependent variable, including known sarcopenia-related factors. There were significant correlations of sarcopenia with age (odds ratio 2.37, 95% confidence interval 1.52-3.70), body mass index (odds ratio 0.75, 95% confidence interval 0.69-0.81) and chewing ability (odds ratio 2.18, 95% confidence interval 1.21-3.93). The present study shows that chewing ability is related to sarcopenia, which is equal to the relationship with the known factor of age by odds ratio. © 2014 Japan Geriatrics Society.

  8. Development of the Gerotranscendence Scale Type 2: Japanese Version

    ERIC Educational Resources Information Center

    Hoshino, Kazumi; Zarit, Steven H.; Nakayama, Makoto

    2012-01-01

    This study developed the Japanese version of the Gerotranscendence Scale Type 2 (the GST2) and examined reliability and validity of the scale. In Japan, 525 community-dwelling older adults (Male = 260, Female = 265) answered a questionnaire. An exploratory factor analysis of the Japanese version of the GST2 revealed the same three-factor structure…

  9. Development of the Gerotranscendence Scale Type 2: Japanese Version

    ERIC Educational Resources Information Center

    Hoshino, Kazumi; Zarit, Steven H.; Nakayama, Makoto

    2012-01-01

    This study developed the Japanese version of the Gerotranscendence Scale Type 2 (the GST2) and examined reliability and validity of the scale. In Japan, 525 community-dwelling older adults (Male = 260, Female = 265) answered a questionnaire. An exploratory factor analysis of the Japanese version of the GST2 revealed the same three-factor structure…

  10. Relationship between masticatory ability and physical performance in community-dwelling edentulous older adults wearing complete dentures.

    PubMed

    Moriya, Shingo; Notani, Kenji; Miura, Hiroko; Inoue, Nobuo

    2014-12-01

    This study aimed to elucidate the association between masticatory ability and physical performance in community-dwelling edentulous older adults wearing complete dentures. Physical performance parameters are significant predictors of decreased activities of daily living. Previous studies have shown the relationships between oral conditions and these parameters. Here, we focused on complete denture wearers. Two hundred and ten edentulous adults aged ≥65 years and wearing complete dentures were enrolled. The following oral conditions were examined: masticatory ability measured by colour-changing chewing gum, number of foods considered chewable, pain when using dentures and denture base fit. Handgrip strength (HG) and one-leg standing time with eyes open (OLST) were used to evaluate muscle strength and static balance. Spearman's rank correlation coefficients were calculated to examine the correlations between oral conditions and physical performance. Forward stepwise linear regression models were applied with each physical performance parameters as the dependent variable and oral conditions as the independent variable. The women did not show significant correlations between oral conditions and the physical performance. In men, significant and positive correlations were found between the number of chewable foods and HG, and between the colour scores and OLST. The significant correlation between the colour scores and OLST was still noted in the stepwise liner regression analysis after adjusting for demographic, social and medical conditions, and other oral conditions. In Japanese elderly edentulous men wearing complete dentures, masticatory ability evaluated as the mixing ability may be associated with static balance. © 2012 The Gerodontology Society and John Wiley & Sons A/S.

  11. Falls are associated with stroke, arthritis and multiple medications among community-dwelling elderly persons in Japan.

    PubMed

    Mizukami, Satoshi; Arima, Kazuhiko; Abe, Yasuyo; Kanagae, Mitsuo; Kusano, Yosuke; Niino, Naoakira; Aoyagi, Kiyoshi

    2013-12-01

    Falls are a major public health problem and the second leading cause of death due to unintentional accidental injury after road traffic accidents. Inactive, older individuals with several chronic illnesses fall more frequently than older individuals who are active and healthy. No population-based study has addressed the association of stroke, arthritis, hypnotic and other prescription medications with falls among the elderly simultaneously in a single population in Japan. We examined the prevalence of falls among community-dwelling elderly Japanese individuals, whom we randomly selected from a list of inhabitants aged ≥ 65 years compiled from the resident registration, and the associations between falls and each of stroke, arthritis, and hypnotic and other prescription medications. We interviewed 295 men and 307 women, and collected information about the number of falls during the latest one year, hemiplegia due to stroke, arthritis in the legs, and the number of hypnotic and other medications. We found that 46 men (16%) and 67 women (22%) had fallen at least once during the latest one year. Logistic regression analysis adjusted for age showed that hemiplegia due to stroke (p < 0.001), arthritis in the legs (p < 0.001), and taking at least four daily prescription medications (p < 0.05) were significantly associated with falls in men. Arthritis in the legs (p = 0.05) and taking at least four daily prescription medications (p < 0.05) were associated with falls in women. Treatment of fall-related diseases and medication management are important strategies for reducing falls among elderly persons.

  12. 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.

  13. Sex-specific differences in risk factors for sarcopenia amongst community-dwelling older adults.

    PubMed

    Tay, L; Ding, Y Y; Leung, B P; Ismail, N H; Yeo, A; Yew, S; Tay, K S; Tan, C H; Chong, M S

    2015-12-01

    With considerable variation including potential sex-specific differential rate of skeletal muscle loss, identifying modifiable factors for sarcopenia will be pivotal to guide targeted interventions. This study seeks to identify clinical and biological correlates of sarcopenia in community-dwelling older adults, with emphasis on the role of anabolic and catabolic stimuli, and special reference to gender specificity. In this cross-sectional study involving 200 community-dwelling and functionally independent older adults aged ≥50 years, sarcopenia was defined using the Asian Working Group for Sarcopenia criteria. Comorbidities, cognitive and functional performance, physical activity and nutritional status were routinely assessed. Biochemical parameters included haematological indices, lipid panel, vitamin D level, anabolic hormones [insulin-like growth factor-1 (IGF-1), free testosterone (males only)] and catabolic markers [inflammatory markers (interleukin-6, C-reactive protein) and myostatin]. Multiple logistic regression was performed to identify independent predictors for sarcopenia. Age was associated with sarcopenia in both genders. Malnutrition conferred significantly higher odds for sarcopenia in women (OR = 5.71, 95% CI 1.13-28.84.44, p = 0.035) while higher but acceptable range serum triglyceride was protective in men (OR = 0.05, 95% CI 0.00-0.52, p = 0.012). Higher serum myostatin independently associated with higher odds for sarcopenia in men (OR = 1.11, 95% CI 1.00-1.24, p = 0.041). Serum IGF-1 was significantly lower amongst female sarcopenic subjects, with demonstrable trend for protective effect against sarcopenia in multiple regression models, such that each 1 ng/ml increase in IGF-1 was associated with 1% decline in odds of sarcopenia in women (p = 0.095). Our findings support differential pathophysiological mechanisms for sarcopenia that, if corroborated, may have clinical utility in guiding sex-specific targeted

  14. Validity of the Fitbit activity tracker for measuring steps in community-dwelling older adults

    PubMed Central

    Paul, Serene S; Tiedemann, Anne; Hassett, Leanne M; Ramsay, Elisabeth; Kirkham, Catherine; Chagpar, Sakina; Sherrington, Catherine

    2015-01-01

    Background Commercially available activity monitors, such as the Fitbit, may encourage physical activity. However, the accuracy of the Fitbit in older adults remains unknown. This study aimed to determine (1) the criterion validity of Fitbit step counts compared to visual count and ActiGraph accelerometer step counts and (2) the accuracy of ActiGraph step counts compared to visual count in community-dwelling older people. Methods Thirty-two community-dwelling adults aged over 60 wore Fitbit and ActiGraph devices simultaneously during a 2 min walk test (2MWT) and then during waking hours over a 7-day period. A physiotherapist counted the steps taken during the 2MWT. Results There was excellent agreement between Fitbit and visually counted steps (intraclass correlation coefficient (ICC2,1)=0.88, 95% CI 0.76 to 0.94) from the 2MWT, and good agreement between Fitbit and ActiGraph (ICC2,1=0.66, 95% CI 0.41 to 0.82), and between ActiGraph and visually counted steps (ICC2,1=0.60, 95% CI 0.33 to 0.79). There was excellent agreement between the Fitbit and ActiGraph in average steps/day over 7 days (ICC2,1=0.94, 95% CI 0.88 to 0.97). Percentage agreement was closest for Fitbit steps compared to visual count (mean 0%, SD 4%) and least for Fitbit average steps/day compared to the ActiGraph (mean 13%, SD 25%). Conclusions The Fitbit accurately tracked steps during the 2MWT, but the ActiGraph appeared to underestimate steps. There was strong agreement between Fitbit and ActiGraph counted steps. The Fitbit tracker is sufficiently accurate to be used among community-dwelling older adults to monitor and give feedback on step counts. PMID:27900119

  15. Delta Activity at Sleep Onset and Cognitive Performance in Community-Dwelling Older Adults.

    PubMed

    Kawai, Makoto; Beaudreau, Sherry A; Gould, Christine E; Hantke, Nathan C; Jordan, Josh T; O'Hara, Ruth

    2016-04-01

    Frontal intermittent rhythmic delta activity (FIRDA) has long been considered to be an abnormal variant in the electroencephalogram (EEG) among older adults. Prior work also indicates a predominance of slow wave EEG activity among patients with dementia. However, instability of state control occurring with aging generally and among many neurodegenerative diseases raises the possibility that FIRDA might represent the intrusion of sleep related elements of the EEG into the waking state. We examined delta activity at sleep onset (DASO) in community-dwelling, older adults without dementia, and examined whether this activity is related to poorer cognitive performance. 153 community-dwelling, older adults without dementia underwent overnight polysomnography and measures of global cognition, delayed verbal memory, information processing speed, attention, inhibition, verbal naming, and visuospatial ability. Delta activity during sleep/wake transitions (scored either as Waking or N1) was analyzed visually. Participants were 83 women and 70 men, mean age 71.3 ± 0.6 y. DASO was present in 30 participants (19.6%). Age, years of education, sex, and body mass index did not differ between DASO (+) and (-) groups. Multiple regression analyses indicated faster reading of the Stroop color words in DASO (+) subjects (P = 0.007). None of the other cognitive domains differed between the two groups. DASO was relatively common in our sample of community-dwelling, older adults without dementia. DASO was not associated with poorer performance on any cognitive domain. Instead, individuals with DASO demonstrated better performance on a simple reading task. Although these findings suggest that an abnormal EEG activity may represent normal variation, our work underscores the importance of distinguishing DASO from FIRDA when examining sleep in older adults. A commentary on this article appears in this issue on page 725. © 2016 Associated Professional Sleep Societies, LLC.

  16. Frailty predicts trajectories of quality of life over time among British community-dwelling older people.

    PubMed

    Kojima, Gotaro; Iliffe, Steve; Morris, Richard W; Taniguchi, Yu; Kendrick, Denise; Skelton, Dawn A; Masud, Tahir; Bowling, Ann

    2016-07-01

    To investigate associations between baseline frailty status and subsequent changes in QOL over time among community-dwelling older people. Among 363 community-dwelling older people ≥65 years, frailty was measured using Frailty Index (FI) constructed from 40 deficits at baseline. QOL was measured using Older People's Quality of Life Questionnaire (OPQOL) six times over 2.5 years. Two-level hierarchical linear models were employed to predict QOL changes over time according to baseline frailty. At baseline, mean age was 73.1 (range 65-90) and 62.0 % were women. Mean FI was 0.17 (range 0.00-0.66), and mean OPQOL was 130.80 (range 93-163). The hierarchical linear model adjusted for age, gender, ethnicity, education, and enrollment site predicted that those with higher FI at baseline have lower QOL than those with lower FI (regression coefficient = -47.64, p < 0.0001) and that QOL changes linearly over time with slopes ranging from 0.80 (FI = 0.00) to -1.15 (FI = 0.66) as the FI increases. A FI of 0.27 is the cutoff point at which improvements in QOL over time change to declines in QOL. Frailty was associated with lower QOL among British community-dwelling older people. While less frail participants had higher QOL at baseline and QOL improved over time, QOL of frailer participants was lower at baseline and declined.

  17. Feasibility and Acceptability of Qigong Exercise in Community-Dwelling Older Adults in the United States.

    PubMed

    Chang, Pei-Shiun; Knobf, M Tish; Funk, Marjorie; Oh, Byeongsang

    2017-07-14

    Qigong exercise has been shown to improve physical and psychological well-being in adults with chronic conditions, but little is known about the feasibility and acceptability of engaging in a qigong exercise program in community-dwelling older adults in the United States. The purpose of this study was to explore the feasibility, acceptance, and adherence to an 8-week qigong exercise intervention in community-dwelling American older adults. An exploratory study design. Two senior centers in southern Connecticut. Forty-five community-dwelling older adults aged 65 to 85 years enrolled. A supervised 1-h health qigong exercise session twice weekly for 8 weeks. An investigator-designed questionnaire with seven items that were rated on a 1 to 6 scale, with higher scores indicating better results, and nine open-ended questions were used to obtain data on feasibility and acceptability. Adherence was calculated as the proportion of the 16 planned sessions attended. Of the 45 older adults enrolled, 6 never started and 6 withdrew, with 33 evaluable at the end of the intervention. The mean age of the sample was 74.8 years; the majority were female (84.4%) and white (91.1%). Mean scores on aspects of difficulty, acceptability, suitability, or effectiveness of qigong exercise were all ≥5. Participants identified benefits of qigong exercise, such as calming and relaxing feelings, inner peace, better balance, and flexibility. Attendance rate was 78.8%, with 94% performing qigong exercise at least once weekly outside the class. All participants indicated that they would recommend qigong exercise to others. No adverse events occurred. An 8-week qigong exercise program was feasible, acceptable, and safe for American older adults. Future robust randomized controlled trials are needed to confirm these findings.

  18. ED Utilization and Self-Reported Symptoms in Community-Dwelling Older Adults.

    PubMed

    Dermody, Gordana; Sawyer, Patricia; Kennedy, Richard; Williams, Courtney; Brown, Cynthia J

    2017-01-01

    The rise in ED utilization among older adults is a nursing concern, because emergency nurses are uniquely positioned to have a positive impact on the care of older adults. Symptoms have been associated with ED utilization; however, it remains unclear whether symptoms are the primary reason for ED utilization. The purpose of this study was to describe the self-reported symptoms of community-dwelling older adults prior to accessing the emergency department and to examine the differences in self-reported symptoms among those who did and did not utilize the emergency department. A prospective longitudinal design was used. The sample included 403 community-dwelling older adults aged 75 years and older. Baseline in-home interviews were conducted followed by monthly telephone interviews over 15 months. Commonly reported symptoms at baseline included pain, feeling tired, and having shortness of breath. In univariate analysis, pain, shortness of breath, fair/poor well-being, and feeling tired were significantly correlated with ED utilization. In multivariable models, problems with balance and fair/poor well-being were significantly associated with ED utilization. Several symptoms were common among this cohort of older adults. However, no significant differences were found in the types of symptoms reported by older adults who utilized the emergency department compared with those who did not utilize the emergency department. Based on these findings, it appears that symptoms among community-dwelling older adults may not be the primary reason for ED utilization. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  19. Pilot study on the Chinese version of the Life Space Assessment among community-dwelling elderly.

    PubMed

    Ji, Mengting; Zhou, Yan; Liao, Jiali; Feng, Fangming

    2015-01-01

    To translate the Life Space Assessment (LSA) into Chinese and to examine the reliability and validity of the Chinese version of the LSA (LSA-C) among community-dwelling elderly. Data were collected from 100 community-dwelling elderly people (50 males and 50 females) aged over 65 years (72.23±5.05) in Shanghai. The criterion convergent validity was evaluated by bivariate Pearson correlation analysis separately between the LSA-C and physical health section of the Short Form 36 Health Survey Questionnaire (SF-36-PH), Activities of Daily Living Scale (ADLs), Instrumental Activities of Daily Living Scale (IADLs), and Mini Physical Performance Test (Mini-PPT). The construct validity was estimated using mental health section of the Short Form 36 Health Survey Questionnaire (SF-36-MH), Geriatric Depression Scale (GDS), and Mini-Mental State Examination (MMSE). The test-retest reliability of the LSA-C was tested after two weeks by inter-class correlation method. The test-retest reliability of the LSA-C was 0.76. The criterion convergent validity, which was evaluated by bivariate Pearson correlation analysis between the LSA-C and SF-36-PH, IADLs, and Mini-PPT, was 0.595 (P<0.001), 0.567 (P<0.001), and 0.433 (P<0.001), respectively. The construct validity, which was evaluated by the SF-36, GDS, and MMSE, was 0.704 (P<0.001), -0.544 (P<0.001), and 0.424 (P<0.001), respectively. The LSA-C has acceptable reliability and validity and is significantly correlated with other health evaluation tools with respect to, e.g., health status, daily function, physical performance, presence of depression, and cognitive status. These results demonstrate that the LSA-C can be applied to health evaluations and interventions in community-dwelling elderly in China. Copyright © 2015. Published by Elsevier Ireland Ltd.

  20. Balance and Mobility in Community-Dwelling Older Adults: Effect of Daytime Sleepiness.

    PubMed

    Tyagi, Shachi; Perera, Subashan; Brach, Jennifer S

    2017-05-01

    To examine the effect of self-reported daytime sleepiness on performance-based balance measures and self-reported balance confidence in community-dwelling older adults. Cross-sectional secondary analysis of an observational cohort study designed to develop and refine measures of balance and mobility in community-dwelling older adults. Community. Older adults (aged 78.2 ± 5.9) (n = 120). The performance-based gait and balance measures included gait speed, double support time, and step width. Narrow walk, obstacle walk, and timed standing balance were also assessed. The Activities-Specific Balance Confidence Scale was included as a self-reported measure. Daytime sleepiness was defined as an Epworth Sleepiness Scale score of 9 or greater. Body mass index, fall-related comorbidities, and use of central nervous system (CNS) medications were considered as covariates. Forty-five percent of participants reported daytime sleepiness. Participants reporting daytime sleepiness differed significantly from those without in gait speed (adjusted difference (standard error (SE)) -0.09 (0.04) m/s, P = .03), step width (adjusted difference (SE) 0.02 (0.01), P = .03), and self-reported balance confidence (adjusted difference (SE) -1.02 (0.38), P = .01) even after adjusting for covariates. Two-way analysis of variance of CNS medication use and daytime sleepiness showed no significant interaction effects. Self-reported daytime sleepiness is associated with slower gait speed and poor balance confidence in community-dwelling older adults. Subjective sleep assessment should be considered when assessing balance and implementing interventions for improving balance in older adults. Further study is needed to examine the role of CNS medication use. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  1. Opioid-induced hyperalgesia in community-dwelling adults with chronic pain.

    PubMed

    Hooten, W Michael; Lamer, Tim J; Twyner, Channing

    2015-06-01

    The hyperalgesic effects of long-term opioid use in community-dwelling adults with chronic pain have not been widely reported. Therefore, the primary aim of this study was to determine the associations between opioid use and heat pain (HP) perception in a sample of community-dwelling adults with chronic pain. The study cohort involved 187 adults (85 opioid and 102 nonopioid) with chronic pain consecutively admitted to an outpatient interdisciplinary pain treatment program. Heat pain perception was assessed using a validated quantitative sensory test method of levels. An effect of opioid use was observed for nonstandardized (P = 0.004) and standardized (P = 0.005) values of HP 5-0.5 in which values of the opioid group were lower (more hyperalgesic) compared with those of the nonopioid group. HP 5-0.5 is a measure of the slope of the line connecting HP 0.5 (HP threshold) and HP 5 (intermediate measure of HP tolerance). In univariable (P = 0.019) and multiple variable (P = 0.003) linear regression analyses (adjusted for age, sex, body mass index, work status, pain diagnosis, pain severity, depression, and pain catastrophizing), opioid use was associated with lower (more hyperalgesic) nonstandardized values of HP 5-0.5. Similarly, in univariable (P = 0.004) and multiple variable (P = 0.011) linear regression analyses (adjusted for work status, pain diagnosis, pain severity, depression, and pain catastrophizing), opioid use was associated with lower standardized values of HP 5-0.5. In this sample of community-dwelling adults, these observations suggest that long-term opioid use was associated with hyperalgesia independent of other clinical factors known to influence HP perception.

  2. Prevalence of Wheelchair and Scooter Use Among Community-Dwelling Canadians.

    PubMed

    Smith, Emma M; Giesbrecht, Edward M; Mortenson, W Ben; Miller, William C

    2016-08-01

    Mobility impairments are the third leading cause of disability for community-dwelling Canadians. Wheelchairs and scooters help compensate for these challenges. There are limited data within the last decade estimating the prevalence of wheelchair and scooter use in Canada. The aims of this study were: (1) to estimate the prevalence of wheelchair and scooter use in Canada and (2) to explore relevant demographic characteristics of wheelchair and scooter users. This study was a secondary analysis of a cross-sectional national survey. The Canadian Survey on Disability (2012) collected data on wheelchair and scooter use from community-dwelling individuals aged 15 years and over with a self-identified activity limitation on the National Household Survey. Prevalence estimates were calculated as weighted frequencies, with cross-tabulations to determine the number of wheelchair and scooter users in Canada, by province, and demographic characteristics (ie, age, sex) and bootstrapping to estimate the variance of all point estimates. There were approximately 288,800 community-dwelling wheelchair and scooter users aged 15 years and over, representing 1.0% of the Canadian population. The sample included 197,560 manual wheelchair users, 42,360 powered wheelchair users, and 108,550 scooter users. Wheelchair and scooter users were predominantly women, with a mean age of 65 years. Approximately 50,620 individuals used a combination of 2 different types of devices. The results are representative of individuals living in the community in Canada and exclude individuals in residential or group-based settings; estimates do not represent the true population prevalence. This analysis is the first in more than 10 years to provide a prevalence estimate and description of wheelchair and scooter users in Canada. Since 2004, there has been an increase in the proportion of the population who use wheelchairs and scooters, likely related to an aging Canadian population. These new prevalence data

  3. Purpose in Life Is Associated With Mortality Among Community-Dwelling Older Persons

    PubMed Central

    Boyle, Patricia A.; Barnes, Lisa L.; Buchman, Aron S.; Bennett, David A.

    2009-01-01

    Objective To assess the association between purpose in life as an important determinant of health outcomes and mortality in community-dwelling elderly persons. Methods We used data from 1238 older persons without dementia from two longitudinal cohort studies (Rush Memory and Aging Project and Minority Aging Research Study) with baseline evaluations of purpose in life and up to 5 years of follow-up to test the hypothesis that greater purpose in life is associated with a reduced risk of mortality among community-dwelling older persons. Results The mean ± standard deviation score on the purpose in life measure at baseline was 3.7 ± 0.5 (range = 2−5), with higher scores indicating greater purpose in life. During the 5-year follow-up (mean = 2.7 years), 151 of 1238 persons (12.2%) died. In a proportional hazards model adjusted for age, sex, education, and race, a higher level of purpose in life was associated with a substantially reduced risk of mortality (hazard ratio = 0.60, 95% Confidence Interval = 0.42, 0.87). Thus, the hazard rate for a person with a high score on the purpose in life measure (score = 4.2, 90th percentile) was about 57% of the hazard rate of a person with a low score (score = 3.1, 10th percentile). The association of purpose in life with mortality did not differ among men and women or Whites and Blacks. Further, the finding persisted after the addition of terms for several potential confounders, including depressive symptoms, disability, neuroticism, the number of chronic medical conditions, and income. Conclusion Greater purpose in life is associated with a reduced risk of all-cause mortality among community-dwelling older persons. PMID:19414613

  4. Polypharmacy in a Belgian cohort of community-dwelling oldest old (80+).

    PubMed

    Wauters, Maarten; Elseviers, Monique; Vaes, Bert; Degryse, Jan; Dalleur, Olivia; Vander Stichele, Robert; Van Bortel, Luc; Azermai, Majda

    2016-06-01

    Polypharmacy is highly prevalent among older people (65+), but little is known on the medication use of the oldest old (80+). This study explores the medication use of the Belgian community-dwelling oldest old in relation to their demographic, clinical and functional characteristics. Baseline data was used from the BELFRAIL study; a prospective, observational population-based cohort of Belgian community-dwelling patients (80+). General practitioners recorded clinical problems and medications. Medications were coded by the Anatomic Therapeutic Chemical classification. Participants' (n = 503) mean age was 84.4 years (range 80-102) and 61.2% was female. Median chronic medication use was 5 (range 0-16). Polypharmacy (≥5 medications) was high (57.7%), with excessive polypharmacy (≥10 medications) in 9.1%. Most commonly used medication group were antithrombotics, but also benzodiazepines and antidepressants were frequently consumed. Demographics related to polypharmacy (univariate analysis) were female gender, low education and moderate alcohol use. Age, care dependency and cognitive impairment showed no association with polypharmacy. In multivariate analysis, the predominant association with polypharmacy was found for multimorbidity (OR 1.78, 95% CI 1.5-2.1), followed by depression (OR 3.7, 95% CI 4.4-9.7) and physical activity (OR 0.8, 95% CI 0.7-0.9). Polypharmacy was high among Belgian community-dwelling oldest old (80+). Determinants of polypharmacy were interrelated, but dominated by multimorbidity. On top of the burden of multimorbidity, polypharmacy was independently associated with less physical activity, and with depressive symptoms.

  5. Prevalence of Wheelchair and Scooter Use Among Community-Dwelling Canadians

    PubMed Central

    Smith, Emma M.; Giesbrecht, Edward M.; Mortenson, W. Ben

    2016-01-01

    Background Mobility impairments are the third leading cause of disability for community-dwelling Canadians. Wheelchairs and scooters help compensate for these challenges. There are limited data within the last decade estimating the prevalence of wheelchair and scooter use in Canada. Objective The aims of this study were: (1) to estimate the prevalence of wheelchair and scooter use in Canada and (2) to explore relevant demographic characteristics of wheelchair and scooter users. Design This study was a secondary analysis of a cross-sectional national survey. Methods The Canadian Survey on Disability (2012) collected data on wheelchair and scooter use from community-dwelling individuals aged 15 years and over with a self-identified activity limitation on the National Household Survey. Prevalence estimates were calculated as weighted frequencies, with cross-tabulations to determine the number of wheelchair and scooter users in Canada, by province, and demographic characteristics (ie, age, sex) and bootstrapping to estimate the variance of all point estimates. Results There were approximately 288,800 community-dwelling wheelchair and scooter users aged 15 years and over, representing 1.0% of the Canadian population. The sample included 197,560 manual wheelchair users, 42,360 powered wheelchair users, and 108,550 scooter users. Wheelchair and scooter users were predominantly women, with a mean age of 65 years. Approximately 50,620 individuals used a combination of 2 different types of devices. Limitations The results are representative of individuals living in the community in Canada and exclude individuals in residential or group-based settings; estimates do not represent the true population prevalence. Conclusion This analysis is the first in more than 10 years to provide a prevalence estimate and description of wheelchair and scooter users in Canada. Since 2004, there has been an increase in the proportion of the population who use wheelchairs and scooters, likely

  6. Nutrient intake in community-dwelling adolescent girls with anorexia nervosa and in healthy adolescents123

    PubMed Central

    Misra, Madhusmita; Tsai, Patrika; Anderson, Ellen J; Hubbard, Jane L; Gallagher, Katie; Soyka, Leslie A; Miller, Karen K; Herzog, David B; Klibanski, Anne

    2011-01-01

    Background Adolescence is a common time for the onset of anorexia nervosa (AN), a condition associated with long-term medical and hormonal consequences. Objective The objective was to compare the nutrient intakes of community-dwelling girls with AN with those of healthy adolescents and to describe the associations between specific nutrient intakes and nutritionally dependent hormones. Design Nutrient intakes in 39 community-dwelling girls with AN and 39 healthy adolescents aged 12.1–18.7 y were determined by using 4-d food records. Fasting adiponectin, leptin, ghrelin, insulin, and insulin-like growth factor I (IGF-I) concentrations were measured. Indirect calorimetry was used to assess respiratory quotient and resting energy expenditure. Results In contrast with the control group, the AN group consumed fewer calories from fats (P < 0.0001) and more from carbohydrates (P = 0.0009) and proteins (P < 0.0001). Intake of individual fat components was lower and of dietary fiber higher in the AN group. No significant between-group differences were observed in dietary intakes of calcium, zinc, and iron; however, total intake was greater in the AN group because of greater supplement use (P = 0.006, 0.02, and 0.01, respectively). The AN group had greater intakes of vitamins A, D, and K and of most of the B vitamins, and significantly more girls with AN met the Dietary Reference Intake for calcium (P = 0.01) and vitamin D (P = 0.02) from supplement use. Fat intake predicted ghrelin, insulin, and IGF-I concentrations; carbohydrate intake predicted adiponectin. Resting energy expenditure was lower (P < 0.0001) and leisure activity levels higher in the AN group. Conclusions Despite outpatient follow-up, community-dwelling girls with AN continue to have lower fat and higher fiber intakes than do healthy adolescents, which results in lower calorie intakes. Nutritionally related hormones are associated with specific nutrient intakes. PMID:17023694

  7. The Association of Anxiety and Depressive Symptoms with Cognitive Performance in Community-Dwelling Older Adults

    PubMed Central

    Beaudreau, Sherry A.; O’Hara, Ruth

    2009-01-01

    We examined the association of anxiety, depressive symptoms, and their co-occurrence on cognitive processes in 102 community-dwelling older adults. Participants completed anxiety and depression questionnaires, and measures of episodic and semantic memory, word fluency, processing speed/shifting attention, and inhibition. Participants with only increased anxiety had poorer processing speed/shifting attention, and inhibition, but depressive symptoms alone were not associated with any cognitive deficits. Although co-existing anxiety and depressive symptoms was associated with deficits in 3 cognitive domains, reductions in inhibition were solely attributed to anxiety. Findings suggest an excess cognitive load on inhibitory ability in normal older adults reporting mild anxiety. PMID:19485667

  8. Therapeutic recreation interventions for need-driven dementia-compromised behaviors in community-dwelling elders.

    PubMed

    Fitzsimmons, Suzanne; Buettner, Linda L

    2002-01-01

    This study describes a clinical trial of at-home recreational therapy for community dwelling older adults with dementia and disturbing behaviors. After two weeks of daily, individualized recreational therapy interventions (TRIs), results indicated a significant decrease in levels of both passivity and agitation. Biograph data collection was useful in identifying the physiological changes that occurred with each intervention technique. Specific information is included on the time of day each behavior occurred and the most effective interventions, as well as implications for service delivery.

  9. Pet Therapy: Enhancing Social and Cardiovascular Wellness in Community Dwelling Older Adults.

    PubMed

    Krause-Parello, Cheryl A; Kolassa, John

    2016-01-01

    Pet therapy can be therapeutic for older adults living in the community. A crossover design was used to examine changes in blood pressure and heart rate before and after a pet therapy visit versus a volunteer-only visit in 28 community dwelling older adults. Relationships among stress, pet attitude, social support, and health status were also examined. Study findings supported that pet therapy significantly decreased blood pressure and heart rate. Ultimately, the findings supported the notion that community health nurses should consider developing and implementing pet therapy programs in the communities they serve. Further implications for community health nurses are discussed.

  10. Falls and Fall-Related Injuries among Community-Dwelling Adults in the United States

    PubMed Central

    Verma, Santosh K.; Willetts, Joanna L.; Corns, Helen L.; Marucci-Wellman, Helen R.; Lombardi, David A.; Courtney, Theodore K.

    2016-01-01

    Introduction Falls are the leading cause of unintentional injuries in the U.S.; however, national estimates for all community-dwelling adults are lacking. This study estimated the national incidence of falls and fall-related injuries among community-dwelling U.S. adults by age and gender and the trends in fall-related injuries across the adult life span. Methods Nationally representative data from the National Health Interview Survey (NHIS) 2008 Balance and Dizziness supplement was used to develop national estimates of falls, and pooled data from the NHIS was used to calculate estimates of fall-related injuries in the U.S. and related trends from 2004–2013. Costs of unintentional fall-related injuries were extracted from the CDC’s Web-based Injury Statistics Query and Reporting System. Results Twelve percent of community-dwelling U.S. adults reported falling in the previous year for a total estimate of 80 million falls at a rate of 37.2 falls per 100 person-years. On average, 9.9 million fall-related injuries occurred each year with a rate of 4.38 fall-related injuries per 100 person-years. In the previous three months, 2.0% of older adults (65+), 1.1% of middle-aged adults (45–64) and 0.7% of young adults (18–44) reported a fall-related injury. Of all fall-related injuries among community-dwelling adults, 32.3% occurred among older adults, 35.3% among middle-aged adults and 32.3% among younger adults. The age-adjusted rate of fall-related injuries increased 4% per year among older women (95% CI 1%–7%) from 2004 to 2013. Among U.S. adults, the total lifetime cost of annual unintentional fall-related injuries that resulted in a fatality, hospitalization or treatment in an emergency department was 111 billion U.S. dollars in 2010. Conclusions Falls and fall-related injuries represent a significant health and safety problem for adults of all ages. The findings suggest that adult fall prevention efforts should consider the entire adult lifespan to ensure a

  11. Falls and Fall-Related Injuries among Community-Dwelling Adults in the United States.

    PubMed

    Verma, Santosh K; Willetts, Joanna L; Corns, Helen L; Marucci-Wellman, Helen R; Lombardi, David A; Courtney, Theodore K

    2016-01-01

    Falls are the leading cause of unintentional injuries in the U.S.; however, national estimates for all community-dwelling adults are lacking. This study estimated the national incidence of falls and fall-related injuries among community-dwelling U.S. adults by age and gender and the trends in fall-related injuries across the adult life span. Nationally representative data from the National Health Interview Survey (NHIS) 2008 Balance and Dizziness supplement was used to develop national estimates of falls, and pooled data from the NHIS was used to calculate estimates of fall-related injuries in the U.S. and related trends from 2004-2013. Costs of unintentional fall-related injuries were extracted from the CDC's Web-based Injury Statistics Query and Reporting System. Twelve percent of community-dwelling U.S. adults reported falling in the previous year for a total estimate of 80 million falls at a rate of 37.2 falls per 100 person-years. On average, 9.9 million fall-related injuries occurred each year with a rate of 4.38 fall-related injuries per 100 person-years. In the previous three months, 2.0% of older adults (65+), 1.1% of middle-aged adults (45-64) and 0.7% of young adults (18-44) reported a fall-related injury. Of all fall-related injuries among community-dwelling adults, 32.3% occurred among older adults, 35.3% among middle-aged adults and 32.3% among younger adults. The age-adjusted rate of fall-related injuries increased 4% per year among older women (95% CI 1%-7%) from 2004 to 2013. Among U.S. adults, the total lifetime cost of annual unintentional fall-related injuries that resulted in a fatality, hospitalization or treatment in an emergency department was 111 billion U.S. dollars in 2010. Falls and fall-related injuries represent a significant health and safety problem for adults of all ages. The findings suggest that adult fall prevention efforts should consider the entire adult lifespan to ensure a greater public health benefit.

  12. 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

  13. Health-related quality of life in Brazilian community-dwelling and institutionalized elderly: Comparison between genders.

    PubMed

    Cucato, Gabriel Grizzo; Ritti-Dias, Raphael Mendes; Cendoroglo, Maysa Seabra; Carvalho, José Maria Maluf DE; Nasri, Fábio; Costa, Maria Luiza Monteiro; Matos, Luciana Diniz Nagem Janot DE; Franco, Fábio Gazelato DE Mello

    2016-12-01

    To compare the health-related quality of life (HRQL) indicators between institutionalized and community-dwelling elderly men and women. This was a cross-sectional study with a sample of 496 elderly men and women, surveyed by researchers at a private hospital that attends institutionalized and community-dwelling elderly. HRQL (World Health Organization Quality of Life), daily living activities (Katz questionnaire), and instrumental daily living activities (Lawton questionnaire), mini-mental state examination, handgrip strength test, and function capacity (timed up and go test) were obtained. Institutionalized men presented higher scores in physical and psychological domains of HRQL compared to elderly men living alone (p<0.05). Among women, the scores in all domains (physical, psychological, relationship, and environment) were similar between institutionalized and community-dwelling individuals. Institutionalized elderly men reported better scores in physical and psychological domains of HRQL compared to their community-dwelling pairs, while both institutionalized and community-dwelling elderly women presented similar HRQL.

  14. Serum carotenoids and pulmonary function in older community-dwelling women.

    PubMed

    Semba, R D; Chang, S S; Sun, K; Talegawkar, S; Ferrucci, L; Fried, L P

    2012-04-01

    Deterioration in pulmonary function is associated with greater disability and mortality in older adults. Dietary antioxidants are implicated in lung health, but the relationship between major dietary antioxidants, such as serum carotenoids, and pulmonary function have not been well characterized. Serum carotenoids are considered the most reliable indicator of fruit and vegetable intake. We examined the relationship between serum α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin, and lycopene with pulmonary function (forced expiratory volume in one second [FEV1] and forced vital capacity [FVC]) in a population-based sample of 631 moderately to severely disabled community-dwelling older women (Women's Health and Aging Study I) in Baltimore, Maryland, USA. Higher serum α-carotene and β-carotene concentrations were positively associated with both FEV1 and FVC, respectively (all P < 0.05), in separate multivariate linear regression models adjusting for age, race, education, cognition, anemia, inflammation, and chronic diseases. Total serum carotenoids were associated with FEV1 (P = 0.08) and FVC (P = 0.06), respectively, in similar models. No association was found between β-cryptoxanthin, lutein/zeaxanthin, and lycopene, and FEV1 or FVC. Higher serum α-carotene and β-carotene concentrations, which reflect greater intake of orange and dark green leafy fruits and vegetables, were associated with better pulmonary function among older community-dwelling women.function may lead to food avoidance and to a higher incidence of digestive complaints.

  15. 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

  16. Association of personality traits with elder self-neglect in a community-dwelling population.

    PubMed

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

    2011-08-01

    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 as follows: 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. Population-based study conducted from 1993 to 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. 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. Neuroticism, extraversion, rigidity, and information processing were not associated with significantly increased risk of elder self-neglect after consideration of potential confounders.

  17. The effectiveness of Pilates on balance and falls in community dwelling older adults.

    PubMed

    Josephs, Sharon; Pratt, Mary Lee; Calk Meadows, Emily; Thurmond, Stephanie; Wagner, Amy

    2016-10-01

    The purpose of this study was to determine whether Pilates is more effective than traditional strength and balance exercises for improving balance measures, balance confidence and reducing falls in community dwelling older adults with fall risk. Thirty-one participants with fall risk were randomly assigned to the Pilates group (PG) or the traditional exercise group (TG). Both groups participated in 12 weeks of exercise, 2 times/week for 1 h. There was significant improvement in the Fullerton Advanced Balance Scale for both the PG (mean difference = 6.31, p < .05) and the TG (mean difference = 7.45, p = .01). The PG also showed significant improvement in the Activities-Specific Balance Confidence Scale (mean difference = 10.57, p = .008). Both Pilates and traditional balance programs are effective at improving balance measures in community dwelling older adults with fall risk, with the Pilates group showing improved balance confidence. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Prevalence, work-loss days and quality of life of community dwelling subjects with depressive symptoms.

    PubMed

    Sohn, Jee Hoon; Ahn, Seung Hee; Seong, Su Jeong; Ryu, Ji Min; Cho, Maeng Je

    2013-02-01

    The nationwide prevalence of major depressive disorder in Korea is lower than most countries, despite the high suicide rate. To explain this unexpectedly low prevalence, we examined the functional disability and quality of life in community-dwelling subjects with significant depressive symptoms not diagnosable as depressive disorder. A total of 1,029 subjects, randomly chosen from catchment areas, were interviewed with the Center for Epidemiologic Studies Depression scale, Mini International Neuropsychiatric Interview, WHO Quality of Life scale, and the WHO Disability Assessment Schedule. Those with scores over 21 on the depression scale were interviewed by a psychiatrist for diagnostic confirmation. Among community-dwelling subjects, the 1-month prevalence of major depressive disorder was 2.2%, but the 1-month prevalence of depressive symptoms not diagnosable as depressive disorder was 14.1%. Depressive disorders were the cause of 24.7% of work loss days, while depressive symptoms not diagnosable as depressive disorder were the cause of 17.2% of work loss days. These findings support the dimensional or spectrum approach to depressive disorder in the community and might be the missing link between the apparent low prevalence of depressive disorder and high suicide rate in Korea.

  19. Relationship between Pelvic Alignment and Weight-bearing Asymmetry in Community-dwelling Chronic Stroke Survivors

    PubMed Central

    Karthikbabu, Suruliraj; Chakrapani, Mahabala; Ganesan, Sailakshmi; Ellajosyula, Ratnavalli

    2016-01-01

    Background and Purpose: Altered pelvic alignment and asymmetrical weight bearing on lower extremities are the most common findings observed in standing and walking after stroke. The purpose of this study was to find the relationship between pelvic alignment and weight-bearing asymmetry (WBA) in community-dwelling chronic stroke survivors. Materials and Methods: This cross-sectional study was conducted in tertiary care rehabilitation centers. In standing, the lateral and anterior pelvic tilt angle of chronic stroke survivors was assessed using palpation (PALM™) meter device. The percentage of WBA was measured with two standard weighing scales. Pearson correlation coefficient (r) was used to study the correlation between pelvic tilt and WBA. Results: Of 112 study participants, the mean (standard deviation) age was 54.7 (11.7) years and the poststroke duration was 14 (11) months. The lateral pelvic tilt on the most affected side and bilateral anterior pelvic tilt were 2.47 (1.8) and 4.4 (1.8) degree, respectively. The percentage of WBA was 23.2 (18.94). There was a high correlation of lateral pelvic tilt with WBA (r = 0.631; P < 0.001) than anterior pelvic tilt (r = 0.44; P < 0.001). Conclusion: Excessive lateral pelvic tilt toward the most affected side in standing may influence the weight-bearing ability of the ipsilateral lower extremity in community-dwelling chronic stroke survivors. PMID:28163501

  20. Health Outcomes Associated with Polypharmacy in Community-Dwelling Older Adults: A Systematic Review

    PubMed Central

    Fried, Terri R.; O’Leary, John; Towle, Virginia; Goldstein, Mary K.; Trentalange, Mark; Martin, Deanna K.

    2014-01-01

    Background/Objectives Polypharmacy is receiving increased attention as a potential problem for older persons, who frequently have multiple chronic conditions. The purpose of this study was to summarize evidence regarding the health outcomes associated with polypharmacy, defined as number of prescribed medications,among older community-dwelling persons. Design Systematic review of MEDLINE (OvidSP 1946 to May Week 3 2014). Setting Community Participants Observational studies examining health outcomes according to the number of prescription medications taken. Measurements Association of number of medications with health outcomes. Because of the importance of comorbidity as a potential confounder of the relationship between polypharmacy and health outcomes, articles were assessed regarding the quality of their adjustment for confounding. Results Of the total of 50 studies identified, the majority studies that were rated as “good” in terms of their adjustment for comorbidity demonstrated relationships between polypharmacy and a range of outcomes, including falls/fall outcomes/fall risk factors; adverse drug events, hospitalization, mortality, and measures of function and cognition. However, a number of these studies failed to demonstrate associations, as did a substantial proportion of those studies rated as “fair” or “poor.” Conclusions Data are mixed regarding the relationship between polypharmacy, considered in terms of number of medications, and adverse outcomes among community-dwelling older persons. Because of the challenge of confounding, randomized controlled trials of medication discontinuation may provide more definitive evidence regarding this relationship. PMID:25516023

  1. Prevalence, Work-Loss Days and Quality of Life of Community Dwelling Subjects with Depressive Symptoms

    PubMed Central

    Sohn, Jee Hoon; Ahn, Seung Hee; Seong, Su Jeong; Ryu, Ji Min

    2013-01-01

    The nationwide prevalence of major depressive disorder in Korea is lower than most countries, despite the high suicide rate. To explain this unexpectedly low prevalence, we examined the functional disability and quality of life in community-dwelling subjects with significant depressive symptoms not diagnosable as depressive disorder. A total of 1,029 subjects, randomly chosen from catchment areas, were interviewed with the Center for Epidemiologic Studies Depression scale, Mini International Neuropsychiatric Interview, WHO Quality of Life scale, and the WHO Disability Assessment Schedule. Those with scores over 21 on the depression scale were interviewed by a psychiatrist for diagnostic confirmation. Among community-dwelling subjects, the 1-month prevalence of major depressive disorder was 2.2%, but the 1-month prevalence of depressive symptoms not diagnosable as depressive disorder was 14.1%. Depressive disorders were the cause of 24.7% of work loss days, while depressive symptoms not diagnosable as depressive disorder were the cause of 17.2% of work loss days. These findings support the dimensional or spectrum approach to depressive disorder in the community and might be the missing link between the apparent low prevalence of depressive disorder and high suicide rate in Korea. PMID:23399785

  2. [Discussion between informal and formal caregivers of community-dwelling older adults].

    PubMed

    Jacobs, M T; Broese van Groenou, M I; Deeg, D J H

    2014-04-01

    Current Dutch policy on long-term care is aimed at a stronger connection between formal home care and informal care. We examined if formal and informal caregivers of community-dwelling older adults discuss the care and whether this is related to characteristics of the older adult, the care network and the individual caregivers. Data are derived from 63 community-dwelling older adults, including their health, their perceived control of the care and their care network. In addition, 79 informal and 90 formal caregivers are interviewed on their motives and vision on caregiving. The 112 dyads between those formal and informal caregivers are the units of analysis in the current study. Bivariate analyses reveal that informal caregivers are more likely to discuss the care with formal caregivers when they are residing with the older adult, when they provide a lot of care and/or when they are strongly motivated to keep the older adult at home. This is particularly the case when the care demands are high. Characteristics of the formal caregivers were not important. In conclusion, discussion of care between non-resident informal caregivers and formal caregivers is not self-evident and requires more effort to be established.

  3. Fear Avoidance Behavior, Not Walking Endurance, Predicts the Community Reintegration of Community-Dwelling Stroke Survivors.

    PubMed

    Liu, Tai-Wa; Ng, Shamay S; Kwong, Patrick W; Ng, Gabriel Y

    2015-09-01

    To examine the contribution of walking endurance, subjective balance confidence, and fear avoidance behavior to community reintegration among community-dwelling stroke survivors. Cross-sectional study. University-based rehabilitation center. Patients with chronic stroke (N=57) aged ≥50 years. None. The Chinese version of the Community Integration Measure (CIM). Our correlation analyses revealed that fear avoidance behavior as measured by the Chinese version of the Survey of Activities and Fear of Falling in the Elderly (SAFE) scores had the highest significant negative correlation with CIM scores among all the variables tested. Our regression analyses also revealed that walking endurance and subjective balance confidence were not significant predictors of CIM scores. Based on scores on the number of falls in the previous 6 months, Chinese version of the Geriatric Depression Scale scores, distance covered in the 6-minute walk test, and Chinese versions of the Activities-specific Balance Confidence Scale scores and SAFE scores, our final regression model predicted 49.7% of the variance in the Chinese version of the CIM scores. The levels of walking endurance and subjective balance confidence are not significant predictors of community reintegration of community-dwelling stroke survivors but the fear avoidance behavior. Future studies addressing fear avoidance behavior is clearly warranted for stroke rehabilitation. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. Conceptualization and nursing implications of self-imposed activity limitation among community-dwelling elders.

    PubMed

    Guo, Guifang; Phillips, Linda R

    2010-01-01

    The purposes of this paper are to explore, from a theoretical perspective, explanations for why some community-dwelling elders self-impose activity limitations (SIALs); to develop an integrated explanation for SIAL from a nursing perspective; and to identify some clinical implications of relevance to public health nursing practice. Activity limitation is an important risk factor for functional decline, morbidity, and mortality among community-dwelling elders. Many studies have focused on disease and environmental influences on activity limitations. The intrinsic processes associated with voluntary or SIAL in old age among otherwise physically and mentally capable elders are poorly understood and little studied. The conceptualization of SIAL provides nurses with an understanding of an understudied aging phenomenon and helps nurses understand how elders see activities related to their life priorities. The conceptual framework will facilitate future qualitative and quantitative study of SIAL, assist nurses in the development of a new gerontological nursing theory, and design of interventions for elders with activity limitations. Public health nurses with a better understanding of SIAL may be able to help elders improve or maintain their independence.

  5. Predicting Disability among Community-Dwelling Medicare Beneficiaries Using Claims-Based Indicators.

    PubMed

    Ben-Shalom, Yonatan; Stapleton, David C

    2016-02-01

    To assess the feasibility of using existing claims-based algorithms to identify community-dwelling Medicare beneficiaries with disability based solely on the conditions for which they are being treated, and improving on these algorithms by combining them in predictive models. Data on 12,415 community-dwelling fee-for-service Medicare beneficiaries who first responded to the Medicare Current Beneficiary Survey (MCBS) in 2003-2006. Logistic regression models in which six claims-based disability indicators are used to predict self-reported disability. Receiver operating characteristic (ROC) curves were used to assess the performance of the predictive models. The predictive performance of the regression-based models is better than that of the individual claims-based indicators. At a predicted probability threshold chosen to maximize the sum of sensitivity and specificity, sensitivity is 0.72 for beneficiaries age 65 or older and specificity is 0.65. For those under 65, sensitivity is 0.54 and specificity is 0.67. The findings also suggest ways to improve predictive performance for specific disability populations of interest to researchers. Predictive models that incorporate multiple claims-based indicators provide an improved tool for researchers seeking to identify people with disabilities in claims data. © Health Research and Educational Trust.

  6. Predictors of cessation of regular leisure-time physical activity in community-dwelling elderly people.

    PubMed

    Shimada, Hiroyuki; Lord, Stephen R; Yoshida, Hideyo; Kim, Hunkyung; Suzuki, Takao

    2007-01-01

    Maintaining regular physical activity is important for physical and mental health, providing benefits including protection against chronic disease. However, little is known about the causes of cessation of habitual physical activity in older people. To identify predictors of cessation of regular physical activity in community-dwelling elderly people. 582 community-dwelling people aged 70 years and over who were living in Tokyo, Japan, were surveyed regarding physical activity levels 2 years after completing an initial survey where they indicated they took part in physical activity at least 5 days a week. Baseline demographic, health, physical functioning and psychological status measures were used as predictors of exercise cessation. At the 2-year follow-up, 192 subjects (33%) had ceased taking part in regular physical activity. In univariate analyses, women, smokers, those who reported a fear of falling and those with a slower walking speed at baseline were significantly more likely to cease regular physical activity. Multiple logistic regression analysis identified 3 of these variables as significant and independent predictors of activity cessation: female gender (adjusted OR = 1.67, 95% CI = 1.13-2.47); smoking (OR = 2.34, 95% CI = 1.33-4.13), and slow walking speed (OR = 1.79, 95% CI = 1.07-2.98). The study identified simple screening measures for identifying elderly people at risk of ceasing regular physical activity. Currently active older people with these factors may benefit from counseling and interventions to enable them to continue participating in regular physical activity.

  7. Implementation and dissemination of military informed and evidence-based interventions for community dwelling military families.

    PubMed

    Murphy, Robert A; Fairbank, John A

    2013-12-01

    Community dwelling military families from the National Guard and Reserve contend with deployment-related stressors in relative isolation, living in communities where mental health providers may have little knowledge of military culture. When they are community residents, active duty service members and families tend to live in close proximity to their military installations. This article will focus primarily on the challenges to quality mental health care for reserve component (RC) families. Where studies of RC families are absent, those of active component (AC) families will be highlighted as relevant. Upon completion of a deployment, reintegration for RC families is complicated by high rates of symptomatology, low service utilization, and greater barriers to care relative to AC families. A paucity of providers skilled in evidence-based treatments (EBTs) limits community mental health capacity to serve RC military families. Several emergent programs illustrate the potential for better serving community dwelling military families. Approaches include behavioral health homes, EBTs and treatment components, structured resiliency and parent training, military informed schools, outreach methods, and technology-based coping, and psychoeducation. Methods from implementation science to improve clinical skill acquisition and spread and sustainability of EBTs may advance access to and quality of mental health treatment and are reviewed herein. Recommendations related to research methods, military knowledge and treatment competencies, and transition to a public health model of service delivery are discussed.

  8. ALTERATION IN COMMUNITY-DWELLING OLDER ADULTS’ LEVEL WALKING FOLLOWING PERTURBATION TRAINING

    PubMed Central

    Yang, Feng; Pai, Yi-Chung

    2013-01-01

    While perturbation training is promising in reducing fall-risk among older adults, its impact on altering their spontaneous gait pattern has not been investigated. The purpose of this study was to determine to what extent older adults’ gait pattern would be affected by exposure to 24 repeated slips. Seventy-three community-dwelling older adults (age: 72.6 ± 5.4 years) underwent 24 repeated-slip exposure induced by unannounced unlocking and relocking of low-friction sections of a 7-m pathway upon which they walked. Full body kinematics and kinetics were recorded during the training. The gait parameters and the center of mass (COM) stability against backward balance loss were compared before and after the training. The results revealed that the training reduced fall incidence from 43.8% upon the novel slip to 0 at the end of training. After the training, subjects significantly improved gait stability by forward positioning of their COM relative to the base of support without altering gait speed. This forward COM shift resulted from a shortened step at the end of single stance and forward trunk leaning during double stance. They also adopted flat foot landing with knee flexed at touchdown (with an average change of 6.9 and 4.1 degrees, respectively). The perturbation training did alter community-dwelling older adults’ spontaneous gait pattern. These changes enabled them to improve their volitional control of stability and their resistance to unpredictable and unpreventable slip-related postural disturbance. PMID:23978691

  9. [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.

  10. Life-space mobility and dimensions of depressive symptoms among community-dwelling older adults.

    PubMed

    Polku, Hannele; Mikkola, Tuija M; Portegijs, Erja; Rantakokko, Merja; Kokko, Katja; Kauppinen, Markku; Rantanen, Taina; Viljanen, Anne

    2015-01-01

    To examine the association between life-space mobility and different dimensions of depressive symptoms among older community-dwelling people. Cross-sectional analyses of baseline data of the 'Life-Space Mobility in Old Age' cohort study were carried out. The participants were community-dwelling women and men aged 75-90 years (N = 848). Data were gathered via structured interviews in participants' home. Life-space mobility (the University of Alabama at Birmingham (UAB) Life-Space Assessment - questionnaire) and depressive symptoms (Centre for Epidemiological Studies Depression Scale, CES-D) were assessed. Other factors examined included sociodemographic factors, difficulties walking 500 m, number of chronic diseases and the sense of autonomy in participation outdoors (subscale of Impact on Participation and Autonomy questionnaire). Poorer life-space mobility was associated with higher prevalence of different dimensions of depressive symptoms. The associations were partially mediated through walking difficulties, health and the sense of autonomy in participation outdoor activities. Poorer life-space mobility interrelates with higher probability for depressive symptoms, thus compromising older adults' mental wellbeing. A focus on older adults' life-space mobility may assist early identification of persons, who have elevated risk for depressive symptoms. The association between life-space mobility and depressive symptoms should be studied further utilizing longitudinal study designs to examine temporality and potential causality.

  11. Validation analysis of a geriatric dehydration screening tool in community-dwelling and institutionalized elderly people.

    PubMed

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

    2015-03-02

    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.

  12. Age- and gender-related test performance in community-dwelling adults.

    PubMed

    Steffen, T M; Mollinger, L A

    2005-12-01

    Interpretation of patient scores on functional tests is enhanced by an understanding of test performance in reference groups. The purpose of this study was to expand performance values, by age and gender, on balance tests [the Multi-Directional Reach (MDRT); Berg Balance (BBS); Sharpened Romberg, eyes open (SREO), eyes closed (SREC); Activities-Specific Balance Confidence (ABC)], and a general mobility test [Physical Performance Test, (PPT-7, PPT-9)]. The study also examined relationships between test performance and subject characteristics. Eighty-three community-dwelling adults over 50 participated in the study and completed the 5 functional tests during one test session. Means, standard deviations, and confidence intervals were calculated for each of the tests. Multiple linear regression analysis was used to examine relationships between test scores and age, gender, height, and weight. Test performance is reported by gender,within 10-year age cohorts. Regression analysis showed that age contributed significantly to prediction of performance on all of the tests and gender contributed significantly to prediction of scores on the Berg, SREO, and SREC. Test performance values, in a sample of community-dwelling adults, is provided by age and gender cohorts to provide additional reference data that can be used by clinicians for comparison with client data. The small sample size for subjects over 80 years limits the reference value of data for this age group. In regression analyses, age and gender help predict outcomes on the dependent variables used in the study.

  13. 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.

  14. Relationship Between Self-Rated Masticatory Ability and Independent Life in Community-Dwelling Older Adults

    PubMed Central

    Hironaka, Mikiko; Kayama, Yoshiko; Misaka, Yoshie

    2015-01-01

    Objective: The aim of the present study was to elucidate the influence of self-rated masticatory ability on independent living in community-dwelling older adults. Method: A total of 1,377 subjects aged 65 and over who lived in Kumamoto City, Japan were participated in a survey to investigate critical factors for self-reliance in older adults. In this study, we defined independent life in older adults as self-perceived adequate health without long-term care certification. Logistic regression analysis was used to assess self-perceived masticatory ability in relation to the independent life. Results: The population with adequate self-rated masticatory ability included a significantly higher proportion of subjects with good self-perceived health without long-term care (72.7%) than the remaining subjects (27.3%). A logistic regression analysis revealed that there was significant relationship between subjective adequate mastication and living a self-reliant healthy life (p < .001). Conclusion: Our results showed that satisfactory masticatory function was positively related to a self-reliant life with subjective healthy conditions in community-dwelling older adults, which was associated with an extended active life expectancy. PMID:28138466

  15. 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

  16. Evaluation of the Iranian Mini Nutritional Assessment Short-Form in Community-dwelling Elderly.

    PubMed

    Malek Mahdavi, Aida; Mahdavi, Reza; Lotfipour, Mohammad; Asghari Jafarabadi, Mohammad; Faramarzi, Elnaz

    2015-01-01

    This study was aimed to assess agreement and diagnostic accuracy of the Iranian version of Mini Nutritional Assessment short-form (MNA-SF) against the original MNA, as a gold standard in community-dwelling elderly. The full MNA and 9-item MNA-SF comprising questions regarding clinical status, dietary assessment and self-perception of health status and nutri-tion together with mid-arm and calf circumference measurements without in-cluding the body mass index (BMI) were completed for 205 volunteers aged 65 or older recruited from all over Markazi Province (Iran). Correlation, diagnostic accuracy and agreement between the MNA-SF and full MNA were calculated. The MNA and the MNA-SF classified 45.4% and 64.4% of the sub-jects as malnourished or at risk of malnutrition, respectively. Substantial agree-ment between the MNA-SF and full MNA was observed (Kappa=0.633). The MNA-SF correlated strongly with the full MNA (r=0.868, P<0.001). The MNA-SF showed high sensitivity (96.77%) and negative predictive values (95.89%), relatively high specificity (62.5%) and positive predictive values (68.18%) and fair accuracy (Area under curve =0.796). Iranian MNA-SF seems to be an applicable screening tool for quick detection of malnutrition or at risk of malnutrition in community-dwelling elderly especially when BMI is unavailable.

  17. Nutritional screening in community-dwelling older adults: a systematic literature review.

    PubMed

    Phillips, Megan B; Foley, Amanda L; Barnard, Robert; Isenring, Elisabeth A; Miller, Michelle D

    2010-01-01

    Nutrition screening is a process used to quickly identify those who may be at risk of malnutrition so that a full nutrition assessment and appropriate nutrition intervention can be provided. While many nutrition screening tools have been developed, few have been evaluated for use in older adults in the community setting. The aim of this paper is to determine the most appropriate nutrition screening tool/s, in terms of validity and reliability, for identifying malnutrition risk in older adults living in the community. Electronic databases MEDLINE, PUBMED, CINAHL and the Cochrane Library were searched for nutrition screening tools to identify malnutrition or under-nutrition for adults greater than 65 years living in the community. Ten screening tools were found for use in community-dwelling older adults and subjected to validity and/or reliability testing: Mini Nutritional Assessment-Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), Nutrition Screening Initiative (NSI), which includes the DETERMINE Checklist and Level I and II Screen, Australian Nutritional Screening Initiative (ANSI), Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN I and SCREEN II), Short Nutritional Assessment Questionnaire (SNAQ), Simplified Nutritional Appetite Questionnaire (SNAQ), and two unnamed tools. MNA-SF appears to be the most appropriate nutrition screening tool for use in community-dwelling older adults although MUST and SCREEN II also have evidence to support their use. Further research into the acceptability of screening tools focusing on the outcomes of nutrition screening and appropriate nutrition intervention are required.

  18. Anxiety Among Community-Dwelling U.S. Chinese Older Adults

    PubMed Central

    Chen, Ruijia; Simon, Melissa A.

    2014-01-01

    Background. This study aimed to explore the prevalence and correlates of anxiety disorders and any anxiety symptoms among community-dwelling U.S. Chinese older adults. Methods. Guided by a community-based participatory research approach, 3,159 community-dwelling Chinese older adults in the Greater Chicago area were interviewed in person between 2011 and 2013. Results. Of 3,159 older adults surveyed, 8.5% had anxiety disorders and 65.0% reported having any anxiety symptoms. Being female, unmarried, poorer health status, lower quality of life, and worsening health over the past year were positively correlated with anxiety disorders and any anxiety symptoms. Living with fewer people and having fewer children were only correlated with any anxiety symptoms and lower income was only correlated with anxiety disorders. Conclusions. This study emphasizes that interventions for anxiety among Chinese older adults should give special attention to older women, those who are unmarried, with impaired health status, and poorer quality of life. Further longitudinal studies should be conducted to better understand risk factors and outcomes associated with anxiety among U.S. Chinese older adults. PMID:25378450

  19. Health outcomes associated with polypharmacy in community-dwelling older adults: a systematic review.

    PubMed

    Fried, Terri R; O'Leary, John; Towle, Virginia; Goldstein, Mary K; Trentalange, Mark; Martin, Deanna K

    2014-12-01

    To summarize evidence regarding the health outcomes associated with polypharmacy, defined as number of prescribed medications, in older community-dwelling persons. Systematic review of MEDLINE (OvidSP 1946 to May, Week 3, 2014). Community. Observational studies examining health outcomes according to number of prescription medications taken. Association between number of medications and health outcomes. Because of the importance of comorbidity as a potential confounder of the relationship between polypharmacy and health outcomes, articles were assessed regarding the quality of their adjustment for confounding. Of the 50 studies identified, the majority that were rated good in terms of their adjustment for comorbidity demonstrated relationships between polypharmacy and a range of outcomes, including falls, fall outcomes, fall risk factors, adverse drug events, hospitalization, mortality, and measures of function and cognition. However, a number of these studies failed to demonstrate associations, as did a substantial proportion of studies rated fair or poor. Data are mixed regarding the relationship between polypharmacy, considered in terms of number of medications, and adverse outcomes in community-dwelling older persons. Because of the challenge of confounding, randomized controlled trials of medication discontinuation may provide more-definitive evidence regarding this relationship than observational studies can provide. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  20. Correlates of plasma fibrinogen (FG) levels in a random sample of community-dwelling elderly.

    PubMed

    Kostka, Tomasz; Para, Jadwiga; Kostka, Barbara

    2008-01-01

    The aim of this study was to evaluate the association between plasma FG levels and coexisting cardiovascular diseases (CVD) risk factors, comorbidities, functional status and cognitive function in a random sample of 270 (163 women and 107 men) community-dwelling elderly aged 65-79 years. The assessment included demographic and social variables, health status, nutritional state, physical and cognitive function. Physical activity was assessed by the Stanford Usual Activity Questionnaire. The average plasma FG level was lower in men 3.1+/-0.9 g/l (+/-SD) than in women 3.6+/-1.1g/l. In the whole group of elderly people, body mass index (BMI), percentage of body fat, calf circumference as well as total and low density cholesterol were positively correlated with FG levels, whereas the Stanford Moderate Index-negatively. Multifactor analysis of variance (ANOVA) revealed that female gender, calf circumference and the Stanford Moderate Index are the factors that independently predict FG levels. In conclusion, FG seems not to be related to functional status or cognitive function of older individuals. Nevertheless, our findings suggest that female gender, excess body fatness and low physical activity have an independent contribution to higher plasma FG levels in community-dwelling older subjects.

  1. Depressive symptoms as a risk factor for disabling back pain in community-dwelling older persons.

    PubMed

    Reid, M Carrington; Williams, Christianna S; Concato, John; Tinetti, Mary E; Gill, Thomas M

    2003-12-01

    To determine whether the presence of depressive symptoms is an independent risk factor for disabling back pain in community-dwelling older persons. Prospective cohort study with a 12-month follow-up period. General community. Seven hundred forty-four members of a large health plan who were aged 70 and older and independent in bathing, walking, dressing, and transferring at baseline. The presence of depressive symptoms, defined as a score of 16 or greater on the Center for Epidemiologic Studies-Depression Scale, was documented during a comprehensive baseline assessment that also included information regarding participants' demographic, medical, and physical/cognitive status. The occurrence of disabling back pain was ascertained during monthly telephone interviews. Depressive symptoms were present in 153 (20.6%) participants at baseline. Over the 12-month follow-up period, 186 participants (25.0%) reported disabling back pain during 1 to 2 months and 91 (12.2%) during 3 or more months. After adjustment for potential confounders, the presence of depressive symptoms was independently associated with the occurrence of disabling back pain (adjusted odds ratio (AOR)=2.3 (95% confidence interval (CI)=1.2-4.4) for 1 to 2 months with disabling back pain; AOR=7.8 (95% CI=3.7-16.4) for 3 or more months with disabling back pain). The presence of depressive symptoms is a strong, independent, and highly prevalent risk factor for the occurrence of disabling back pain in community-dwelling older persons.

  2. The association between the home environment and physical activity in community-dwelling older adults.

    PubMed

    Benzinger, P; Iwarsson, S; Kroog, A; Beische, D; Lindemann, U; Klenk, J; Becker, C

    2014-08-01

    Physical activity (PA) decreases with increasing age despite the fact that PA exerts beneficial effects on many age-related diseases and conditions. Consequently, there is an interest in modifiable factors that may influence PA among older persons. The purpose of this study was to examine the association between PA and the home environment in well-functioning older community-dwelling persons. This study used a person-environment (P-E) fit perspective to the home environment, operationalized by means of assessment of functional limitations in 81 community-dwelling persons (median age 79 years) as well as environmental barriers in their home environments and the nearby exterior surroundings. The interaction between functional limitations and environmental barriers generated a score expressing the magnitude of P-E fit problems in their home environment. PA was rated with a questionnaire covering household-related and recreational activities. We found a significant association between PA and the magnitude of P-E fit problems that explained 3.9 % of the variance of PA. The number of environmental barriers per se was not significantly associated with PA, while functional limitations explained 6.8 % of the variance of PA. In well-functioning older persons living in the community environmental aspects of housing demonstrated a weak association with PA.

  3. Hypertension as a Risk Factor for Developing Depressive Symptoms among Community-Dwelling Elders

    PubMed Central

    García-Fabela, Luis; Melano-Carranza, Efrén; Aguilar-Navarro, Sara; García-Lara, Juan M. A.; Gutiérrez-Robledo, Luis Miguel; Ávila-Funes, José Alberto

    2014-01-01

    Objective To determine whether hypertension (HTA) is an independent predictor of depressive symptoms (DS) in a sample of elderly Mexican community-dwelling persons. Patients and methods Two-year longitudinal study of 3276 community-dwelling persons aged 60 years and older, participating in the Mexican Health and Aging Study. Subjects that self-reported both having or not having HTA while denying DS at baseline were included. Two-year follow-up data were analyzed, and multiple regression analyses were used to test whether HTA is an independent predictor of incident DS after adjusting for many potential confounders. Results Mean age of participants was 68.4 ± 6.9 years. Prevalence of HTA was 36.6%. At follow-up, 28.7% developed DS. After adjusting for multiple covariates (age, sex, education level, relationship status, self-reported health and economic status, diabetes, arthritis, stroke, ischemic cardiopathy, falls, pain, hearing impairment, visual impairment, urinary incontinence, cognitive impairment, smoking, alcohol use, and baseline disability), HTA was an independent predictor of DS at two years follow-up (Adjusted Odds Ratio = 1.18; 95% confidence interval = 1.01–1.40). Conclusions Hypertension is an independent risk factor for the development of depressive symptoms. Programs to support early treatment of cardiovascular disease and hypertension should be implemented in order to prevent late-onset of depressive symptoms. PMID:19848303

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

    PubMed

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

    2016-11-01

    [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.

  5. Features of problematic eating behaviors among community-dwelling older adults with dementia: family caregivers' experience.

    PubMed

    Hsiao, Hua-Chen; Chao, Hui-Chen; Wang, Jing-Jy

    2013-01-01

    This study aimed to explore family caregivers' experience of the problematic eating behaviors among community-dwelling older adults with dementia, and how these caregivers cope with these problems. An exploratory qualitative study using purposive sampling recruited family caregivers of community-dwelling older adults with dementia in southern Taiwan. In-depth interviews were carried out with a semi-structured interview guide. Data were saturated when the number of participants reached a certain number. The following three features were derived from the content analysis: fundamental deviations of eating behaviors, expressing needs through eating behaviors, and loss of eating ability. The results also show that caregivers often derived their own ways of coping with the problems they faced, and tended to have negative attitudes and behaviors with regard to coping with the demands of older adults with dementia. The findings of this study can provide valuable information to family caregivers with regard to the problematic eating behaviors of older adults with dementia, so that early recognition and understanding of such behaviors facilitate appropriate responses, thus reducing the burden shouldered by caregivers. Copyright © 2013 Mosby, Inc. All rights reserved.

  6. Ability to negotiate stairs predicts free-living physical activity in community-dwelling people with stroke: an observational study.

    PubMed

    Alzahrani, Matar Abdullah; Dean, Catherine M; Ada, Louise

    2009-01-01

    Which clinical measures of walking performance best predict free-living physical activity in community-dwelling people with stroke? Cross-sectional observational study. 42 community-dwelling stroke survivors. Predictors were four clinical measures of walking performance (speed, automaticity, capacity, and stairs ability). The outcome of interest was free-living physical activity, measured as frequency (activity counts) and duration (time on feet), collected using an activity monitor called the Intelligent Device for Energy Expenditure and Physical Activity. Time on feet was predicted by stairs ability alone (B 166, 95% CI 55 to 278) which accounted for 48% of the variance. Activity counts were also predicted by stairs ability alone (B 6486, 95% CI 2922 to 10 050) which accounted for 58% of the variance. The best predictor of free-living physical activity in community-dwelling people with stroke was stairs ability.

  7. 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.

  8. 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

  9. Effects of Short-Term Training of Community-Dwelling Elderly with Modular Interactive Tiles

    PubMed Central

    Jessen, Jari Due

    2014-01-01

    Abstract Objective: The objective of this study is to test for the increased mobility, agility, balancing, and general fitness of community-dwelling elderly individuals as a result of short-term training involving playing with modular interactive tiles (Entertainment Robotics, Odense, Denmark) at two community activity centers for the elderly. Three different tests from the Senior Fitness Test were used in order to test a variety of health parameters of the community-dwelling elderly, including those parameters related to fall prevention. Materials and Methods: Eighteen community-dwelling elderly individuals (63–95 years of age; mean, 83.2 years of age) were assessed in one intervention group without the use of a control group. The intervention group performed nine group sessions (1–1.5 hours each) of playful training with the modular interactive tiles over a 12-week period in two community activity centers for the elderly. Data were collected using pre-tests and post-tests of the 6-Minute Walk Test (6MWT), the 8-foot Timed Up & Go Test (TUG), and the Chair-Stand Test (CS). Data were analyzed for statistically significant differences and increases of means. Results: The 6MWT, TUG, and CS measurements showed statistically significant differences and increases of means between the pre-tests and post-tests with the 6MWT (P<0.001) (means difference, 22.4 percent), TUG (P<0.001) (means difference, 15 percent), and CS (P<0.002) (means difference, 14 percent). Fifty-six percent of the elderly progressed from one health risk level to a better level, according to the three tests. Conclusions: Statistically significant increases in scores were found across all tests, suggesting an improvement of many different health parameters for the elderly. Well-established research has shown the relationship between such test scores and fall incidents, balancing, mobility, agility, etc. This significant improvement in the health status of the elderly is obtained in as few as nine

  10. Factors related to fear of falling among community-dwelling older adults.

    PubMed

    Hoang, Oanh Tran Thi; Jullamate, Pornchai; Piphatvanitcha, Naiyana; Rosenberg, Edwin

    2017-01-01

    To investigate the relationship between age, gender, history of falls, balance and gait status, general health perception, activities of daily living and depression to fear of falling in community-dwelling older people in Danang, Vietnam. Fear of falling is a common and consequential psychosocial problem for older people and can lead to decreased quality of life. There is only limited research on fear of falling in Vietnam. This is a cross-sectional descriptive study. One hundred fifty-three community-dwelling older people were recruited from seven communities of different districts in Danang. Data were collected using six instruments: a demographic questionnaire, the Fall Efficacy Scale-International, the General Health Perception questionnaire, the Barthel Activities of Daily Living, the Geriatric Depression Scale and the Timed Up and Go test. Data were analysed using descriptive and correlational statistics. The mean Fall Efficacy Scale-International score was 35, indicating a high level of fear of falling. ADLs, general health perception and Timed Up and Go were significantly and negatively related to fear of falling (rp  = -0·80, rsp  = -0·77 and rp  = -0·75, respectively). Age, depression and history of falls were significantly and positively related to fear of falling (rp  = 0·54, rp  = 0·45 and rs  = 0·39, respectively). Women were significantly more likely than men to have higher fear of falling (rpb  = -0·28). Fear of falling is more common in older people who are female, have a history of falls, have poor balance and gait status, have poor health perception, have greater ADL dependency, are depressed and, within the older people population, are older. Further research could examine additional correlates of fear of falling and develop/evaluate factor-specific intervention strategies to reduce fear of falling among community-dwelling older people. Understanding correlates of fear of falling among older Vietnamese people contributes to

  11. Association between sleep duration and sarcopenia among community-dwelling older adults

    PubMed Central

    Hu, Xiaoyi; Jiang, Jiaojiao; Wang, Haozhong; Zhang, Lei; Dong, Birong; Yang, Ming

    2017-01-01

    Abstract Both sleep disorders and sarcopenia are common among older adults. However, little is known about the relationship between these 2 conditions. This study aimed to investigate the possible association between sleep duration and sarcopenia in a population of Chinese community-dwelling older adults. Community-dwelling older adults aged 60 years or older were recruited. Self-reported sleep duration, anthropometric data, gait speed, and handgrip strength were collected by face-to-face interviews. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS). We included 607 participants aged 70.6 ± 6.6 years (range, 60–90 years) in the analyses. The prevalence of sarcopenia in the whole study population was 18.5%. In women, the prevalence of sarcopenia was significantly higher in the short sleep duration group (< 6 hours) and long sleep duration group (>8 hours) compared with women in the normal sleep duration group (6–8 hours; 27.5%, 22.2% and 13.9%, respectively; P = .014). Similar results were found in men; however, the differences between groups were not statistically significant (18.5%, 20.6%, and 13.0%, respectively; P = .356). After adjustments for the potential confounding factors, older women having short sleep duration (OR: 4.34; 95% CI: 1.74–10.85) or having long sleep duration (OR: 2.50; 95% CI: 1.05–6.99) had greater risk of sarcopenia compared with women having normal sleep duration. With comparison to men with normal sleep duration, the adjusted OR for sarcopenia was 2.12 (0.96–8.39) in the short sleep duration group and 2.25 (0.88–6.87) in the long sleep duration group, respectively. A U-shape relationship between self-reported sleep duration and sarcopenia was identified in a population of Chinese community-dwelling older adults, especially in women. PMID:28272238

  12. 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

  13. Falls prevention activities among community-dwelling elderly in the Netherlands: A Delphi study.

    PubMed

    Olij, Branko F; Erasmus, Vicki; Kuiper, Judith I; van Zoest, Frans; van Beeck, Ed F; Polinder, Suzanne

    2017-09-01

    This study aimed to provide an overview of the current falls prevention activities in community-dwelling elderly with an increased risk of falling in the Netherlands. Therefore, we determined: a) how health professionals detect community-dwelling elderly with an increased risk of falling; b) which falls prevention activities are used by health professionals and why; c) how elderly can be stimulated to participate in falls prevention programs; and d) how to finance falls prevention. A two-round online Delphi study among health experts was conducted. The panel of experts (n=125) consisted of community physiotherapists, community nurses, general practitioners, occupational therapists and geriatricians, from all over the Netherlands. The median and Inter Quartile Deviation (IQD) were reported for the questions with 5-point Likert scales, ranging from 'least' (1) to 'most' (5). Respectively 68% (n=85/125) and 58% (n=72/125) of the panel completely filled in the first and second round questionnaires. According to the panel, regular detection of fall risk of community-dwelling elderly with an increased risk of falling hardly takes place (median=2 [hardly]; IQD=1). Furthermore, these elderly are reluctant to participate in annual detection of fall risk (median=3 [reluctant]; IQD=1). According to 73% (n=37/51) of the panel, 0-40% of the elderly with an increased risk of falling are referred to exercise programs. In general, the panel indicated that structural follow-up is often lacking. Namely, after one month (n=21/43; 49%), three months (n=24/42; 57%), and six months (n=27/45; 60%) follow-up is never or hardly ever offered. Participation of elderly in falls prevention programs could be stimulated by a combination of measures. Should a combination of national health education, healthcare counseling, and removal of financial barriers be applied, 41-80% of the elderly is assumed to participate in falls prevention programs (n=47/64; 73%). None of the panel members indicated

  14. Differences in Self-Reported Oral Health Among Community-Dwelling Black, Hispanic, and White Elders

    PubMed Central

    Wu, Bei; Plassman, Brenda L.; Liang, Jersey; Remle, R. Corey; Bai, Lina; Crout, Richard J.

    2011-01-01

    Objectives To compare differences in self-rated oral health among community-dwelling Black, Hispanic, and White adults aged 60 and older. Method A total of 4,859 participants in the National Health and Nutrition Examination Survey (1999–2004) provided self-report information on oral health. Results Blacks and Hispanics reported poorer self-rated oral health than Whites. In separate dentate and edentulous groups, socioeconomic status, social support, physical health, clinical oral health outcomes, and dental checkups accounted for much of the difference in self-rated oral health in Blacks, but significant differences remained for Hispanics. Discussion The study findings may have important implications for health policy and program development. Programs and services designed for minority populations should target treatments for dental diseases and include components that take into account subjective evaluations of oral health conditions and perceived dental needs of the individuals. PMID:20858912

  15. The power of power wheelchairs: Mobility choices of community-dwelling, older adults

    PubMed Central

    Mortenson, WB; Hammell, KW; Luts, A; Soles, C; Miller, WC

    2015-01-01

    Background Power wheelchairs are purported to have a positive effect on health, occupation, and quality of life. However, there is limited knowledge about what factors shape power wheelchair use decisions. Aims/Objectives A study was undertaken to understand the mobility choices of community-dwelling, power wheelchair users. Methods A series of semi-structured qualitative interviews was conducted with 13 older adult power wheelchair users. Participants were interviewed at enrollment and four months later. Data analysis was informed by Bourdieu’s theoretical constructs of habitus, capital, and field. Results Three main styles of power wheelchair use were identified: reluctant use, strategic use and essential use, and each type is illustrated using an aggregate case study. Conclusion/Significance These findings highlight the need to alter the power relationship that exists between prescribers and device users and to effect policy changes that enable people with physical impairments to make as wide a range of mobility choices as possible. PMID:26027749

  16. The power of power wheelchairs: Mobility choices of community-dwelling, older adults.

    PubMed

    Mortenson, William Bennett; Hammell, Karen W; Luts, Anneli; Soles, Chelsea; Miller, William C

    2015-01-01

    Power wheelchairs are purported to have a positive effect on health, occupation, and quality of life. However, there is limited knowledge about what factors shape power wheelchair use decisions. A study was undertaken to understand the mobility choices of community-dwelling, power wheelchair users. A series of semi-structured qualitative interviews was conducted with 13 older adult power wheelchair users. Participants were interviewed at enrollment and four months later. Data analysis was informed by Bourdieu's theoretical constructs of habitus, capital, and field. Three main styles of power wheelchair use were identified: reluctant use, strategic use, and essential use, and each type is illustrated using an aggregate case study. These findings highlight the need to alter the power relationship that exists between prescribers and device users and to effect policy changes that enable people with physical impairments to make as wide a range of mobility choices as possible.

  17. Exercise intervention designed to improve strength and dynamic balance among community-dwelling older adults.

    PubMed

    DiBrezzo, Ro; Shadden, Barbara B; Raybon, Blake H; Powers, Melissa

    2005-04-01

    Loss of balance and falling are critical concerns for older adults. Physical activity can improve balance and decrease the risk of falling. The purpose of this study was to evaluate a simple, low-cost exercise program for community-dwelling older adults. Sixteen senior adults were evaluated using the Senior Fitness Test for measures of functional strength, aerobic endurance, dynamic balance and agility, and flexibility. In addition, measures of height, weight, resting blood pressure, blood lipids, and cognitive function were obtained. Participants then attended a 10-week exercise class including stretching, strengthening, and balance-training exercises. At the completion of the program, significant improvements were observed in tests measuring dynamic balance and agility, lower and upper extremity strength, and upper extremity flexibility. The results indicate that exercise programs such as this are an effective, low-cost solution to improving health and factors that affect falling risk among older adults.

  18. Association Between Social and Physical Activities and Insomnia Symptoms Among Community-Dwelling Older Adults

    PubMed Central

    Endeshaw, Yohannes W.; Yoo, Wonsuk

    2016-01-01

    Objective To examine the association between organized social activity, walking exercise, and insomnia symptoms. Material and Method Data for analysis are derived from the National Health Aging Trends Study (NHATS). At baseline, demographic characteristics, socioeconomic status, health-related behaviors, sleep-related problems, and health status were assessed using questionnaires. Results Data for 7,162 community-dwelling older adults were available for analysis. Difficulty falling asleep, trouble staying asleep, and both insomnia symptoms were reported by 12%, 5%, and 11% of the participants, respectively. The proportion of participants who reported engaging in organized social activity, walking exercise, and both activities were 11%, 35%, and 26%, respectively. Participants who reported engaging in organized social activity and/or walking exercise were significantly less likely to report insomnia symptoms. Conclusion These results have important implications for future studies that plan to implement nonpharmacological interventions for management of insomnia among older adults. PMID:26690253

  19. Relationships among stress, infectious illness, and religiousness/spirituality in community-dwelling older adults.

    PubMed

    Callen, Bonnie L; Mefford, Linda; Groër, Maureen; Thomas, Sandra P

    2011-07-01

    The purpose of this study was to examine the relationships among stress, infectious illness, and religiousness/spirituality in community-dwelling older adults in the southeastern United States. Four assessment tools were completed by 82 older adults (mean age = 74, age range = 65 to 91): the Perceived Stress Scale, the Carr Infection Symptom Checklist (SCL), the Brief Multidimensional Measurement of Religiousness/Spirituality, and a demographic form. A significant correlation was found between stress and SCL scores; however, four dimensions of religiousness/spirituality moderated the relationship between stress and infection. Older adults who were unable to forgive themselves or forgive others, or feel forgiven by God, were more likely to have had an infection in the previous month. Increased infections also occurred when older participants did not feel they had religious support from their congregations. Using these findings, gerontological nurses are well positioned to deliver tailored stress management and forgiveness interventions when older adults report increased stress.

  20. Factors associated with low life life satisfaction in community-dwelling elderly: FIBRA Study.

    PubMed

    Pinto, Juliana Martins; Neri, Anita Liberalesso

    2013-12-01

    The objectives were to identify factors associated with decreased life satisfaction in community-dwelling elderly and describe such factors according to gender and age bracket. The study interviewed 2,472 elderly individuals 65 years or older without cognitive deficits suggestive of dementia, in probabilistic samples from seven Brazilian cities. All measures were self-reported except for functional performance, indicated by handgrip and gait speed. Women had more chronic diseases, worse functional performance, and greater social involvement when compared to men. The oldest participants showed worse functional performance and less social involvement when compared to the youngest. Low satisfaction was associated with three or more diseases, memory problems, low social involvement, low handgrip strength, and urinary incontinence. The authors conclude that health, functional performance, and social involvement interact with well-being, so interventions targeting these areas can favor quality of life for the elderly.

  1. Factors associated with impaired appetite in well-functioning community-dwelling older adults.

    PubMed

    Lee, Jung Sun; Kritchevsky, Stephen B; Tylavsky, Frances; Harris, Tamara B; Ayonayon, Hilsa N; Newman, Anne B

    2006-01-01

    Poor appetite in older adults is a common problem in clinical practice, but prevalence of this symptom and its risk factors in community-dwelling older adults are not well understood. As part of the Health, Aging and Body Composition Study, we ascertained self-reported impaired appetite and related factors in 2,169 older adults aged 70-79 years. About 12% of participants reported impaired appetite. Those reporting impaired appetite were more likely to be older, female, and black and to report having illness or physical conditions interfering with appetite than those not reporting impaired appetite. Hierarchical logistic regression suggested that multiple factors contributed to impaired appetite. In particular, symptomatic depression (OR (95% CI) = 2.5 (1.6- 4.1)), poor self-reported health (2.4 (1.7-3.2)), current smoking, chewing problems, reported visual impairment, weight loss since age 50, and log (TNF-alpha) were significantly related to impaired appetite.

  2. Prevalence and Risk Factors of Abuse among Community Dwelling Elderly of Guwahati City, Assam

    PubMed Central

    Saikia, Anku Moni; Mahanta, Neelakshi; Mahanta, Ajaya; Deka, Ashok Jyoti; Kakati, Arupjyoti

    2015-01-01

    Background: In spite of tremendous impact on health, elder abuse is still an underreported and unrecognized issue. Objectives: To assess the prevalence of abuse among community dwelling elderly and to identify the various risk factors. Materials and Methods: This community-based cross-sectional study was conducted in 10 randomly selected wards of Guwahati city. A total of 331 elderly (60 years and above) were interviewed. Abuse was screened by Hwalek-Sengstock Elder Abuse Screening Test (H-S EAST). Results: The study revealed 9.31% prevalence. Neglect was the most common type of abuse reported. Age, sex, socioeconomic status, living status, and functional status were found to be significantly associated with abuse. Conclusion: Abuse is prevalent among elderly population. PMID:26435603

  3. 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

  4. Health-promotion theories in nutritional interventions for community-dwelling older adults: a systematic review.

    PubMed

    Raffaele, Barbara; Matarese, Maria; Alvaro, Rosaria; De Marinis, Maria Grazia

    2017-01-01

    To identify theories applied in interventions promoting healthy nutrition among community-dwelling older adults and determine the efficacy of theories in changing knowledge, attitudes, and behaviors. The PubMed, PsycINFO, Embase, and ERIC databases were searched for English articles from January 1990 to December 2015. Mono or multicomponent randomized controlled trial studies were included, whereas research on nutritional interventions related to acute or chronic diseases were excluded. Eight articles satisfied the inclusion criteria. Only three articles referred explicitly to health promotion theories. Nutritional programs varied in terms of contents, outcomes, lengths of interventions and follow-up. Pooling the results and identifying the most effective theories were therefore impossible. Although researchers and practitioners recognize the significance of theoretical models in guiding the health-promoting interventions, referring to a theoretical model for such interventions is still relatively recent.

  5. Problems meeting basic needs predict cognitive decline in community-dwelling Hispanic older adults.

    PubMed

    Sachs-Ericsson, Natalie; Corsentino, Elizabeth; Cougle, Jesse R

    2009-09-01

    Objectives. Indices of low socioeconomic status (SES) have been found to predict negative health outcomes. However, problems meeting basic needs (e.g., not having enough money for health care, adequate food, etc.) may be a more potent measure of negative health outcomes than other more typically assessed indices of SES, such as income. This article examined the association between problems meeting basic needs and cognitive decline in a sample of community-dwelling Hispanic older adults (N = 1,964). Method. The authors used a prospective design to study the influence of problems meeting basic needs on cognitive functioning. Analyses controlled for demographics, health problems, and depressive symptoms. Results. The authors found problems meeting basic needs to be a more potent predictor of cognitive decline than income. Discussion. Interventions focused on providing older adults with resources for meeting basic needs, such as adequate food and health care, may substantially reduce the subsequent level of stress and health problems in this population.

  6. Chair yoga: benefits for community-dwelling older adults with osteoarthritis.

    PubMed

    Park, Juyoung; McCaffrey, Ruth

    2012-05-01

    The aim of this pilot study was to examine whether chair yoga was effective in reducing pain level and improving physical function and emotional well-being in a sample of community-dwelling older adults with osteoarthritis. One-way repeated measures analysis of variance was performed to examine the effectiveness of chair yoga at baseline, midpoint (4 weeks), and end of the intervention (8 weeks). Although chair yoga was effective in improving physical function and reducing stiffness in older adults with osteoarthritis, it was not effective in reducing pain level or improving depressive symptoms. Future research planned by this team will use rigorous study methods, including larger samples, randomized controlled trials, and follow up for monitoring home practice after the interventions.

  7. Elder Mistreatment in U.S. Community-Dwelling Chinese Older Women.

    PubMed

    Dong, XinQi; Chen, Ruijia; Simon, Melissa A

    2016-08-01

    This study explored the prevalence and correlates of elder mistreatment among community-dwelling Chinese women in the U.S. Data were from the Population Study of Chinese Elderly in Chicago (PINE), a population-based study of U.S. Chinese older adults aged 60 years and above. Of the 1,833 older women, 289 (15.8%) reported suffering from elder mistreatment. Higher educational levels, lower overall health status, and worsening health over the past year were positively correlated with elder mistreatment, while a greater number of children and grandchildren were negatively correlated with elder mistreatment. Considerable efforts should be put into designing tailored interventions to reduce elder mistreatment in U.S. Chinese women. © The Author(s) 2015.

  8. Cognitive Change Checklist (3CL): Psychometric Characteristicsin Community Dwelling Older Adults

    PubMed Central

    Schinka, John A.; Robinson, Diane C.; Mills, Whitney L.; Brown, Lisa M.

    2012-01-01

    Objective To extend the psychometric study of the Cognitive Change Checklist (3CL) by examining the reliability, factor structure, and external correlates of 3CL informant and self-report ratings in community dwelling adults. We also conducted ROC analyses examining rating scores from this normative sample with those of clinical samples. Design Scale reliability and validity study. Setting Community sites. Participants Six hundred and seventy-nine older adults. Results The pattern of scale relationships within and across versions, and the failure to find associations with age and education, were consistent with findings in clinic samples reported previously. Factor analysis replicated the four-factor structure of the informant ratings. All informant version scales significantly discriminated amnestic Mild Cognitive Impairment (MCI) cases and patients with mild dementia from normals. Conclusion These findings provide support for the use of the checklist as a clinical tool to facilitate identification of cases of MCI and early dementia. PMID:23032479

  9. Concept of successful ageing among the community-dwelling oldest old in Japan.

    PubMed

    Sato-Komata, Michiko; Hoshino, Akiko; Usui, Kanae; Katsura, Toshiki

    2015-12-01

    In Japan, increasing human longevity has forced society to rethink the notion of what constitutes 'successful ageing'. This study attempts to advocate a new concept of successful ageing that involves complete acceptance of the ageing process. Research was based on semi-structured interviews with 15 community dwelling oldest-old (aged 85 years and above) participants. The analysis was completed using a grounded theory approach. Successful ageing for the oldest old was grouped into six categories. Within these categories, we discovered the structure of successful ageing, which synthesises ideas from the adaptation process with those of physical and cognitive decreased function as well as spirituality. The oldest old in Japan work to arrive at a conclusion with their lives, all the while coping with the drawbacks of ageing, such as declining physical and cognitive functions. This resilient and flexible way of life makes their form of ageing an equally 'successful' one.

  10. 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

  11. Remote monitoring of sitting behaviors for community-dwelling manual wheelchair users with spinal cord injury.

    PubMed

    Yang, Y-S; Chang, G-L; Hsu, M-J; Chang, J-J

    2009-01-01

    A case series study. To describe the sitting behaviors in community-dwelling manual wheelchair users (MWUs) with spinal cord injury (SCI) by using a custom data logger and to compare the sitting time parameters between the groups with paraplegia and tetraplegia. Data were collected from the MWUs living in the community area of Kaohsiung, Taiwan. A custom data logger with six force sensor resistors was designed and installed on a personal daily-use wheelchair. Twenty MWU participants were instructed to disregard the activation of data logger and pursue their regular activities of daily living. Cumulative sitting time, averaged uninterrupted sitting time, lift-off frequency, and the symmetry ratio of sitting weight distribution for 24 h per day over a 1-week period were recorded. Manual wheelchair users spent an average of 9.2 h (median 9.7, range 3.2-12.2 h) per day in their own wheelchair. They sat for an average of 97 min (median 62, range 24-284 min) without displaying any lift-off behavior. The average lift-off frequency was 9.4 times (median 9.2, range 2-20 times) per day. During sitting, the median value of symmetrical right-left and front-rear weight distribution ratio was 0.9 (range 0.5-1.4), and 0.5 (range 0.01-1.6), respectively. There was no significant difference in sitting time parameters between MWUs with paraplegia and those with tetraplegia. Community-dwelling MWUs spent long periods of time in their wheelchairs and did not engage frequently in pressure relief activities. Regardless of their neurological levels, education on the pressure relief activity is still a core component for all MWUs.

  12. Physical Activity Correlates with Arterial Stiffness in Community-dwelling Individuals with Stroke

    PubMed Central

    Tang, Ada; Eng, Janice J.; Brasher, Penelope M.; Madden, Kenneth M.; Mohammadi, Azam; Krassioukov, Andrei V.; Tsang, Teresa S. M.

    2013-01-01

    Background Physical inactivity contributes to atherosclerotic processes, which manifest as increased arterial stiffness. Arterial stiffness is associated with myocardial demand and coronary perfusion and is a risk factor for stroke and other adverse cardiac outcomes. Poststroke mobility limitations often lead to physical inactivity and sedentary behaviors. This exploratory study aimed to identify functional correlates, reflective of daily physical activity levels, with arterial stiffness in community-dwelling individuals >1 year poststroke. Methods Carotid–femoral pulse wave velocity (cfPWV) was measured in 35 participants (65% men; mean ± SD age 66.9 ± 6.9 years; median time poststroke 3.7 years). Multivariable regression analyses examined the relationships between cfPWV and factors associated with daily physical activity: aerobic capacity (VO2 peak), gait speed, and balance ability (Berg Balance Scale). Age and the use of antihypertensive medications, known to be associated with pulse wave velocity, were also included in the model. Results Mean cfPWV was 11.2 ± 2.4 m/s. VO2 peak and age were correlated with cfPWV (r = −0.45 [P = .006] and r = 0.46 [P = .004], respectively). In the multivariable regression analyses, age and the use of antihypertensive medication accounted for 20.4% of the variance of cfPWV, and the addition of VO2 peak explained an additional 4.5% of the variance (R2 = 0.249). Conclusions We found that arterial stiffness is elevated in community-dwelling, ambulatory individuals with stroke relative to healthy people. Multivariable regression analysis suggests that aerobic capacity (VO2 peak) may contribute to the variance of cfPWV after accounting for the effects of age and medication use. Whether intense risk modification and augmented physical activity will improve arterial stiffness in this population remains to be determined. PMID:23473623

  13. 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

  14. Risk of pneumonia associated with incident benzodiazepine use among community-dwelling adults with Alzheimer disease

    PubMed Central

    Taipale, Heidi; Tolppanen, Anna-Maija; Koponen, Marjaana; Tanskanen, Antti; Lavikainen, Piia; Sund, Reijo; Tiihonen, Jari; Hartikainen, Sirpa

    2017-01-01

    BACKGROUND: Knowledge regarding whether benzodiazepines and similarly acting non-benzodiazepines (Z-drugs) are associated with an increased risk of pneumonia among older adults is lacking. We sought to investigate this association among community-dwelling adults with Alzheimer disease, a condition in which both sedative/hypnotic use and pneumonia are common. METHODS: We obtained data on all community-dwelling adults with a recent diagnosis of Alzheimer disease in Finland (2005–2011) from the Medication use and Alzheimer disease (MEDALZ) cohort, which incorporates national registry data on prescriptions, reimbursement, hospital discharges and causes of death. Incident users of benzodiazepines and Z-drugs were identified using a 1-year washout period and matched with nonusers using propensity scores. The association with hospital admission or death due to pneumonia was analyzed with the Cox proportional hazards model and adjusted for use of other psychotropic drugs in a time-dependent manner. RESULTS: Among 49 484 eligible participants with Alzheimer disease, 5232 taking benzodiazepines and 3269 taking Z-drugs were matched 1:1 with those not taking these drugs. Collectively, use of benzodiazepines and Z-drugs was associated with an increased risk of pneumonia (adjusted hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.05–1.42). When analyzed separately, benzodiazepine use was significantly associated with an increased risk of pneumonia (adjusted HR 1.28, 95% CI 1.07–1.54), whereas Z-drug use was not (adjusted HR 1.10, 95% CI 0.84–1.44). The risk of pneumonia was greatest within the first 30 days of benzodiazepine use (HR 2.09, 95% CI 1.26–3.48). INTERPRETATION: Benzodiazepine use was associated with an increased risk of pneumonia among patients with Alzheimer disease. Risk of pneumonia should be considered when weighing the benefits and risks of benzodiazepines in this population. PMID:28396328

  15. Prognosis for functional deterioration and functional improvement in late life among community-dwelling persons.

    PubMed

    Stineman, Margaret G; Zhang, Guangyu; Kurichi, Jibby E; Zhang, Zi; Streim, Joel E; Pan, Qiang; Xie, Dawei

    2013-05-01

    To examine how health-related, socioeconomic, and environmental factors combine to influence the onset of activity of daily living (ADL) limitations or prognosis for death or further functional deterioration or improvement among elderly people. A national representative sample with 2-year follow-up. Community-dwelling people. Included were 9447 persons (≥70 years of age) in the United States from the Second Longitudinal Study of Aging who were interviewed in 1994, 1995, or 1996. Self- or proxy-reported health conditions, ADLs expressed as 5 stages describing severity and pattern of limitations, and other baseline characteristics were obtained. A multinomial logistic regression model was used to predict stage transitions. Because of incomplete follow-up (17.7% of baseline sample), primary analyses were determined by multiple imputation to address potential bias associated with loss to follow-up. ADL stage transitions in 2 years (death, deteriorated, stable, and improved ADL function). In the imputed-case analysis, the percentages for those who died, deteriorated, were stable, and improved were 12.6%, 32.7%, 48.4%, and 6.2%, respectively. Persons at a mild stage of ADL limitation were most likely to deteriorate further. Persons at advanced stages were most likely to die. Married people and high school graduates had a lower likelihood of deterioration. The risk of mortality and functional deterioration increased with age. Certain conditions, such as diabetes, were associated both with mortality and functional deterioration; other conditions, such as cancer, were associated with mortality only, and arthritis was associated only with functional deterioration. Although overlap occurs, different clinical traits are associated with mortality, functional deterioration, and functional improvement. ADL stages might aid physical medicine and rehabilitation clinicians and researchers in developing and monitoring disability management strategies targeted to maintaining and

  16. A systematic review of interventions by healthcare professionals on community-dwelling postmenopausal women with osteoporosis.

    PubMed

    Lai, P; Chua, S S; Chan, S P

    2010-10-01

    A systematic review was conducted to evaluate evidence concerning the effect of non-drug interventions by healthcare professionals on community-dwelling postmenopausal osteoporotic women. Evidence available indicates that such interventions are effective in improving the quality of life, medication compliance, and calcium intake, but effect on other outcomes is less conclusive. The purpose of this study is to conduct a systematic review to evaluate evidence concerning the effect of non-drug interventions by healthcare professionals on community-dwelling postmenopausal osteoporotic women. Randomized controlled trials (RCTs) published in English between year 1990 and 2009 were identified. Types of patient outcome used as assessment included quality of life (QOL), bone mineral density (BMD), medication compliance and persistence, knowledge level, and lifestyle modification. Twenty four RCTs met the inclusion criteria. Seven studies assessed interventions by physiotherapists, six by physicians, seven by nurses, three by multi-disciplinary teams and one by dietitians. Variability in the types and intensity of interventions made comparison between each study difficult. Collectively, these studies provided some evidence to show that interventions by healthcare professionals improved the QOL medication compliance and calcium intake of patients but its effects on BMD, medication persistence, knowledge, and other lifestyle modifications were less conclusive. From this review, it was found that some outcome measures of such non-drug interventions still required further studies. Future studies should use validated instruments to assess the outcomes, with focus on common definitions of interventions and outcome measures, more intensive one-to-one interventions, appropriate control groups, adequate randomization procedures, and also provide information on effect size.

  17. 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

    2017-08-04

    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.

  18. Poor Appetite and Dietary Intake in Community-Dwelling Older Adults.

    PubMed

    van der Meij, Barbara S; Wijnhoven, Hanneke A H; Lee, Jung S; Houston, Denise K; Hue, Trisha; Harris, Tamara B; Kritchevsky, Stephen B; Newman, Anne B; Visser, Marjolein

    2017-07-26

    Poor appetite in older adults leads to sub-optimal food intake and increases the risk of undernutrition. The impact of poor appetite on food intake in older adults is unknown. The aim of this study was to examine the differences in food intake among older community-dwelling adults with different reported appetite levels. Cross-sectional analysis of data from a longitudinal prospective study. Health, aging, and body composition study performed in the USA. 2,597 community-dwelling adults aged 70-79. A semi-quantitative, interviewer-administered, 108-item food frequency questionnaire designed to estimate dietary intake. Poor appetite was defined as the report of a moderate, poor, or very poor appetite in the past month and was compared with good or very good appetite. The mean age of the study sample was 74.5 ± 2.8 years; 48.2% were men, 37.7% were black, and 21.8% reported a poor appetite. After adjustment for total energy intake and potential confounders (including biting/chewing problems), participants with a poor appetite had a significantly lower consumption of protein and dietary fiber, solid foods, protein rich foods, whole grains, fruits, and vegetables, but a higher consumption of dairy foods, fats, oils, sweets, and sodas compared to participants with very good appetite. In addition, they were less likely to report consumption of significant larger portion sizes. Older adults reporting a poor appetite showed a different dietary intake pattern compared to those with (very) good appetite. Better understanding of the specific dietary intake pattern related to a poor appetite in older adults can be used for nutrition interventions to enhance food intake, diet variety, and diet quality. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  19. Antihypertensive drug class use and differential risk of urinary incontinence in community-dwelling older women.

    PubMed

    Peron, Emily P; Zheng, Yan; Perera, Subashan; Newman, Anne B; Resnick, Neil M; Shorr, Ronald I; Bauer, Douglas C; Simonsick, Eleanor M; Gray, Shelly L; Hanlon, Joseph T; Ruby, Christine M

    2012-12-01

    Medication use is a potentially reversible cause of urinary incontinence (UI). The objective of this longitudinal cohort study was to evaluate whether self-reported UI in community-dwelling older women is associated with the use of different classes of antihypertensive agents. The sample consisted of 959 black and white women aged 72-81 years without baseline (Year 1) UI from the Health, Aging, and Body Composition Study. Use of any antihypertensive from 10 drug classes (ie, alpha blockers [central], alpha blockers [peripheral], angiotensin-converting enzyme inhibitors, angiotensin-II receptor blockers, beta blockers, calcium channel blockers, diuretics [loop], diuretics [potassium-sparing], diuretics [thiazide], and vasodilators) was determined during Year 3 in-person interviews. The number of unique antihypertensive agents used and the standardized daily dosage were also examined. Self-reported UI, operationally defined as leaking urine at least weekly during the previous 12 months, was assessed at Year 4 visits. A total of 197 women (20.5%) reported UI at Year 4. Although any antihypertensive use, number of agents used, and standardized daily dosage at Year 3 were not associated with UI at Year 4, use of one particular drug class-peripheral alpha blockers (ie, doxazosin, prazosin, and terazosin)-was associated with fourfold greater odds of UI (adjusted odds ratio = 4.47; 95% confidence interval = 1.79-11.21; p = .0014). Further, in post hoc analyses, these odds nearly doubled in those also taking loop diuretics (adjusted odds ratio = 8.81; 95% confidence interval = 1.78-43.53; p = .0076). In community-dwelling older women, peripheral alpha blocker use was associated with UI, and the odds nearly doubled when used with loop diuretics.

  20. 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.

  1. Antihypertensive Drug Class Use and Differential Risk of Urinary Incontinence in Community-Dwelling Older Women

    PubMed Central

    2012-01-01

    Background. Medication use is a potentially reversible cause of urinary incontinence (UI). The objective of this longitudinal cohort study was to evaluate whether self-reported UI in community-dwelling older women is associated with the use of different classes of antihypertensive agents. Methods. The sample consisted of 959 black and white women aged 72–81 years without baseline (Year 1) UI from the Health, Aging, and Body Composition Study. Use of any antihypertensive from 10 drug classes (ie, alpha blockers [central], alpha blockers [peripheral], angiotensin-converting enzyme inhibitors, angiotensin-II receptor blockers, beta blockers, calcium channel blockers, diuretics [loop], diuretics [potassium-sparing], diuretics [thiazide], and vasodilators) was determined during Year 3 in-person interviews. The number of unique antihypertensive agents used and the standardized daily dosage were also examined. Self-reported UI, operationally defined as leaking urine at least weekly during the previous 12 months, was assessed at Year 4 visits. Results. A total of 197 women (20.5%) reported UI at Year 4. Although any antihypertensive use, number of agents used, and standardized daily dosage at Year 3 were not associated with UI at Year 4, use of one particular drug class—peripheral alpha blockers (ie, doxazosin, prazosin, and terazosin)—was associated with fourfold greater odds of UI (adjusted odds ratio = 4.47; 95% confidence interval = 1.79–11.21; p = .0014). Further, in post hoc analyses, these odds nearly doubled in those also taking loop diuretics (adjusted odds ratio = 8.81; 95% confidence interval = 1.78–43.53; p = .0076). Conclusion. In community-dwelling older women, peripheral alpha blocker use was associated with UI, and the odds nearly doubled when used with loop diuretics. PMID:22972942

  2. 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

  3. 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.

  4. Functional ability, community reintegration and participation restriction among community-dwelling female stroke survivors in Ibadan.

    PubMed

    Hamzat, T K; Olaleye, O A; Akinwumi, O B

    2014-01-01

    Stroke is not gender-discriminatory. Yet, the subject of stroke among females has apparently not received significant attention from clinical researchers. The consequences of stroke include functional and psychosocial sequelae which may cause disability, hinder community reintegration and restrict participation. The inter-relationships among functional ability, community reintegration and participation restriction of community-dwelling, female stroke survivors in Ibadan were assessed in this descriptive study. Fifty-two community-dwelling female stroke survivors (mean age = 56.55±9.91 years) were surveyed using consecutive sampling technique. Their functional ability level was measured using the Functional Independence Measure (FIM) while London Handicap Scale (LHS) was used to assess their participation restriction. Data were analyzed using Spearman Rank Correlation Coefficient (rho) and Mann-Whitney U test at p = 0.05. Significantly positive correlations (p< 0.05) were found between functional ability and community reintegration (r = 0.54; p = 0.01) as well as between participation restriction and community reintegration (r = 0.34; p = 0.05). Individuals with left hemiplegia had significantly higher mean rank scores in functional ability (30.41) than those who had right hemiplegia (mean rank scores = 21.94). Functional ability which appears to be related to stroke laterality showed positive association with both community reintegration and participation restriction. This suggests that improving the functional ability of the stroke survivors may reduce participation restriction and enhance their reintegration into the community. A similar study which compares male and female stroke survivors in the same community is thus necessary.

  5. Musculoskeletal pain characteristics associated with lower balance confidence in community-dwelling older adults.

    PubMed

    Stubbs, Brendon; Schofield, Patricia; Patchay, Sandhi; Leveille, Suzanne

    2016-06-01

    To determine whether musculoskeletal pain (pain severity and number of chronic pain sites; single or multisite) is associated with balance confidence over and above previously established risk factors. Cross-sectional study. Ten community sites (five day centres, two sheltered housing schemes and three community 'clubs') in the UK. Two hundred and eighty-nine community-dwelling older adults [response rate 72%, mean age 78 (standard deviation 8) years, 67% female] completed the study assessment. Eligibility criteria were as follows: living in the community; aged ≥60 years; able to walk ≥10m; able to communicate in English; and no cognitive (e.g. dementia), neurological or mental health conditions. Not applicable. Balance confidence as measured by the 16-item Activities Balance Confidence (ABC) scale (lower scores indicate less confidence). One hundred and fifty participants had at least one site of chronic musculoskeletal pain (52%), and the remaining 139 (48%) participants did not report chronic musculoskeletal pain. Older people with chronic musculoskeletal pain had significantly lower scores on the ABC scale compared with those without chronic musculoskeletal pain (mean 48.3 vs 71.3, P<0.001). After adjustment for established risk factors, two separate hierarchical regression models demonstrated that both pain severity (β=-0.106, P=0.029) and number of chronic musculoskeletal pain sites (β=-0.98, P=0.023) were significantly associated with lower balance confidence. Both pain severity and number of chronic pain sites (particularly multisite pain) are associated with lower balance confidence in community-dwelling older adults. Further research is needed to target pain symptoms and balance confidence in relation to fall risk in older adults with chronic musculoskeletal pain. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  6. Risk of pneumonia associated with incident benzodiazepine use among community-dwelling adults with Alzheimer disease.

    PubMed

    Taipale, Heidi; Tolppanen, Anna-Maija; Koponen, Marjaana; Tanskanen, Antti; Lavikainen, Piia; Sund, Reijo; Tiihonen, Jari; Hartikainen, Sirpa

    2017-04-10

    Knowledge regarding whether benzodiazepines and similarly acting non-benzodiazepines (Z-drugs) are associated with an increased risk of pneumonia among older adults is lacking. We sought to investigate this association among community-dwelling adults with Alzheimer disease, a condition in which both sedative/hypnotic use and pneumonia are common. We obtained data on all community-dwelling adults with a recent diagnosis of Alzheimer disease in Finland (2005-2011) from the Medication use and Alzheimer disease (MEDALZ) cohort, which incorporates national registry data on prescriptions, reimbursement, hospital discharges and causes of death. Incident users of benzodiazepines and Z-drugs were identified using a 1-year washout period and matched with nonusers using propensity scores. The association with hospital admission or death due to pneumonia was analyzed with the Cox proportional hazards model and adjusted for use of other psychotropic drugs in a time-dependent manner. Among 49 484 eligible participants with Alzheimer disease, 5232 taking benzodiazepines and 3269 taking Z-drugs were matched 1:1 with those not taking these drugs. Collectively, use of benzodiazepines and Z-drugs was associated with an increased risk of pneumonia (adjusted hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.05-1.42). When analyzed separately, benzodiazepine use was significantly associated with an increased risk of pneumonia (adjusted HR 1.28, 95% CI 1.07-1.54), whereas Z-drug use was not (adjusted HR 1.10, 95% CI 0.84-1.44). The risk of pneumonia was greatest within the first 30 days of benzodiazepine use (HR 2.09, 95% CI 1.26-3.48). Benzodiazepine use was associated with an increased risk of pneumonia among patients with Alzheimer disease. Risk of pneumonia should be considered when weighing the benefits and risks of benzodiazepines in this population. © 2017 Canadian Medical Association or its licensors.

  7. Urinary incontinence and disability in community-dwelling women: a cross-sectional study.

    PubMed

    Greer, Joy A; Xu, Rengyi; Propert, Kathleen J; Arya, Lily A

    2015-08-01

    Disability, an individual's reduced capacity to perform physical tasks encountered in daily routine, is associated with urinary incontinence in the elderly. Our objective was to determine if urinary incontinence is associated with disability in community-dwelling women 40 years and older. Cross-sectional study among US women ≥40 years (n = 4,458) from National Health and Nutrition Examination Surveys 2005-2010. We estimated the age-stratified weighted prevalence and factors independently associated with disability (Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), mobility, and functional limitations) in women with and without urinary incontinence while controlling for confounders of the association between disability and urinary incontinence. The weighted prevalence of all disabilities was higher in women with urinary incontinence than women without urinary incontinence across most decades of life with the greatest difference in the prevalence of mobility disabilities: 40-49 years (12.1% vs. 7.0%), 50-59 years (17.0% vs. 9.2%), 60-69 years (28.3% vs. 19.8%), and 70+ years (43.8% vs. 33.0%, all P < 0.05). On multivariable analysis, after controlling for the confounding effect of age, co-morbidities, and income-poverty ratio, urinary incontinence was weakly associated with disabilities. The adjusted odds ratio (95% confidence interval) of disabilities for urinary incontinence was ADL 1.96 (1.07, 3.58), IADL 1.18 (0.78, 1.78), mobility 1.26 (1.01, 1.56), and functional limitations 1.36 (1.07, 1.73). Urinary incontinence is weakly associated with disabilities and cannot be implicated as a cause of disability in community dwelling women. © 2014 Wiley Periodicals, Inc.

  8. Quality of life in community-dwelling Dutch elderly measured by EQ-5D-3L.

    PubMed

    Mangen, Marie-Josée J; Bolkenbaas, Marieke; Huijts, Susanne M; van Werkhoven, Cornelis H; Bonten, Marc J M; de Wit, G Ardine

    2017-01-06

    We aimed to evaluate health status and associated factors in community-dwelling elderly in the Netherlands. Participants from a placebo-controlled double-blind randomized controlled trial conducted in the Netherlands were invited at the time of enrolment to participate in this study. Data were collected on comorbidities, socio-demographic background and health status, using EQ-5D-3L instrument. EQ-5D-3L summary index values (EQ-5D-indices) was derived using Dutch tariff. Regression analysis was conducted to identify factors associated with EQ-5D-indices and visual analogue scale (EQ-VAS). 48,634 elderly (≥65 years) were included. The most frequently reported complaint was pain/discomfort (29.4%), but for the elder elderly (i.e. ≥85 years) it was mobility (52.9%). The proportion of persons reporting (multiple) problems increased with age from 31.5% for 65-69 years old subjects to 65.9% for elder elderly. The mean EQ-5D-indices and EQ-VAS decreased with age from 0.94 and 84, respectively in those 65 to 69 years old to 0.86 and 76, respectively, in ≥85 years old subjects. Increasing age, female gender, low education, geographic factors and comorbidities were associated with impaired health status. Within community-dwelling elderly large differences in health status exist. Impairment increases rapidly with age, but health status is also associated with socio-demographic variables and comorbidities. ClinicalTrials.gov, NCT00812084 .

  9. 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.

  10. Prevalence and Correlates of Nocturia in Community-Dwelling Older Adults

    PubMed Central

    Burgio, Kathryn L.; Johnson, Theodore M.; Goode, Patricia S.; Markland, Alayne D.; Richter, Holly E.; Roth, David L.; Sawyer, Patricia; Allman, Richard M.

    2010-01-01

    Objectives To determine the prevalence and correlates of nocturia in community-dwelling older adults. Design Planned secondary analysis of cross-sectional data from the University of Alabama at Birmingham Study of Aging population-based survey. Setting Participants’ homes. Participants One thousand older adults (aged 65 to 106 years) recruited from Medicare beneficiary lists between 1999 and 2001. The sample was selected to include 25% African American women, 25% African American men, 25% white women, and 25% white men. Measurements In-person interviews included socio-demographic information, medical history, Mini-Mental State Examination, and measurement of body mass index (BMI). Nocturia was defined in the main analyses as getting up 2 or more times per night to void. Results Nocturia was more common among men than women (63.2% vs. 53.8%, OR=1.48, 95% CI=1.15–1.91, P=.003) and more common among African Americans than whites (66.3% vs. 50.9%, OR=1.89, CI=1.46–2.45, P< .0001). In multiple backward elimination regression analysis in men, nocturia was significantly associated with African American race (OR=1.54) and BMI (OR=1.22 per 5 kg/m2). Higher MMSE was protective (OR=0.96). In women, nocturia was associated with older age (OR=1.21 per 5 years), African American race (OR=1.64), history of any urine leakage (OR=2.17), swelling in feet and legs (OR=1.67), and hypertension (OR=1.62). Higher education was protective (OR=0.92). Conclusion Nocturia in community-dwelling older adults is a common symptom associated with male gender, African-American race, and some medical conditions. Given the significant morbidity associated with nocturia, any evaluation of lower urinary tract symptoms should include assessment for the presence of nocturia. PMID:20406317

  11. A Prospective Study of Back Pain and Risk of Falls Among Older Community-dwelling Women

    PubMed Central

    Litwack-Harrison, Stephanie; Cawthon, Peggy M.; Kado, Deborah M.; Deyo, Richard A.; Makris, Una E.; Carlson, Hans L.; Nevitt, Michael C.

    2016-01-01

    Background. Back pain and falls are common health conditions among older U.S. women. The extent to which back pain is an independent risk factor for falls has not been established. Methods. We conducted a prospective study among 6,841 community-dwelling U.S. women at least 65 years of age from the Study of Osteoporotic Fractures (SOF). Baseline questionnaires inquired about any back pain, pain severity, and frequency in the past year. During 1 year of follow-up, falls were summed from self-reports obtained every 4 months. Two outcomes were studied: recurrent falls (≥2 falls) and any fall (≥1 fall). Associations of back pain and each fall outcome were estimated with risk ratios (RRs) and 95% confidence intervals (CIs) from multivariable log-binomial regression. Adjustments were made for age, education, smoking status, fainting history, hip pain, stroke history, vertebral fracture, and Geriatric Depression Scale. Results. Most (61%) women reported any back pain. During follow-up, 10% had recurrent falls and 26% fell at least once. Any back pain relative to no back pain was associated with a 50% increased risk of recurrent falls (multivariable RR = 1.5, 95% CI: 1.3, 1.8). Multivariable RRs for recurrent falls were significantly elevated for all back pain symptoms, ranging from 1.4 (95% CI: 1.1, 1.8) for mild back pain to 1.8 (95% CI: 1.4, 2.3) for activity-limiting back pain. RRs of any fall were also significantly increased albeit smaller than those for recurrent falls. Conclusions. Older community-dwelling women with a recent history of back pain are at increased risk for falls. PMID:26757988

  12. A Prospective Study of Back Pain and Risk of Falls Among Older Community-dwelling Women.

    PubMed

    Marshall, Lynn M; Litwack-Harrison, Stephanie; Cawthon, Peggy M; Kado, Deborah M; Deyo, Richard A; Makris, Una E; Carlson, Hans L; Nevitt, Michael C

    2016-09-01

    Back pain and falls are common health conditions among older U.S. women. The extent to which back pain is an independent risk factor for falls has not been established. We conducted a prospective study among 6,841 community-dwelling U.S. women at least 65 years of age from the Study of Osteoporotic Fractures (SOF). Baseline questionnaires inquired about any back pain, pain severity, and frequency in the past year. During 1 year of follow-up, falls were summed from self-reports obtained every 4 months. Two outcomes were studied: recurrent falls (≥2 falls) and any fall (≥1 fall). Associations of back pain and each fall outcome were estimated with risk ratios (RRs) and 95% confidence intervals (CIs) from multivariable log-binomial regression. Adjustments were made for age, education, smoking status, fainting history, hip pain, stroke history, vertebral fracture, and Geriatric Depression Scale. Most (61%) women reported any back pain. During follow-up, 10% had recurrent falls and 26% fell at least once. Any back pain relative to no back pain was associated with a 50% increased risk of recurrent falls (multivariable RR = 1.5, 95% CI: 1.3, 1.8). Multivariable RRs for recurrent falls were significantly elevated for all back pain symptoms, ranging from 1.4 (95% CI: 1.1, 1.8) for mild back pain to 1.8 (95% CI: 1.4, 2.3) for activity-limiting back pain. RRs of any fall were also significantly increased albeit smaller than those for recurrent falls. Older community-dwelling women with a recent history of back pain are at increased risk for falls. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. 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.

  14. Prevalence and Correlates of Urinary Incontinence Among Older, Community-Dwelling Women

    PubMed Central

    Bresee, Catherine; Dubina, Emily D.; Khan, Aqsa A.; Sevilla, Claudia; Grant, David; Eilber, Karyn S.; Anger, Jennifer T.

    2016-01-01

    OBJECTIVES As the aging population in the United States grows, the investigation of urinary incontinence (UI) issues becomes increasingly important, especially among women. Using data from the California Health Interview Survey (CHIS), we sought to determine the prevalence and correlates of UI among an ethnically diverse population of older, community-dwelling women. METHODS 5,374 female Californians aged 65 or older participated in a population-based, cross-sectional random digit dialing telephone survey. The CHIS 2003 adult survey included one question for Californians aged 65+ about UI. Additional information collected via the self-reported survey included demographics (age, race/ethnicity, education, and household income); general health data (self-reported health status, height and weight, fall history, and special equipment needs); medical co-morbidities; and health behaviors (tobacco usage, physical activity, and hormone replacement therapy (HRT)). RESULTS The estimated state-wide female prevalence rate for UI was 24.4%. Prevalence rates increased with age. UI was significantly associated with poorer overall health (adjusted OR 3.43, p<0.001), decreased mobility (OR 1.81, p=0.004), current use of HRT (OR 1.72, p<0.001), being overweight or obese (OR 1.60, p<0.001), a history of falls (OR 1.53, p=0.002), and a history of heart disease (OR 1.38, p=0.010). After adjusting for all health factors, UI was not found to have any significant association with level of education, household poverty status, or smoking status. CONCLUSIONS UI prevalence among this diverse group of older community-dwelling Californian women parallels that of other population-based studies. CHIS demonstrated that poor health, increased BMI, falls, and decreased mobility are strongly correlated with UI. PMID:25185631

  15. Long-term sedative use among community-dwelling adults: a population-based analysis

    PubMed Central

    Weymann, Deirdre; Gladstone, Emilie J.; Smolina, Kate; Morgan, Steven G.

    2017-01-01

    Background: Chronic use of benzodiazepines and benzodiazepine-like sedatives (z-drugs) presents substantial risks to people of all ages. We sought to assess trends in long-term sedative use among community-dwelling adults in British Columbia. Methods: Using population-based linked administrative databases, we examined longitudinal trends in age-standardized rates of sedative use among different age groups of community-dwelling adults (age ≥ 18 yr), from 2004 to 2013. For each calendar year, we classified adults as nonusers, short-term users, or long-term users of sedatives based on their patterns of sedative dispensation. For calendar year 2013, we applied cross-sectional analysis and estimated logistic regression models to identify health and socioeconomic risk factors associated with long-term sedative use. Results: More than half (53.4%) of long-term users of sedatives in British Columbia are between ages 18 and 64 years (young and middle-aged adults). From 2004 to 2013, long-term sedative use remained stable among adults more than 65 years of age (older adults) and increased slightly among young and middle-aged adults. Although the use of benzodiazepines decreased during the study period, the trend was offset by equal or greater increases in long-term use of z-drugs. Being an older adult, sick, poor and single were associated with increased odds of long-term sedative use. Interpretation: Despite efforts to stem such patterns of medication use, long-term use of sedatives increased in British Columbia between 2004 and 2013. This increase was driven largely by increased use among middle-aged adults. Future deprescribing efforts that target adults of all ages may help curb this trend. PMID:28401119

  16. Quality of life of Nigerian informal caregivers of community-dwelling stroke survivors.

    PubMed

    Vincent-Onabajo, Grace; Ali, Aisha; Hamzat, Talhatu

    2013-12-01

    Caregivers play important roles in the collaborative efforts that characterize successful stroke rehabilitation, and their quality of life (QoL) may have implications for outcome of care. This study explored the QoL of caregivers of community-dwelling stroke survivors in north-eastern Nigeria. Fifty-nine caregivers of community-dwelling stroke survivors attending physiotherapy out-patients departments of two government hospitals in the city of Maiduguri participated in the study. Information on participants' age, gender, employment status, educational background, relationship with the stroke patient, and time after onset of stroke were obtained through interview, while their QoL was assessed with WHOQoLBREF questionnaire. Demographic and QoL data were summarized with descriptive statistics, and influence of caregivers and care recipients' factors on QoL was analysed using Kruskal-Wallis test. Majority of caregivers were males (55.9%) and provided care for their parents (69.5%) who had suffered stroke within 1 year prior to study (72.9%). Mean scores on all QoL domains were above average with the physical domain recording the lowest scores. Caregivers' factors of age, educational background and employment, and duration poststroke onset were significantly associated with domains of QoL. Although QoL of stroke caregivers was fair across domains, the physical domain recorded the lowest mean scores. Older age, lack of formal education, unemployment and caring for stroke patients within the second year poststroke were associated with lower QoL scores. Information from this study may aid in identifying those caregivers who require support programmes and care the most. © 2012 The Authors Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

  17. Body mass index and functional status in community dwelling older Turkish males.

    PubMed

    Bahat, Gulistan; Muratlı, Sevilay; İlhan, Birkan; Tufan, Asli; Tufan, Fatih; Aydin, Yucel; Erten, Nilgun; Karan, Mehmet Akif

    2015-01-01

    Disability is utmost important on an aging population's health. Obesity is associated with increased risk for disability. On-the-other-hand, higher-BMI is reported as associated with better functionality in older people in some reports defined as "obesity paradox". There is some evidence on differential relationship between body weight status and functionality by living setting gender, and different populations. We studied the relation between body mass index and functionality in Turkish community dwelling older males accounting for the most confounding factors: age, multimorbidity, polypharmacy and nutritional status. This is a cross-sectional study in a geriatric outpatient clinic of a university hospital. Functionality was assessed with evaluation of activities of daily living (ADL) and instrumental activities of daily living (IADL) scales. Nutrition was assessed by mini-nutritional assessment test. Two hundred seventy-four subjects comprised our study cohort. Mean age was 74.4 ± 7.1 years, BMI was 25.8 ± 4.4 kg/m(2). Linear regression analysis revealed significant and independent association of lower BMI with higher ADL and IADL scores (B = 0.047 and B = 0.128, respectively) (p < 0.05) and better nutritional status (B = 1.94 and B = 3.05, respectively) (p < 0.001) but not with the total number of medications. Higher IADL score was associated with younger age and lower total number of diseases (B = 0.121, B = 0.595, respectively) (p < 0.05) while ADL was not. We suggest that lower BMI is associated with better functional status in Turkish community-dwelling male older people. Our study recommends longitudinal studies with higher participants from different populations, genders and living settings are needed to comment more.

  18. 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.

  19. Inflammatory biomarkers as predictors of hospitalization and death in community-dwelling older adults.

    PubMed

    Salanitro, Amanda H; Ritchie, Christine S; Hovater, Martha; Roth, David L; Sawyer, Patricia; Locher, Julie L; Bodner, Eric; Brown, Cynthia J; Allman, Richard M

    2012-01-01

    Individuals with multimorbidity may be at increased risk of hospitalization and death. Comorbidity indexes do not capture severity of illness or healthcare utilization; however, inflammation biomarkers that are not disease-specific may predict hospitalization and death in older adults. We sought to predict hospitalization and mortality of older adults using inflammation biomarkers. From a prospective, observational study, 370 community-dwelling adults 65 years or older from central Alabama participated in an in-home assessment and provided fasting blood samples for inflammation biomarker testing in 2004. We calculated an inflammation summary score (range 0-4), one point each for low albumin, high C-reactive protein, low cholesterol, and high interleukin-6. Utilizing Cox proportional hazards models, inflammation summary scores were used to predicted time to hospitalization and death during a 4-year follow up period. The mean age was 73.7 (±5.9 yrs), and 53 (14%) participants had summary scores of 3 or 4. The rates of dying were significantly increased for participants with inflammation summary scores of 2, 3, or 4 (hazard ratio (HR) 2.22, 2.78, and 7.55, respectively; p<0.05). An inflammation summary score of 4 significantly predicted hospitalization (HR 5.92, p<0.05). Community-dwelling older adults with biomarkers positive for inflammation had increased rates of being hospitalized or dying during the follow up period. Assessment of the individual contribution of particular inflammation biomarkers in the prediction of health outcomes in older populations and the development of validated summary scores to predict morbidity and mortality are needed.

  20. MMSE as a predictor of on-road driving performance in community dwelling older drivers.

    PubMed

    Crizzle, Alexander M; Classen, Sherrilene; Bédard, Michel; Lanford, Desiree; Winter, Sandra

    2012-11-01

    Screening tools such as the MMSE have been used extensively in driving research studies to determine mild cognitive impairment or dementia. While some studies have shown the MMSE to correlate with driving performance, few studies have shown the predictive validity of the MMSE in determining on-road performance. In a sample of 168 community dwelling older adults, including 20 with Parkinson's disease (PD), the primary objective was to determine the validity of the MMSE to predict pass/fail outcomes of an on-road driving test using receiver operating characteristics curves. The area under the curve (AUC), an index of discriminability, for the total sample was .654, 95% CI=0.536-0.772, p=.009. Meanwhile, the AUC for the PD group was 0.791, 95% CI=0.587-0.996, p=.036. The total sample showed statistically significant yet poor predictive validity. However, the PD group showed statistically significant and good predictive validity of the MMSE to predict pass/fail outcomes on the road test, but caution is warranted as the confidence intervals are wide (due to small sample) and the positive and negative predictive values are less than desirable due to the associated error. The findings show that using the current cut-off point of ≤24 on the MMSE is not adequately sensitive to predict on-road performance in both community dwelling older drivers and in drivers with PD. This study offers strong evidence to support the current best practice of not using the MMSE in isolation to predict on-road performance. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Association of home care needs and functional recovery among community-dwelling elderly hip fracture patients.

    PubMed

    Wu, Li-Chu; Chou, Ming-Yueh; Liang, Chih-Kuang; Lin, Yu-Te; Ku, Yan-Chiou; Wang, Ruey-Hsia

    2013-01-01

    The aim of this study was to assess the home care needs and task difficulty of community-dwelling aged hip fracture and the association of functional recovery with care received. A cohort of hip fracture patients admitted to orthopedic wards for surgery was collected from August 2009 to December 2010. Patients transferred to long-term care facilities after surgery were excluded. Functional status (feeding, clothing, grooming, bathing, getting in/out of bed, walking, toileting, standing up/sitting down, and walking up/down stairs) and task difficulty for caregivers were recorded at discharge, one week and one month after discharge. In total, 116 patients (mean age: 79.4 ± 8.5 years, 51.7% males) were enrolled. The mean age of primary caregivers was 53.4 ± 14.2 years, and most were daughters or sons (54.3%), spouses (34.5%) or foreign workers (11.0%). The most common care needs were wound care (95.7%), medical visits (94.8%), cleaning and maintaining living quarters (92.2%) and vigilance to ensure patient safety (92.2%). The care needs and task difficulty significantly correlated with physical function before, one week and one month after discharge (r=-0.530, p<0.001; r=-0.326, p=0.001; r=-0.432, p<0.001; r=-0.684, p<0.001; and r=-0.475, p<0.001, respectively). The complex and taxing home care needs of community-dwelling elderly hip fracture patients were significantly associated with functional recovery. Comprehensive geriatric assessment and related special medical services may greatly help caregivers and promote the practice of aging in place. Further study is needed to develop appropriate caregiver education to promote the functional recovery of elderly hip fracture patients at home. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Dementia Literacy among Community-Dwelling Older Adults in Urban China: A Cross-sectional Study.

    PubMed

    Zhang, Haifeng; Loi, Samantha M; Zhou, Shu'aijun; Zhao, Mei; Lv, Xiaozhen; Wang, Jing; Wang, Xiao; Lautenschlager, Nicola; Yu, Xin; Wang, Huali

    2017-01-01

    Delay in seeking diagnosis of dementia is common in China. Misinformation and poor knowledge about dementia may contribute to it. The study was designed to explore the nationwide dementia literacy among older adults in urban China and to investigate the factors associated with overall dementia literacy. In a cross-sectional study, a convenience sample of 3,439 community-dwelling old adults aged 60 and over was recruited from 34 cities in 20 provinces between June 20 and August 20, 2014. All participants were administered the face-to-face mental health literacy questionnaire, which included the prevalence, symptoms, intention, and options for treatment of dementia. Stepwise multivariate regression analysis was used to explore factors associated with overall dementia literacy. The response rate was 87.4%. The overall dementia literacy was 55.5% (SD = 20.9%) among all respondents. The correct response rate was higher for questions on symptoms (58.7-89.6%), but lower for questions on the prevalence (22.2%) and choosing appropriate professional care personnel (22.2%). Being male [OR = 1.256, 95% CI (1.022-1.543)], having lower per capita annual income [OR = 1.314, 95% CI (1.064-1.623)], lower education [OR = 1.462, 95% CI (1.162-1.839)], and suspected depression [OR = 1.248, 95% CI (1.009-1.543)] were negatively associated with overall dementia literacy. Dementia literacy among community-dwelling older adults in urban China remains very low, in particular about the impact of dementia and appropriate treatment personnel. Community educational programs aiming to close this knowledge gap are encouraged to focus on those in the population at highest risk of low dementia literacy.

  3. Self-reported estrogen use and newly incident urinary incontinence among postmenopausal community-dwelling women.

    PubMed

    Northington, Gina M; de Vries, Heather F; Bogner, Hillary R

    2012-03-01

    The aim of this study was to examine the relationship between self-reported estrogen use and newly incident urinary incontinence (UI) among community-dwelling postmenopausal women. The study was a population-based longitudinal survey of postmenopausal women who did not report UI in 1993 and for whom complete data were available. Women were classified as having newly incident UI if they reported uncontrolled urine loss within 12 months of the 2004 interview. Condition-specific functional loss secondary to UI was assessed using questions on the participants' inability to engage in certain activities because of UI. The duration of hormone therapy containing estrogen was obtained in 1993 using a structured questionnaire. Among the 167 postmenopausal women who did not report UI in 1993, 47 (28.1%) reported newly incident UI, and 31 (18.6%) reported newly incident UI with condition-specific functional loss in 2004. Of the 167 postmenopausal women, 46 (27.5%) reported using hormone therapy containing estrogen ever, and 14 (8.3%) women reported using hormone therapy containing estrogen for 5 years or more in 1993. Estrogen use for 5 years or more was significantly associated with newly incident UI with condition-specific functional loss compared with estrogen use for less than 5 years or having no reported history of estrogen (adjusted relative odds, 3.97; 95% CI, 1.02-15.43) in multivariate models controlling for potentially influential characteristics. Postmenopausal community-dwelling women with a history of estrogen use for 5 years or more were more likely to report newly incident UI with condition-specific functional loss after 10 years of follow-up.

  4. 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…

  5. Theory-Driven Intervention Improves Calcium Intake, Osteoporosis Knowledge, and Self-Efficacy in Community-Dwelling Older Black Adults

    ERIC Educational Resources Information Center

    Babatunde, Oyinlola T.; Himburg, Susan P.; Newman, Frederick L.; Campa, Adriana; Dixon, Zisca

    2011-01-01

    Objective: To assess the effectiveness of an osteoporosis education program to improve calcium intake, knowledge, and self-efficacy in community-dwelling older Black adults. Design: Randomized repeated measures experimental design. Setting: Churches and community-based organizations. Participants: Men and women (n = 110) 50 years old and older…

  6. Predictors of 4-Year Retention among African American and White Community-Dwelling Participants in the UAB Study of Aging

    ERIC Educational Resources Information Center

    Allman, Richard M.; Sawyer, Patricia; Crowther, Martha; Strothers, Harry S., III; Turner, Timothy; Fouad, Mona N.

    2011-01-01

    Purpose: To identify racial/ethnic differences in retention of older adults at 3 levels of participation in a prospective observational study: telephone, in-home assessments, and home visits followed by blood draws. Design and Methods: A prospective study of 1,000 community-dwelling Medicare beneficiaries aged 65 years and older included a…

  7. 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…

  8. Factors Influencing Administration of Hepatitis B Vaccine to Community-Dwelling Teenagers Aged 12-18 with an Intellectual Disability

    ERIC Educational Resources Information Center

    Yen, Chia-Feng; Lin, Jin-Ding

    2011-01-01

    The study aims to determine hepatitis B vaccination coverage rates among community-dwelling teenagers with an intellectual disability in Taiwan and to identify the possible influencing factors of their vaccination. The present paper was part of the results of the "2007 National Survey on Healthy Behaviors and Preventive Health Utilizations of…

  9. Hospitalization, Depression and Dementia in Community-Dwelling Older Americans: Findings from the National Health and Aging Trends Study

    PubMed Central

    Davydow, Dimitry S.; Zivin, Kara; Langa, Kenneth M.

    2014-01-01

    Objective To estimate the prevalence of both dementia and depression among community-dwelling older Americans, and to determine if hospitalization is independently associated with dementia or depression in this population. Method This cross-sectional study utilized data from a nationally representative, population-based sample of 7,197 community-dwelling adults ≥ 65 years old interviewed in 2011 as part of the National Health and Aging Trends Study. Information on hospitalizations was obtained from self or proxy-report. Possible and probable dementia was assessed according to a validated algorithm. Depressive symptoms were assessed with the Patient Health Questionnaire-2. Results An estimated 3.1 million community-dwelling older Americans may have dementia, and approximately 5.3 million may have substantial depressive symptoms. After adjusting for demographic and social characteristics, medical diagnoses, smoking history, serious falls, and pain symptoms, being hospitalized in the previous year was independently associated with greater odds of probable dementia (odds ratio [OR]: 1.42, 95% confidence interval[95%CI]: 1.16, 1.73) and substantial depressive symptoms (OR: 1.60, 95%CI: 1.29, 1.99). Conclusions Dementia and depression are common in community-dwelling older Americans, and hospitalization is associated with these conditions. Additional research increasing understanding of the bi-directional relationship between hospitalizations, dementia, and depression, along with targeted interventions to reduce hospitalizations, are needed. PMID:24388630

  10. Psychometric Properties of the Beck Depression Inventory-II (BDI-II) among Community-Dwelling Older Adults

    ERIC Educational Resources Information Center

    Segal, Daniel L.; Coolidge, Frederick L.; Cahill, Brian S.; O'Riley, Alisa A.

    2008-01-01

    The psychometric properties of the Beck Depression Inventory-II (BDI-II) as a self-administered screening tool for depressive symptoms were examined in a sample of community-dwelling older and younger adults. Participants completed the BDI-II, the Center for Epidemiologic Studies Depression Scale, the Coolidge Axis II Inventory, the Perceived…

  11. Theory-Driven Intervention Improves Calcium Intake, Osteoporosis Knowledge, and Self-Efficacy in Community-Dwelling Older Black Adults

    ERIC Educational Resources Information Center

    Babatunde, Oyinlola T.; Himburg, Susan P.; Newman, Frederick L.; Campa, Adriana; Dixon, Zisca

    2011-01-01

    Objective: To assess the effectiveness of an osteoporosis education program to improve calcium intake, knowledge, and self-efficacy in community-dwelling older Black adults. Design: Randomized repeated measures experimental design. Setting: Churches and community-based organizations. Participants: Men and women (n = 110) 50 years old and older…

  12. Psychometric Properties of the Beck Depression Inventory-II (BDI-II) among Community-Dwelling Older Adults

    ERIC Educational Resources Information Center

    Segal, Daniel L.; Coolidge, Frederick L.; Cahill, Brian S.; O'Riley, Alisa A.

    2008-01-01

    The psychometric properties of the Beck Depression Inventory-II (BDI-II) as a self-administered screening tool for depressive symptoms were examined in a sample of community-dwelling older and younger adults. Participants completed the BDI-II, the Center for Epidemiologic Studies Depression Scale, the Coolidge Axis II Inventory, the Perceived…

  13. Predictors of 4-Year Retention among African American and White Community-Dwelling Participants in the UAB Study of Aging

    ERIC Educational Resources Information Center

    Allman, Richard M.; Sawyer, Patricia; Crowther, Martha; Strothers, Harry S., III; Turner, Timothy; Fouad, Mona N.

    2011-01-01

    Purpose: To identify racial/ethnic differences in retention of older adults at 3 levels of participation in a prospective observational study: telephone, in-home assessments, and home visits followed by blood draws. Design and Methods: A prospective study of 1,000 community-dwelling Medicare beneficiaries aged 65 years and older included a…

  14. Factors Influencing Administration of Hepatitis B Vaccine to Community-Dwelling Teenagers Aged 12-18 with an Intellectual Disability

    ERIC Educational Resources Information Center

    Yen, Chia-Feng; Lin, Jin-Ding

    2011-01-01

    The study aims to determine hepatitis B vaccination coverage rates among community-dwelling teenagers with an intellectual disability in Taiwan and to identify the possible influencing factors of their vaccination. The present paper was part of the results of the "2007 National Survey on Healthy Behaviors and Preventive Health Utilizations of…

  15. Association between physiological falls risk and physical performance tests among community-dwelling older adults.

    PubMed

    Singh, Devinder K A; Pillai, Sharmila G K; Tan, Sin Thien; Tai, Chu Chiau; Shahar, Suzana

    2015-01-01

    Physical performance and balance declines with aging and may lead to increased risk of falls. Physical performance tests may be useful for initial fall-risk screening test among community-dwelling older adults. Physiological profile assessment (PPA), a composite falls risk assessment tool is reported to have 75% accuracy to screen for physiological falls risk. PPA correlates with Timed Up and Go (TUG) test. However, the association between many other commonly used physical performance tests and PPA is not known. The aim of the present study was to examine the association between physiological falls risk measured using PPA and a battery of physical performance tests. One hundred and forty older adults from a senior citizens club in Kuala Lumpur, Malaysia (94 females, 46 males), aged 60 years and above (65.77±4.61), participated in this cross-sectional study. Participants were screened for falls risk using PPA. A battery of physical performance tests that include ten-step test (TST), short physical performance battery (SPPB), functional reach test (FRT), static balance test (SBT), TUG, dominant hand-grip strength (DHGS), and gait speed test (GST) were also performed. Spearman's rank correlation and binomial logistic regression were performed to examine the significantly associated independent variables (physical performance tests) with falls risk (dependent variable). Approximately 13% older adults were at high risk of falls categorized using PPA. Significant differences (P<0.05) were demonstrated for age, TST, SPPB, FRT, SBT, TUG between high and low falls risk group. A significant (P<0.01) weak correlation was found between PPA and TST (r=0.25), TUG (r=0.27), SBT (r=0.23), SPPB (r=-0.33), and FRT (r=-0.23). Binary logistic regression results demonstrated that SBT measuring postural sways objectively using a balance board was the only significant predictor of physiological falls risk (P<0.05, odds ratio of 2.12). The reference values of physical performance tests

  16. Depressive Symptoms and Circadian Activity Rhythm Disturbances in Community-Dwelling Older Women

    PubMed Central

    Maglione, Jeanne E.; Ancoli-Israel, Sonia; Peters, Katherine W.; Paudel, Misti L.; Yaffe, Kristine; Ensrud, Kristine E.; Tranah, Greg J.; Stone, Katie L.

    2014-01-01

    Objectives Aging is associated with changes in circadian rhythms. Current evidence supports a role for circadian rhythms in the pathophysiology of depression. However, little is known about the relationship between depressive symptoms and circadian activity rhythms in older adults. We examined this association in community-dwelling older women. Methods We performed a cross-sectional analysis of 3,020 women (mean age: 83.55 ± 3.79 years) enrolled in the Study of Osteoporotic Fractures. Depressive symptoms were assessed with the Geriatric Depression Scale categorizing participants as “normal” (0–2; referent group, N = 1,961), “some depressive symptoms” (3–5, N = 704), or “depressed” (≥6, N = 355). Circadian activity rhythm variables were measured using wrist actigraphy. Results In age-adjusted and Study of Osteoporotic Fractures site–adjusted models, greater levels of depressive symptoms were associated with decreased amplitude (height; df = 3,014, t = −11.31, p for linear trend <0.001), pseudo F-statistic (robustness; df =3,014, t =−8.07, p for linear trend <0.001), and mesor (mean modeled activity; df = 3014, t = −10.36, p for linear trend <0.001) of circadian activity rhythms. Greater levels of depressive symptoms were also associated with increased odds of being in the lowest quartile for amplitude (df =1, χ2 =9240, p for linear trend <0.001), pseudo F-statistic (df =1, χ2 =49.73, p for linear trend <0.001), and mesor (df =1, χ2 =81.12, p for linear trend <0.001). These associations remained significant in multivariate models. Post-hoc analyses comparing mean amplitude, mesor, and pseudo F-statistic values pair-wise between depression-level groups revealed significant differences between women with “some depressive symptoms” and the “normal” group. Conclusion These data suggest a graded association between greater levels of depressive symptoms and more desynchronization of circadian activity rhythms in community-dwelling

  17. Dyspnea in Community-Dwelling Older Persons: A Multifactorial Geriatric Health Condition.

    PubMed

    Miner, Brienne; Tinetti, Mary E; Van Ness, Peter H; Han, Ling; Leo-Summers, Linda; Newman, Anne B; Lee, Patty J; Vaz Fragoso, Carlos A

    2016-10-01

    To evaluate the associations between a broad array of cardiorespiratory and noncardiorespiratory impairments and dyspnea in older persons. Cross-sectional. Cardiovascular Health Study. Community-dwelling persons (N = 4,413; mean age 72.6, 57.1% female, 4.5% African American, 27.2% community-dwelling older persons, several cardiorespiratory and noncardiorespiratory impairments were significantly associated with moderate to severe dyspnea, akin to a multifactorial geriatric health condition. © 2016, Copyright the Authors Journal

  18. Social cohesion and belonging predict the well-being of community-dwelling older people.

    PubMed

    Cramm, Jane M; Nieboer, Anna P

    2015-03-21

    The neighborhood social environment has been identified as an important aspect of older people's well-being. Poor neighborhood conditions can pose difficulties in obtaining support, especially for older people who live alone. Although social environments have been found to be related to well-being among older people, the longitudinal relationship between the social environment and well-being remains poorly undestood. Research on the effects of changes in neighborhood characteristics, such as social cohesion and social belonging, on well-being is lacking. Therefore, the study aims are (i) describe social cohesion, social belonging, and instrumental goals to achieve well-being among community-dwelling older people, (ii) determine whether these factors varied according to neighborhood social deprivation and compare these findings to those from chronically ill/previously hospitalized older people, and (iii) identify longitudinal relationships between social cohesion and belonging and well-being. Independently living Dutch older adults (aged ≥ 70 years) were asked to complete questionnaires in 2011 (T0) and 2013 (T1). Response rates at T0 and T1 were 66% (945/1440) and 62% (588/945), respectively. Descriptive statistics, paired sample t-tests, analysis of variance, univariate analyses and multilevel regression analyses controlling for background characteristics and baseline well-being were performed. Of 945 respondents [43% male; mean age, 77.5 ± 5.8 (range, 70-101) years], 34.7% were married and 83.3% were Dutch natives. Social cohesion remained constant over time, whereas social belonging improved (p ≤ 0.05). Older people living in socially deprived neighborhoods report poorer overall well-being and instrumental goals to achieve well-being. Baseline social cohesion, changes therein (both p ≤ .001), baseline social belonging, and changes therein (both p ≤ .05) predicted well-being at T1. This study showed that social cohesion, belonging

  19. The associations of alcohol, coffee and tobacco consumption with gait in a community-dwelling population.

    PubMed

    Verlinden, V J A; Maksimovic, A; Mirza, S S; Ikram, M A; Kiefte-de Jong, J C; Hofman, A; Franco, O H; Tiemeier, H; van der Geest, J N

    2016-01-01

    Gait is an important health indicator, relating strongly to the risk of falling, morbidity and mortality. In a community-dwelling population, we investigated associations of alcohol, coffee and tobacco consumption with gait. Two thousand forty-six non-demented participants from the Rotterdam Study underwent gait assessment by electronic walkway. We measured gait velocity and Global Gait, which is the average of seven gait domains: Rhythm, Phases, Variability, Pace, Tandem, Turning and Base of Support. Alcohol, coffee and tobacco consumption was assessed by questionnaires. With analysis of covariance, we investigated associations of consumption of alcoholic beverages, coffee consumption and smoking with Global Gait, gait velocity and the seven individual gait domains. In all, 81.9% of participants drank alcohol, 92.4% drank coffee, 17.3% were current smokers and 50.9% were past smokers. Moderate alcohol consumption (1-3 glasses per day) associated with better gait, as measured by Global Gait (0.20 standard deviations (s.d.) (95% confidence interval: 0.10; 0.31)), gait velocity (2.65 cm/s (0.80; 4.50)), Rhythm and Variability. Consuming high amounts of coffee (>3 cups per day) associated with better Global Gait (0.18 s.d. (0.08; 0.28)), gait velocity (2.63 cm/s (0.80; 4.45)), Pace, Turning and Variability. Current smoking associated with worse Global Gait (-0.11 s.d. (-0.21; 0.00)), gait velocity (-3.47 cm/s (-5.33; -1.60)), Rhythm and Pace, compared with non-smokers. In a community-dwelling population, consuming >1 cup of coffee and 1-3 glasses of alcohol relate to better gait, whereas smoking is related to worse gait. Further studies are required to evaluate whether interventions targeting substance consumption may aid to prevent or reduce gait deterioration and thereby related health problems.

  20. Frailty in community-dwelling older adults: association with adverse outcomes.

    PubMed

    Sánchez-García, Sergio; García-Peña, Carmen; Salvà, Antoni; Sánchez-Arenas, Rosalinda; Granados-García, Víctor; Cuadros-Moreno, Juan; Velázquez-Olmedo, Laura Bárbara; Cárdenas-Bahena, Ángel

    2017-01-01

    The study of frailty is important to identify the additional needs of medical long-term care and prevent adverse outcomes in community dwelling older adults. This study aimed to determine the prevalence of frailty and its association with adverse outcomes in community dwelling older adults. A cross-sectional study was carried out from April to September 2014. The population sample was 1,252 older adults (≥60 years) who were beneficiaries of the Mexican Institute of Social Security (IMSS) in Mexico City. Data were derived from the database of the "Cohort of Obesity, Sarcopenia and Frailty of Older Mexican Adults" (COSFOMA). Operationalization of the phenotype of frailty was performed using the criteria of Fried et al (weight loss, self-report of exhaustion, low physical activity, slow gait, and weakness). Adverse outcomes studied were limitation in basic activities of daily living (ADLs), falls and admission to emergency services in the previous year, and low quality of life (WHOQOL-OLD). Frailty was identified in 20.6% (n=258), pre-frailty in 57.6% (n=721), and not frail in 21.8% (n=273). The association between frailty and limitations in ADL was odds ratio (OR) =2.3 (95% confidence interval [CI] 1.7-3.2) and adjusted OR =1.7 (95% CI 1.2-2.4); falls OR =1.6 (95% CI 1.2-2.1) and adjusted OR =1.4 (95% CI 1.0-1.9); admission to emergency services OR =1.9 (95% CI 1.1-3.1) and adjusted OR =1.9 (95% CI 1.1-3.4); low quality of life OR =3.4 (95% CI 2.6-4.6) and adjusted OR =2.1 (95% CI 1.5-2.9). Approximately 2 out of 10 older adults demonstrate frailty. This is associated with limitations in ADL, falls, and admission to emergency rooms during the previous year as well as low quality of life.

  1. Frailty in community-dwelling older adults: association with adverse outcomes

    PubMed Central

    Sánchez-García, Sergio; García-Peña, Carmen; Salvà, Antoni; Sánchez-Arenas, Rosalinda; Granados-García, Víctor; Cuadros-Moreno, Juan; Velázquez-Olmedo, Laura Bárbara; Cárdenas-Bahena, Ángel

    2017-01-01

    Background The study of frailty is important to identify the additional needs of medical long-term care and prevent adverse outcomes in community dwelling older adults. This study aimed to determine the prevalence of frailty and its association with adverse outcomes in community dwelling older adults. Methods A cross-sectional study was carried out from April to September 2014. The population sample was 1,252 older adults (≥60 years) who were beneficiaries of the Mexican Institute of Social Security (IMSS) in Mexico City. Data were derived from the database of the “Cohort of Obesity, Sarcopenia and Frailty of Older Mexican Adults” (COSFOMA). Operationalization of the phenotype of frailty was performed using the criteria of Fried et al (weight loss, self-report of exhaustion, low physical activity, slow gait, and weakness). Adverse outcomes studied were limitation in basic activities of daily living (ADLs), falls and admission to emergency services in the previous year, and low quality of life (WHOQOL-OLD). Results Frailty was identified in 20.6% (n=258), pre-frailty in 57.6% (n=721), and not frail in 21.8% (n=273). The association between frailty and limitations in ADL was odds ratio (OR) =2.3 (95% confidence interval [CI] 1.7–3.2) and adjusted OR =1.7 (95% CI 1.2–2.4); falls OR =1.6 (95% CI 1.2–2.1) and adjusted OR =1.4 (95% CI 1.0–1.9); admission to emergency services OR =1.9 (95% CI 1.1–3.1) and adjusted OR =1.9 (95% CI 1.1–3.4); low quality of life OR =3.4 (95% CI 2.6–4.6) and adjusted OR =2.1 (95% CI 1.5–2.9). Conclusion Approximately 2 out of 10 older adults demonstrate frailty. This is associated with limitations in ADL, falls, and admission to emergency rooms during the previous year as well as low quality of life. PMID:28721028

  2. Medication use patterns among demented, cognitively impaired and cognitively intact community-dwelling elderly people.

    PubMed

    Schmader, K E; Hanlon, J T; Fillenbaum, G G; Huber, M; Pieper, C; Horner, R

    1998-07-01

    To determine whether medication use patterns in community-dwelling elderly people vary with level of cognitive function-dementia, cognitive impairment (but not dementia) and intact cognition. Cross-sectional survey. A five-county area of central North Carolina, USA. 520 members of the Duke Established Populations for Epidemiologic Studies of the Elderly. Medication use in the previous 2 weeks was ascertained during a interview in the patient's home and was coded as to prescription and therapeutic class status. Cognitive status, the primary independent variable, was divided into: (i) dementia (n=100); (ii) cognitive impairment but not dementia (n=117); and (iii) cognitively intact (n=303). The dependent variables were any prescription or over-the-counter (OTC) medication use (vs non-use); number of prescription or OTC medications used; and prescription and OTC use combined within major therapeutic classes. Multivariate analyses controlled for socio-demographic characteristics, health status, functional status and access to health care. The use of any prescription medication was similar in the three groups. The demented were significantly less likely than cognitively impaired people to use any OTC medications (OR=0.65, 95% CI=0.45, 0.93), cardiovascular medications (OR=0.70, 95% CI=0.49, 0.99) and analgesics (OR=0.54, 95% CI=0.39, 0.75). As a combined group, those who were demented and cognitively impaired were less likely than the cognitively intact group to use any OTC medications (OR=0.78, 95% CI 0.65, 0.92). Compared with the cognitively impaired subjects, the demented group took fewer prescription medications (beta coefficient=-0.31, 95% CI=-0.59, -0.03) and similar numbers of OTC medications. Compared with those who were cognitively intact, the combined group of demented and cognitively impaired subjects took fewer OTC medications (beta coefficient=-0.14, 95% CI=-0.23, -0.05) and similar numbers of prescription medications. Increasing level of cognitive

  3. Vasomotor symptoms are associated with depressive symptoms in community-dwelling older women.

    PubMed

    Zeleke, Berihun M; Bell, Robin J; Billah, Baki; Davis, Susan R

    2017-06-19

    To assess the prevalence of, and factors associated with, moderate-to-severe depressive symptoms in community-dwelling older Australian women. A questionnaire-based, cross-sectional study was conducted amongst community-dwelling older women. Participants were recruited between April and August 2014 from a national database based on the electoral roll. Depressive symptoms were assessed by the Beck Depression Inventory-II (BDI-II) tool. Vasomotor symptoms (VMS), vulvovaginal atrophy (VVA), and pelvic floor symptoms were assessed using validated questionnaires. Women were provided a comprehensive list of psychotropic medications (antidepressants, benzodiazepines, antipsychotics, and mood stabilizers) to identify their use over the preceding month. In all, 1,534 women completed the BDI-II. Overall, 34.2% (95% confidence interval [CI] 31.8%-36.7%) of women had VMS, 6.3% (95% CI 5.2%-7.7%) had moderate-to-severe depressive symptoms (BDI-II score ≥20), 26.8% (95% CI 24.6%-29.1%) had used any psychotropic medication in the previous month, and 17.5% (95%CI: 15.6-19.5%) had taken an antidepressant.Moderate-to-severe depressive symptoms were more common among women using antidepressants compared with nonusers (16.6% vs 4.3%; P < 0.001). Obesity (adjusted odds ratio [AOR] 2.18, 95% CI 1.17-4.04), living in financially insecure housing (AOR 3.84, 95% CI 2.08-8.08), being a caregiver to another person (AOR 2.39, 95% CI 1.36-4.19), being a smoker (AOR 2.28, 95% CI 1.12-4.66), having VMS (AOR 1.67, 95% CI 1.03-2.62), having pelvic floor dysfunction (AOR 1.78, 95% CI 1.08-2.94), and having vaginal dryness during intercourse (AOR 1.84, 95% CI 1.06-3.22, P < 0.05) were positively and independently associated with moderate-to-severe depressive symptoms. Being currently partnered (AOR 0.57, 95% CI 0.33-0.97) and employed (AOR 0.38, 95% CI 0.16-0.92) were associated with a lower likelihood of depressive symptoms. In older women, depressive symptoms are common and are

  4. Disability transitions after 30 months in three community-dwelling diagnostic groups in Spain.

    PubMed

    de Pedro-Cuesta, Jesús; García-Sagredo, Pilar; Alcalde-Cabero, Enrique; Alberquilla, Angel; Damián, Javier; Bosca, Graciela; López-Rodríguez, Fernando; Carmona, Montserrat; Carmona, Monserrat; de Tena-Dávila, María J; García-Olmos, Luis; Salvador, Carlos H

    2013-01-01

    Little is known about changes in disability over time among community-dwelling patients. Accordingly, this study sought to assess medium-term disability transitions. 300 chronic obstructive pulmonary disease (COPD), chronic heart failure and stroke patients living at home in Madrid were selected from general practitioner lists. In 2009, disability was assessed after a mean of 30 months using the World Health Organisation (WHO) Disability Assessment Schedule 2.0 (WHODAS 2.0). Follow-up was completed using death registries. Losses to follow-up were due to: death, 56; institutionalisation, 9; non-location, 18; and non-participation, 17. Changes in WHODAS 2.0 scores and life status were described and analysed using Cox and multinomial regression. Disability at end of follow-up was imputed for 56 deceased and 44 surviving patients. Mean disability scores for 200 surviving patients at end of follow-up were similar to baseline scores for the whole group, higher than their own baseline scores, and rose by 16.3% when imputed values were added. The strongest Cox predictors of death were: age over 84 years, adjusted hazard ratios with 95%CI 8.18 (3.06-21.85); severe/complete vs. no/mild disability, 5.18 (0.68-39.48); and stroke compared to COPD, 1.40 (0.67-2.91). Non-participants and institutionalised patients had higher proportions with severe/complete baseline disability. A one-point change in baseline WHODAS 2.0 score predicted independent increases in risk of 12% (8%-15%) for severe/complete disability or death. A considerably high proportion of community-dwelling patients diagnosed with COPD, CHF and stroke undergo medium-term changes in disability or vital status. The main features of the emerging pattern for this group appear to be as follows: approximately two-thirds of patients continue living at home with moderately reduced functional status; 1/3 die or worsen to severe/complete disability; and 1/10 improve. Baseline disability scores, age and diagnosis are

  5. Resveratrol levels and all-cause mortality in older community-dwelling adults

    PubMed Central

    Semba, Richard D.; Ferrucci, Luigi; Bartali, Benedetta; Urpí-Sarda, Mireia; Zamora-Ros, Raul; Sun, Kai; Cherubini, Antonio; Bandinelli, Stefania; Andres-Lacueva, Cristina

    2015-01-01

    Importance Resveratrol, a polyphenol found in grapes, red wine, chocolate, and certain berries and roots, is considered to have antioxidant, anti-inflammatory, and anti-cancer effects in humans and is related to longevity in some lower organisms. Objective To determine whether resveratrol levels achieved with diet are associated with inflammation, cancer, cardiovascular disease, and mortality in humans. Design Prospective cohort study, the Invecchiare in Chianti (InCHIANTI) Study (“Aging in the Chianti Region”), 1998-2009. Setting Two villages in the Chianti area, Tuscany region of Italy. Participants Population-based sample of 783 community-dwelling men and women, ≥65 y Exposure 24-h urinary resveratrol metabolites Main outcomes and measures Primary outcome measure was all-cause mortality. Secondary outcomes were markers of inflammation (serum C-reactive protein [CRP], interleukin [IL]-6, IL-1β, and tumor necrosis factor [TNF]-α), and prevalent and incident cancer and cardiovascular disease Results Mean (95% Confidence Interval) log total urinary resveratrol metabolite concentrations were 7.08 (6.69, 7.48) nmol/g creatinine. During nine years of follow-up, 268 (34.3%) of the participants died. From the lowest to the highest quartile of baseline total urinary resveratrol metabolites, the proportion of participants who died from all causes was 34.4, 31.6, 33.5, and 37.4%, respectively (P = 0.67). Participants in the lowest quartile had a hazards ratio for mortality of 0.80 (95% confidence interval 0.54, 1.17) when compared with those in the highest quartile of total urinary resveratrol in a multivariable Cox proportional hazards model that adjusted for potential confounders. Resveratrol levels were not significantly associated with serum CRP, IL-6, IL-1β, TNF-α, prevalent or incident cardiovascular disease or cancer. Conclusions: In older community-dwelling adults, total urinary resveratrol metabolite concentration was not associated with inflammatory

  6. Stair Negotiation Time in Community Dwelling Older Adults: Normative Values and Association with Functional Decline

    PubMed Central

    Oh-Park, Mooyeon; Wang, Cuiling; Verghese, Joe

    2011-01-01

    Objective To establish reference values for stair ascent and descent times in community dwelling ambulatory older adults, and to examine their predictive validity for functional decline. Design Longitudinal cohort study. Mean follow-up time was 1.8 year (maximum 3.2 y, total 857.9 person-years). Setting Community sample. Participants Older adults age 70 and older (N=513; mean age, 80.8±5.1y), without disability or dementia. Interventions Not applicable. Main Outcome Measures Time to ascend and descend 3 steps measured at baseline. 14 point Disability scale assessed functional status at baseline and at follow-up interviews every 2–3 months. Functional decline was defined as an increase in the disability score by 1-point during the follow-up period. Results The mean ± standard deviation (SD) stair ascent and descent time for three steps was 2.78 ±1.49 and 2.83 ±1.61 sec respectively. The proportion of self-reported and objective difficulty was higher with longer stair ascent and descent times (P<.001 for trend for both stair ascent and descent). Of the 472 participants with at least one follow-up interview, 315 developed functional decline with a 12-month cumulative incidence of 56.6% (95% confidence interval, CI, 52.1–61.3%). The stair negotiation time was a significant predictor of functional decline after adjusting for covariates including gait velocity (adjusted hazard ratio per one-second increase, aHR 1.12, 95% CI 1.04–1.21 for stair ascent time, aHR 1.15, 95% CI 1.07–1.24 for stair descent time). Stair descent time was a significant predictor of functional decline among relatively high-functioning older adults reporting no difficulty in stair negotiation (P=.001). Conclusions The stair ascent and descent times are simple, quick, and valid clinical measures for assessing the risk of functional decline in community dwelling older adults including high-functioning individuals. PMID:22133249

  7. Physical Activity and Health-Related Quality of Life Among Community Dwelling Elderly

    PubMed Central

    Halaweh, Hadeel; Willen, Carin; Grimby-Ekman, Anna; Svantesson, Ulla

    2015-01-01

    Background Physical activity (PA) and health-related quality of life (HRQoL) are important factors for optimal health in the elderly. Studying the association between PA and HRQoL is becoming more essential as the number of elderly people increases worldwide. This study assesses the association between PA and HRQoL among community dwelling elderly above 60 years old. Methods The study included 115 women and 61 men (mean age: 68.15 ± 6.74 years) recruited from the community and from public centers for the elderly. Data were collected using a background characteristics questionnaire (BCQ), a physical activity socio-cultural adapted questionnaire (PA-SCAQ), and the EuroQuol-5Dimensions-5Levels (EQ-5D-5L) questionnaire. Between groups, comparisons were based on the PA-SCAQ by dividing the participants into three PA groups: low (n = 74), moderate (n = 85), and high (n = 17). Kruskal-Wallis tests were performed on the ordinal variables of the three PA groups to determine differences between the groups according to categorical variables such as gender, body mass index (BMI), and the prevalence of comorbid conditions. Mann-Whitney U tests were performed on the ordinal variables of the EuroQuol-5Dimensions (EQ-5D), and the independent sample t-test was performed on the EQ visual analogue scale (EQ-VAS). Spearman’s rank correlation coefficient was used to examine the correlation between the EQ-5D and level of PA. Results Values in all dimensions of HRQoL were significantly higher (P < 0.05) in the moderate and high PA groups compared with the low PA group. Significant correlations were recorded between the five dimensions of HRQoL and the level of PA (P < 0.001). The low PA group showed higher prevalence of hypertension (64%, P < 0.001) and diabetes (50%, P < 0.001). Conclusion There were strong associations between higher levels of PA and all dimensions of HRQoL. Therefore, adopting a PA lifestyle may contribute to better HRQoL among community dwelling elderly above 60

  8. Disability transitions after 30 months in three community-dwelling diagnostic groups in Spain

    PubMed Central

    de Pedro-Cuesta, Jesús; García-Sagredo, Pilar; Alcalde-Cabero, Enrique; Alberquilla, Angel; Damián, Javier; Bosca, Graciela; López-Rodríguez, Fernando; Carmona, Monserrat; de Tena-Dávila, María J.; García-Olmos, Luis; Salvador, Carlos H.

    2013-01-01

    Background Little is known about changes in disability over time among community-dwelling patients. Accordingly, this study sought to assess medium-term disability transitions. Patients and Methods 300 chronic obstructive pulmonary disease (COPD), chronic heart failure and stroke patients living at home in Madrid were selected from general practitioner lists. In 2009, disability was assessed after a mean of 30 months using the World Health Organisation (WHO) Disability Assessment Schedule 2.0 (WHODAS 2.0). Follow-up was completed using death registries. Losses to follow-up were due to: death, 56; institutionalisation, 9; non-location, 18; and non-participation, 17. Changes in WHODAS 2.0 scores and life status were described and analysed using Cox and multinomial regression. Disability at end of follow-up was imputed for 56 deceased and 44 surviving patients. Results Mean disability scores for 200 surviving patients at end of follow-up were similar to baseline scores for the whole group, higher than their own baseline scores, and rose by 16.3% when imputed values were added. The strongest Cox predictors of death were: age over 84 years, adjusted hazard ratios with 95%CI 8.18 (3.06-21.85); severe/complete vs. no/mild disability, 5.18 (0.68-39.48); and stroke compared to COPD, 1.40 (0.67-2.91). Non-participants and institutionalised patients had higher proportions with severe/complete baseline disability. A one-point change in baseline WHODAS 2.0 score predicted independent increases in risk of 12% (8%-15%) for severe/complete disability or death. Conclusions A considerably high proportion of community-dwelling patients diagnosed with COPD, CHF and stroke undergo medium-term changes in disability or vital status. The main features of the emerging pattern for this group appear to be as follows: approximately two-thirds of patients continue living at home with moderately reduced functional status; 1/3 die or worsen to severe/complete disability; and 1/10 improve

  9. Twelve-week physical and leisure activity programme improved cognitive function in community-dwelling elderly subjects: a randomized controlled trial.

    PubMed

    Kamegaya, Tadahiko; Araki, Yumi; Kigure, Hanami; Yamaguchi, Haruyasu

    2014-03-01

    Japan is one of the most rapidly ageing societies in the world. A number of municipalities have started services for the prevention of cognitive decline for community-dwelling elderly individuals, but the effectiveness of these services is currently insufficient. Our study explored the efficacy of a comprehensive intervention programme consisting of physical and leisure activities to prevent cognitive decline in community-dwelling elderly subjects. We administered a 12-week intervention programme consisting of physical and leisure activities aimed at enhancing participants' motivation to participate and support one another by providing a pleasant atmosphere, empathetic communication, praise, and errorless support. This programme for the prevention of cognitive decline was conducted as a service by the city of Maebashi. All participants underwent the Five-Cog test, which evaluated the cognitive domains of attention, memory, visuospatial function, language, and reasoning. Executive function was evaluated by the Wechsler Digit Symbol Substitution Test and Yamaguchi Kanji-Symbol Substitution Test. Subjective health status, level of social support, functional capacity, subjective quality of life, and depressive symptoms were assessed with a questionnaire. Grip strength test, timed up-and-go test, 5-m maximum walking times test, and functional reach test were performed to evaluate physical function. Fifty-two participants were randomly allocated to intervention (n = 26) and control (n = 26) groups. Twenty-six participants, aged between 65-87 years, received intervention once a week at a community centre. The programme was conducted by health-care professionals, with the help of senior citizen volunteers. The intervention group (n = 19) showed significant improvement on the analogy task of the Five-Cog test (F(1,38) = 4.242, P = 0.046) and improved quality of life (F(1,38) = 4.773, P = 0.035) as compared to the control group (n = 24). A community-based 12-week

  10. Racial disparities in knowledge of pelvic floor disorders among community-dwelling women

    PubMed Central

    MANDIMIKA, Charisse Laura; MURK, William; MCPENCOW, Alexandra M.; LAKE, AeuMuro; Miller, Devin; CONNELL, Kathleen Anne; GUESS, Marsha Kathleen

    2015-01-01

    Objective To evaluate racial and ethnic differences in knowledge about preventative and curative treatments for pelvic floor disorders (PFD). Methods The is a secondary analysis of responses from 416 community-dwelling women, aged 19-98 years, living in New Haven County, Connecticut, who completed the Prolapse and Incontinence Knowledge Questionnaire. Associations between race/ethnicity (categorized as White, African American, and Other Women of Color [OWOC, combined group of Hispanic, Asian or ‘Other’ women] and knowledge proficiency about modifiable risk factors and treatments for PFD were evaluated. Associations were adjusted for age, marital status, socioeconomic status, education, working in a medical field, and PFD history. Results Compared to White women, African American women were significantly less likely to recognize childbirth as a risk factor for UI and POP, to know that exercises can help control leakage, and to recognize pessaries as a treatment option for POP. OWOC were also significantly less likely to know about risk factors, preventative strategies and curative treatment options for POP and UI; however, these findings may not be generalizable given the heterogeneity and small size of this group. Conclusions Significant racial disparities exist in women's baseline knowledge regarding risk factors and treatment options for POP and UI. Targeted, culturally-sensitive educational interventions are essential to enhancing success in reducing the personal and economic burden of PFD, which have proven negative effects on women's quality of life. PMID:26313495

  11. Reliability analysis of time series force plate data of community dwelling older adults.

    PubMed

    Bauer, Christoph; Gröger, Ines; Rupprecht, Roland; Meichtry, André; Tibesku, Carsten Oliver; Gassmann, Karl-Günter

    2010-01-01

    Frequency-based analysis of body sway has been used to distinguish between healthy young, healthy elderly adults and elderly adults with Huntingtons disease. Our aim was to assess the reliability of spectral-based outcomes of the centre of pressure (CoP) kinematics in order to determine if these outcomes could be tested for their capability to distinguish between elderly fallers and non-fallers in a future study. We have studied balance for 30 community dwelling healthy older adults 60 years or older. Four test conditions were used. Three successive trials were performed for each condition. CoP kinematics were estimated with a force platform with three strain gauges set in a triangular position. The frequency content of these signals was estimated. Intrasession correlation coefficients (ICC's) were then calculated for all test conditions. The reliability of the selected parameters varied between low and high (ICC 0.652-0.939). The ICC's for the narrow stance tests were higher compared to tests with normal standing conditions (0.771-0.94) to (0.652-0.865). The highest value was obtained in the high frequency band (0.939). These measures should be viewed with caution when screening geriatric patients because their reliability cannot always be assumed. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  12. Association between serum albumin and periodontal disease in community-dwelling elderly.

    PubMed

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

    2006-05-01

    The purpose of this study was to evaluate the relationship between periodontal disease and general health status in community-dwelling elderly using serum albumin concentration as a criterion index of the severity of an underlying disease and nutrition status. Serum albumin level was detected by the bromcresol green albumin (BCG) method and the data for serum albumin were available in 368 subjects aged 75 years. Pressure-sensitive probes were used to measure loss of attachment (LA) on six sites of all teeth present. Information relevant to gender and smoking habit was obtained by means of a personal interview, while body mass index (BMI) and biochemical serum markers were investigated. Serum albumin concentration ranged from 3.2 to 4.8 g/dl with a mean of 4.1+/-0.2. More than 70% of subjects had at least one site with LA 6+ mm, while 91 exhibited 10% or more sites with LA 6+ mm. Using a multiple regression analysis, we found that sites of LA 6+ mm had a significant effect on serum albumin level (correlation coefficient=-0.14; p<0.05), which was independent of the other covariates. The findings of the present study indicated that there might be an inverse relationship between periodontal disease and serum albumin concentration in these elderly subjects.

  13. The Impact of Transportation Support on Driving Cessation Among Community-Dwelling Older Adults

    PubMed Central

    Adams, Kathryn Betts; Kahana, Eva

    2012-01-01

    Objectives. This study longitudinally examines the impact of transportation support on driving cessation among community-dwelling older adults residing in retirement communities. Method. Data came from 3 waves of the Florida Retirement Study (1990–1992), a population-based cohort study. Analysis was limited to participants who drove at baseline and were reinterviewed in 1992 (N = 636). Transportation support from a spouse, family members, friends/neighbors, agencies/organizations (e.g., church), or hired assistants was included. Discrete-time multivariate hazard models were estimated to examine the impact of transportation support on driving cessation while controlling for demographic and health characteristics. Results. Participants were more likely to stop driving if they had received at least some transportation support from friends/neighbors (Hazard Ratio = 2.49, p = .001) as compared with those with little or no support. Transportation support from organizations/agencies or hired assistants was also significantly associated with the likelihood of driving cessation, but only a small number of participants reported to have received such support. Receiving some or more transportation support from a spouse or family members did not have a statistically significant relationship with driving cessation. Discussion. The findings suggest that available nonkin transportation support, particularly support from peer friends, plays an important role in driving cessation for older adults living in retirement communities. PMID:22454388

  14. 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

  15. Gender differences in widowhood effects among community-dwelling elders by causes of death in Taiwan.

    PubMed

    Fang, Shao-You; Huang, Nicole; Chen, Kuang-Hung; Yeh, Hsueh-Han; Lin, Keh-Ming; Chen, Chuan-Yu

    2012-07-01

    We sought to determine whether widowhood-associated excess mortality differs by gender in terms of causes of death. Data were collected from a five-wave interview of approximately 2500 community-dwelling elders in the Survey of Health and Living Status of the Nearly Elderly and Elderly. Baseline characteristics were used to derive the risk score (RS) to reflect individual's baseline pre-widowhood vulnerability. Time-dependent Cox regression analyses were used to estimate spousal loss-related mortality by causes. For males, the adjusted hazard ratios (aHRs) of widowhood for all-cause and some major causes of death (e.g., neoplasm) increased inversely with RS: the aHRs for all-cause death were 4.81 and 1.76 in the lowest and highest RS groups, respectively. In contrast, the corresponding aHRs were relatively homogeneous for women (1.52 and 1.70). Identifying gender heterogeneity in widowhood effects can guide further efforts to devise gender-tailored programs to enhance healthy aging. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Foot pain impairs balance and functional ability in community-dwelling older people.

    PubMed

    Menz, H B; Lord, S R

    2001-05-01

    Foot problem assessments were performed on 135 community-dwelling older people in conjunction with clinical tests of balance and functional ability. Eighty-seven percent of the sample had at least one foot problem, and women had a higher prevalence than men of foot pain, hallux valgus, plantar hyperkeratosis, lesser digital deformity, and digital lesions. Postural sway did not differ between older people with and without each of these foot conditions. However, the presence of specific foot conditions impaired performance in a more challenging balance test and in some functional tests. In particular, older people with foot pain performed worse in a leaning balance test, stair ascent and descent, an alternate step-up test, and a timed six-meter walk. Furthermore, multiple regression analyses revealed that foot pain was a significant independent predictor of performance in each of these tests. These results show that the presence of foot problems, particularly foot pain, impairs balance and functional ability. As foot pain is amenable to treatment, podiatric intervention has the potential to improve mobility and independence in older people.

  17. Association between risk perception, subjective knowledge, and depression in community-dwelling elderly people in Japan.

    PubMed

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

    2015-05-30

    Risk perception is one of the core factors in theories of health behavior promotion. However, the association between knowledge, risk perception, and depressed mood in depression is unknown. The aim of this study was to clarify the relationships between subjective knowledge, risk perception, and objective scores of depression in community-dwelling elderly people in Japan. A total of 747 elderly participants (mean age: 76.1, female: 59.8%) who completed the 15-item Geriatric Depression Scale (GDS-15) along with items assessing subjective knowledge and risk perception were included in the analysis. We assessed the correlation between subjective knowledge and risk perception, and then compare GDS-15 scores by level of subjective knowledge and risk perception. Subjective knowledge was weakly associated with risk perception and related to lower GDS-15 scores in a dose-response pattern, which did not change after adjusting for age, gender, basic activities of daily living (ADL), instrumental ADL, years of education and history of depression. There was no significant association between risk perception and GDS-15 scores. The relationship between knowledge, risk perception, and depressed mood in younger generations is unclear, but warrants examination.

  18. Effect of age, education and health status on community dwelling older men's health concerns.

    PubMed

    Tannenbaum, Cara

    2012-06-01

    A significant gap in evidence characterizes the process of establishing patient-centered health priorities for older men. A cross-sectional postal survey of 2325 Canadian community dwelling men aged 55-97 years old was conducted in 2008 to gauge older men's level of concern for 24 different health items, to determine the impact of age, education and health status on these perceptions, and to ascertain whether men perceive that their health concerns are being attended to. Health issues of greatest concern to men were mobility impairment (64% of respondents), memory loss (64%), and medication side effects (63%). Respondents with lower educational attainment expressed greater concern about their health and were almost 2-fold times more likely to report being concerned about stroke, heart disease and prostate disorders in analyses that controlled for age and health status. Physical and mental health were independently associated with various concerns about health, but old age was not a reliable predictor, with only younger men (<75 years old) differentially preoccupied by conditions such as erectile dysfunction. Health items of greatest concern to men tended to be those with the lowest screening or counseling rates: these included incontinence, osteoporosis, mobility impairment, falls, anxiety issues, memory loss and depression. An improved consumer-guided agenda for addressing older men's health in the coming decade is urgently required.

  19. 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.

  20. The impact of transportation support on driving cessation among community-dwelling older adults.

    PubMed

    Choi, Moon; Adams, Kathryn Betts; Kahana, Eva

    2012-05-01

    This study longitudinally examines the impact of transportation support on driving cessation among community-dwelling older adults residing in retirement communities. Data came from 3 waves of the Florida Retirement Study (1990-1992), a population-based cohort study. Analysis was limited to participants who drove at baseline and were reinterviewed in 1992 (N = 636). Transportation support from a spouse, family members, friends/neighbors, agencies/organizations (e.g., church), or hired assistants was included. Discrete-time multivariate hazard models were estimated to examine the impact of transportation support on driving cessation while controlling for demographic and health characteristics. Participants were more likely to stop driving if they had received at least some transportation support from friends/neighbors (Hazard Ratio = 2.49, p = .001) as compared with those with little or no support. Transportation support from organizations/agencies or hired assistants was also significantly associated with the likelihood of driving cessation, but only a small number of participants reported to have received such support. Receiving some or more transportation support from a spouse or family members did not have a statistically significant relationship with driving cessation. The findings suggest that available nonkin transportation support, particularly support from peer friends, plays an important role in driving cessation for older adults living in retirement communities.

  1. Physical activity and quality of life in community dwelling older adults

    PubMed Central

    White, Siobhan M; Wójcicki, Thomas R; McAuley, Edward

    2009-01-01

    Background Physical activity has been consistently associated with enhanced quality of life (QOL) in older adults. However, the nature of this relationship is not fully understood. In this study of community dwelling older adults, we examined the proposition that physical activity influences global QOL through self-efficacy and health-status. Methods Participants (N = 321, M age = 63.8) completed measures of physical activity, self-efficacy, global QOL, physical self worth, and disability limitations. Data were analyzed using covariance modeling to test the fit of the hypothesized model. Results Analyses indicated direct effects of a latent physical activity variable on self-efficacy but not disability limitations or physical self-worth; direct effects of self-efficacy on disability limitations and physical self worth but not QOL; and direct effects of disability limitations and physical self-worth on QOL. Conclusion Our findings support the role of self-efficacy in the relationship between physical activity and QOL as well as an expanded QOL model including both health status indicators and global QOL. These findings further suggest future PA promotion programs should include strategies to enhance self-efficacy, a modifiable factor for improving QOL in this population. PMID:19200385

  2. Trajectory of Declines in Physical Activity in Community-Dwelling Older Women: Social Cognitive Influences

    PubMed Central

    Hall, Katherine S.; Motl, Robert W.; White, Siobhan M.; Wójcicki, Thomas R.; Hu, Liang; Doerksen, Shawna E.

    2009-01-01

    Studies examining physical activity behavior suggest that activity levels decline with age. Such declines are particularly problematic among older adults in light of the research suggesting a protective effect of physical activity on numerous physical health outcomes associated with independent living. Despite a growing recognition of the importance of a physically active lifestyle, little is known about the role of demographic and psychosocial variables on this trajectory of change. In this study, the roles played by outcome expectations, self-efficacy, and functional limitations on changes in physical activity levels over a 2-year period in older women were assessed using latent growth curve modeling. Data were obtained from 249 community-dwelling older women (M age = 68.12, n = 81 Black, and n = 168 White). Demographic, health status, and psychosocial data were collected via self-report upon entry into the study. Self-reported physical activity was assessed at baseline and again at 12 and 24 months. As expected, physical activity declined over the 2-year period. Self-efficacy demonstrated an indirect association with the trajectory of decline in physical activity through functional limitations. Importantly, the pattern of relationships appears independent of demographic factors and chronic health conditions. PMID:19528360

  3. Leisure-time physical activity and neuropsychiatric symptoms of community-dwelling persons with cognitive impairment.

    PubMed

    Chiu, Yi-Chen; Kolanowski, Ann M; Huang, Chien-Ying; Lin, Li-Jung; Chang, Ting-Huan; Hsu, Kuang-Hung; Hu, Chaur-Jong; Chen, Ying-Jen

    2014-01-01

    Physical activities are recommended to reduce neuropsychiatric symptoms of nursing home residents with mild dementia. However, relevant information is not available for community-dwelling persons with cognitive impairment. Therefore, this cross-sectional study examined the effects of leisure-time physical activities on cognitively impaired persons' neuropsychiatric symptoms and their family caregivers' distress. Activities were described in terms of their frequency, duration, number of different types, and energy expenditure. Participants were 58 dyads of persons with cognitive impairment and their family caregivers. Data on leisure-time physical activities and neuropsychiatric symptoms were collected using a 7-Day Physical Activity Recall and Chinese Neuropsychiatric Inventory, respectively. The most frequently reported activity was strolling (70.7%). The mean weekly activity frequency, duration, and energy expenditure were 4.52 (SD=4.27) times, 3.7 (SD=4.38) h, and 771.47 (SD=886.38) kcal, respectively. The number of different activity types negatively and significantly predicted cognitively impaired persons' mood and psychosis as well as family caregivers' distress.

  4. Exercise and Sleep in Community-Dwelling Older Adults: Evidence for a Reciprocal Relationship

    PubMed Central

    Dzierzewski, Joseph M; Buman, Matthew P; Giacobbi, Peter R; Roberts, Beverly L; Aiken-Morgan, Adrienne T.; Marsiske, Michael; McCrae, Christina S

    2013-01-01

    Summary Exercise behavior and sleep are both important health indicators that demonstrate significant decreases with age, and remain modifiable well into the later life. The current investigation examined both the chronic and acute relationships between exercise behavior and self-reported sleep in older adults through a secondary analysis of a clinical trial of a lifestyle intervention. Seventy-nine community-dwelling, initially sedentary, older adults (Mean age = 63.58, SD = 8.66 years) completed daily home-based assessments of exercise behavior and sleep using daily diary methodology. Assessments were collected weekly and continued for 18 consecutive weeks. Multilevel models revealed a small positive chronic (between-person mean-level) association between exercise and wake time after sleep onset, and a small positive acute (within-person, day-to-day) association between exercise and general sleep quality rating. The within-person exercise and general sleep quality rating relationship was found to be reciprocal (i.e., sleep quality also predicted subsequent exercise behavior). As such, it appears exercise and sleep are dynamically related in older adults. Efforts to intervene on either sleep or exercise in late-life would be wise to take the other into account. Light exposure, temperature regulation, and mood may be potential mechanisms of action through which exercise can impact sleep in older adults. PMID:23980920

  5. Self-reported versus professionally assessed functional limitations in community-dwelling very old individuals.

    PubMed

    Carlsson, Gunilla; Haak, Maria; Nygren, Carita; Iwarsson, Susanne

    2012-12-01

    The objective of this study was to examine the relationship between self-reported and professionally assessed functional limitations in community-dwelling very old individuals. In total, 306 single-living adults aged 81-90 years were included in this cross-sectional study. The main outcome measure was the presence and absence of self-reported and professionally assessed functional limitations. A significant correlation was found between the total number of self-reported and professionally assessed functional limitations in the total sample (intraclass correlation=0.65) as well as in subgroups with respect to sex, age, and depression. When item-wise differences in the two assessments were assessed, the results showed significant differences for nine of the 15 functional limitations. In general, the participants reported more functional limitations as present than the professional did. In conclusion, research on self-reported and professionally assessed functional limitations contributes toward the understanding of how different modes of data collection influence the results. In this study, functional limitations were examined on a broad basis, including physical as well as cognitive and perceptual limitations. Once the assessments of self-reporting have been refined, we will have a more nuanced picture of functional limitations, incorporating self-report as well as professional assessments.

  6. Physical Activity, Central Adiposity, and Functional Limitations in Community-Dwelling Older Adults.

    PubMed

    Germain, Cassandra M; Vasquez, Elizabeth; Batsis, John A

    2016-01-01

    Obesity and physical inactivity are independently associated with physical and functional limitations in older adults. The current study examines the impact of physical activity on odds of physical and functional limitations in older adults with central and general obesity. Data from 6279 community-dwelling adults aged 60 years or more from the Health and Retirement Study 2006 and 2008 waves were used to calculate prevalence and odds of physical and functional limitation among obese older adults with high waist circumference (waist circumference ≥88 cm in females and ≥102 cm in males) who were physically active versus inactive (engaging in moderate/vigorous activity less than once per week). Logistic regression models were adjusted for age, sex, race/ethnicity, education, smoking status, body mass index, and number of comorbidities. Physical activity was associated with lower odds of physical and functional limitations among older adults with high waist circumference (odds ratio [OR], 0.59; confidence interval [CI], 0.52-0.68, for physical limitations; OR, 0.52; CI, 0.44-0.62, for activities of daily living; and OR, 0.44; CI, 0.39-0.50, for instrumental activities of daily living). Physical activity is associated with significantly lower odds of physical and functional limitations in obese older adults regardless of how obesity is classified. Additional research is needed to determine whether physical activity moderates long-term physical and functional limitations.

  7. Tooth loss and dental caries in community-dwelling older adults in northern Manhattan.

    PubMed

    Northridge, Mary E; Ue, Frances V; Borrell, Luisa N; De La Cruz, Leydis D; Chakraborty, Bibhas; Bodnar, Stephanie; Marshall, Stephen; Lamster, Ira B

    2012-06-01

    To examine tooth loss and dental caries by sociodemographic characteristics from community-based oral health examinations conducted by dentists in northern Manhattan. The ElderSmile programme of the Columbia University College of Dental Medicine serves older adults with varying functional capacities across settings. This report is focused on relatively mobile, socially engaged participants who live in the impoverished communities of Harlem and Washington Heights/Inwood in northern Manhattan, New York City. Self-reported sociodemographic characteristics and health and health care information were provided by community-dwelling ElderSmile participants aged 65 years and older who took part in community-based oral health education and completed a screening questionnaire. Oral health examinations were conducted by trained dentists in partnering prevention centres among ElderSmile participants who agreed to be clinically screened (90.8%). The dental caries experience of ElderSmile participants varied significantly by sociodemographic predictors and smoking history. After adjustment in a multivariable logistic regression model, older age, non-Hispanic Black and Hispanic race/ethnicity, and a history of current or former smoking were important predictors of edentulism. Provision of oral health screenings in community-based settings may result in opportunities to intervene before oral disease is severe, leading to improved oral health for older adults. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

  8. Comparison of Bioelectrical Impedance Analysis and Air Displacement Plethysmography in Community-Dwelling Older Adults.

    PubMed

    Smale, K Brent; McIntosh, Emily I; Vallis, Lori Ann

    2016-05-01

    Clinicians and researchers use body composition measurements to identify individuals who may be at risk of adverse health complications. This study compared two commonly used two-compartmental anthropometric models (bioelectrical impedance analysis [BIA] and air displacement plethysmography [ADP]) to determine whether these two cost-effective methods would provide similar fat free mass index (FFMI) values in a mixed and sex-separated sample population of healthy older adults. Community-dwelling older adults (N= 37, 18 men) aged 74.5 ± 5.2 years participated. FFMIBIAwas correlated with FFMIADP(r= .916); however, these correlations were markedly reduced when the population was split by sex (r< .60). The level of agreement between the difference values (FFMIBIA- FFMIADP) fluctuated ± 2.1 kg/m(2)(illustrated via Bland-Altman plots), but these differences were not statistically different from 0. Findings from the current work suggest that clinicians must be cautious when using portable devices such as BIA to assess FFMI in an older adult population. © The Author(s) 2013.

  9. Current status and trends in oral health in community dwelling older adults: a global perspective.

    PubMed

    Kossioni, Anastassia E

    2013-01-01

    To record the available current national and regional data on the oral health of community-dwelling (living in their own homes, not institutionalised) older people globally and discuss the future trends considering existing dangers and opportunities. A literature search on tooth loss, dental decay and periodontal disease in the elderly was performed using available databases and electronic sources. The findings revealed that the updated national data are scarce in many parts of the world, particularly in Africa, Asia and South America, and direct comparisons are not always possible due to methodological variations. The available information may indicate that dental disease in older adults worldwide is more prevalent compared to younger age groups, with significant variation between countries and regions. Tooth loss is currently more common in the developed countries, while dental decay and periodontal disease are more widespread globally. There are important threats for further deterioration of the oral status among older adults in many developed and less developed areas due to existing sociodemographic and economic risk factors. National studies should be undertaken to record the specific oral problems of the elderly in each area. It is also necessary to develop gerodontology study programmes globally at the undergraduate, postgraduate and continuing education levels which will enhance dentists' knowledge, skills and attitudes towards oral care in the older population, and will promote opportunities for further research and development of relevant policies.

  10. Sleep and Cognition in Community-Dwelling Older Adults: A Review of Literature.

    PubMed

    Brewster, Glenna S; Varrasse, Miranda; Rowe, Meredeth

    2015-12-01

    Changes in sleep and cognition occur with advancing age. While both may occur independently of each other, it is possible that alterations in sleep parameters may increase the risk of age-related cognitive changes. This review aimed to understand the relationship between sleep parameters (sleep latency, wake after sleep onset, sleep efficiency, sleep duration, general sleep complaints) and cognition in community-dwelling adults aged 60 years and older without sleep disorders. Systematic, computer-aided searches were conducted using multiple sleep and cognition-related search terms in PubMed, PsycINFO, and CINAHL. Twenty-nine manuscripts met the inclusion criteria. Results suggest an inconsistent relationship between sleep parameters and cognition in older adults and modifiers such as depressive symptoms, undiagnosed sleep apnea and other medical conditions may influence their association. Measures of sleep and cognition were heterogeneous. Future studies should aim to further clarify the association between sleep parameters and cognitive domains by simultaneously using both objective and subjective measures of sleep parameters. Identifying which sleep parameters to target may lead to the development of novel targets for interventions and reduce the risk of cognitive changes with aging.

  11. Tooth loss and dental caries in community-dwelling older adults in northern Manhattan

    PubMed Central

    Northridge, Mary E.; Ue, Frances V.; Borrell, Luisa N.; De La Cruz, Leydis D.; Chakraborty, Bibhas; Bodnar, Stephanie; Marshall, Stephen; Lamster, Ira B.

    2011-01-01

    Objective To examine tooth loss and dental caries by sociodemographic characteristics from community-based oral health examinations conducted by dentists in northern Manhattan. Background The ElderSmile programme of the Columbia University College of Dental Medicine serves older adults with varying functional capacities across settings. This report is focused on relatively mobile, socially engaged participants who live in the impoverished communities of Harlem and Washington Heights/Inwood in northern Manhattan, New York City. Materials and Methods Self-reported sociodemographic characteristics and health and health care information were provided by community-dwelling ElderSmile participants aged 65 years and older who took part in community-based oral health education and completed a screening questionnaire. Oral health examinations were conducted by trained dentists in partnering prevention centres among ElderSmile participants who agreed to be clinically screened (90.8%). Results The dental caries experience of ElderSmile participants varied significantly by sociodemographic predictors and smoking history. After adjustment in a multivariable logistic regression model, older age, non-Hispanic Black and Hispanic race/ethnicity, and a history of current or former smoking were important predictors of edentulism. Conclusion Provision of oral health screenings in community-based settings may result in opportunities to intervene before oral disease is severe, leading to improved oral health for older adults. PMID:21718349

  12. Poor sleep quality is associated with increased cortical atrophy in community-dwelling adults

    PubMed Central

    Storsve, Andreas B.; Walhovd, Kristine B.; Johansen-Berg, Heidi; Fjell, Anders M.

    2014-01-01

    Objective: To examine the relationship between sleep quality and cortical and hippocampal volume and atrophy within a community-based sample, explore the influence of age on results, and assess the possible confounding effects of physical activity levels, body mass index (BMI), and blood pressure. Methods: In 147 community-dwelling adults (92 female; age 53.9 ± 15.5 years), sleep quality was measured using the Pittsburgh Sleep Quality Index and correlated with cross-sectional measures of volume and longitudinal measures of atrophy derived from MRI scans separated by an average of 3.5 years. Exploratory post hoc analysis compared correlations between different age groups and included physical activity, BMI, and blood pressure as additional covariates. Results: Poor sleep quality was associated with reduced volume within the right superior frontal cortex in cross-sectional analyses, and an increased rate of atrophy within widespread frontal, temporal, and parietal regions in longitudinal analyses. Results were largely driven by correlations within adults over the age of 60, and could not be explained by variation in physical activity, BMI, or blood pressure. Sleep quality was not associated with hippocampal volume or atrophy. Conclusions: We found that longitudinal measures of cortical atrophy were widely correlated with sleep quality. Poor sleep quality may be a cause or a consequence of brain atrophy, and future studies examining the effect of interventions that improve sleep quality on rates of atrophy may hold key insights into the direction of this relationship. PMID:25186857

  13. Physical Activity, Central Adiposity and Functional Limitations in Community Dwelling Older Adults

    PubMed Central

    Germain, Cassandra M.; Vasquez, Elizabeth; Batsis, John A.

    2015-01-01

    Background and Purpose Obesity and physical inactivity are independently associated with declines in physical and functional limitations in older adults. The current study examines the impact of physical activity on odds of physical and functional limitations in older adults with central and general obesity. Methods Data from 6,279 community dwelling adults aged ≥ 60 years from the Health and Retirement Study 2006 and 2008 waves were used to calculate prevalence and odds of physical and functional limitation among obese older adults with high waist circumference (WC) (WC ≥ 88cm in females and ≥ 102cm in males) who were physically active vs. inactive (engaging in moderate/vigorous activity less than once per week). Logistic regression models were adjusted for age, gender, race/ethnicity, education, smoking status, body mass index (BMI) and number of comorbidities. Results Physical activity was associated with lower odds of physical and functional limitations among older adults with high WC odds ratios (OR) and confidence intervals (CI) were OR 0.59 (CI: 0.52–0.68) for physical limitations, OR 0.52 (CI: .44–.62) for activities of daily living and OR 0.44 (CI: 0.39–0.50) for instrumental activities of daily living. Conclusion Physical activity is associated with significantly lower odds of physical and functional limitations in obese older adults regardless of how obesity is classified. Additional research is needed to determine whether physical activity moderates long-term physical and functional limitations. PMID:25794309

  14. Understanding depressive symptoms among community-dwelling Chinese older adults in the Greater Chicago area.

    PubMed

    Dong, XinQi; Chen, Ruijia; Li, Chengyue; Simon, Melissa A

    2014-10-01

    This study aimed to examine the prevalence of depressive symptoms among U.S. Chinese older adults. Data were from the Population Study of Chinese Elderly in Chicago (PINE) study, a population-based survey of U.S. Chinese older adults aged 60 years and above. The Patient Health Questionnaire (PHQ-9) was used to examine depressive symptoms. Of the 3,159 community-dwelling Chinese older adults, 1,717 (54.4%) reported having any depressive symptoms in the last 2 weeks. Older age (r = .09), being female (r = .10), lower income (r = .09), not being married (r = .07), having fewer years in the United States (r = .05), lower overall health status (r = .32), poorer quality of life (r = .14), and worsening health over the past year (r = .24) were significantly and positively correlated with any depressive symptoms. Depressive symptoms are common among U.S. Chinese older adults in the Greater Chicago area. Further longitudinal studies should be conducted to better understand risk factors and outcomes of depressive symptoms among U.S. Chinese older adults. © The Author(s) 2014.

  15. Olfactory discrimination predicts cognitive decline among community-dwelling older adults.

    PubMed

    Sohrabi, H R; Bates, K A; Weinborn, M G; Johnston, A N B; Bahramian, A; Taddei, K; Laws, S M; Rodrigues, M; Morici, M; Howard, M; Martins, G; Mackay-Sim, A; Gandy, S E; Martins, R N

    2012-05-22

    The presence of olfactory dysfunction in individuals at higher risk of Alzheimer's disease has significant diagnostic and screening implications for preventive and ameliorative drug trials. Olfactory threshold, discrimination and identification can be reliably recorded in the early stages of neurodegenerative diseases. The current study has examined the ability of various olfactory functions in predicting cognitive decline in a community-dwelling sample. A group of 308 participants, aged 46-86 years old, were recruited for this study. After 3 years of follow-up, participants were divided into cognitively declined and non-declined groups based on their performance on a neuropsychological battery. Assessment of olfactory functions using the Sniffin' Sticks battery indicated that, contrary to previous findings, olfactory discrimination, but not olfactory identification, significantly predicted subsequent cognitive decline (odds ratio = 0.869; P<0.05; 95% confidence interval = 0.764-0.988). The current study findings confirm previously reported associations between olfactory and cognitive functions, and indicate that impairment in olfactory discrimination can predict future cognitive decline. These findings further our current understanding of the association between cognition and olfaction, and support olfactory assessment in screening those at higher risk of dementia.

  16. Age of dementia diagnosis in community dwelling bilingual and monolingual Hispanic Americans

    PubMed Central

    Lawton, Deborah M.; Gasquoine, Philip G.; Weimer, Amy A.

    2015-01-01

    Bilingualism has been reported to delay the age of retrospective report of first symptom in dementia. This study determined if the age of clinically diagnosed Alzheimer's disease and vascular dementia occurred later for bilingual than monolingual, immigrant and U.S. born, Hispanic Americans. It involved a secondary analysis of the subset of 81 bi/monolingual dementia cases identified at yearly follow-up (1998 through 2008) using neuropsychological test results and objective diagnostic criteria from the Sacramento Area Latino Study on Aging that involved a random sampling of community dwelling Hispanic Americans (N = 1789). Age of dementia diagnosis was analyzed in a 2 × 2 (bi/monolingualism × immigrant/U.S. born) ANOVA that space revealed both main effects and the interaction were non-significant. Mean age of dementia diagnosis was descriptively (but not significantly) higher in the monolingual (M = 81.10 years) than the bilingual (M = 79.31) group. Overall, bilingual dementia cases were significantly better educated than monolinguals, but U.S. born bilinguals and monolinguals did not differ significantly in education. Delays in dementia symptomatology pertaining to bilingualism are less likely to be found in studies: (a) that use age of clinical diagnosis vs. retrospective report of first dementia symptom as the dependent variable; and (b) involve clinical cases derived from community samples rather than referrals to specialist memory clinics. PMID:25598395

  17. Age of dementia diagnosis in community dwelling bilingual and monolingual Hispanic Americans.

    PubMed

    Lawton, Deborah M; Gasquoine, Philip G; Weimer, Amy A

    2015-05-01

    Bilingualism has been reported to delay the age of retrospective report of first symptom in dementia. This study determined if the age of clinically diagnosed Alzheimer's disease and vascular dementia occurred later for bilingual than monolingual, immigrant and U.S. born, Hispanic Americans. It involved a secondary analysis of the subset of 81 bi/monolingual dementia cases identified at yearly follow-up (1998 through 2008) using neuropsychological test results and objective diagnostic criteria from the Sacramento Area Latino Study on Aging that involved a random sampling of community dwelling Hispanic Americans (N = 1789). Age of dementia diagnosis was analyzed in a 2 × 2 (bi/monolingualism × immigrant/U.S. born) ANOVA that space revealed both main effects and the interaction were non-significant. Mean age of dementia diagnosis was descriptively (but not significantly) higher in the monolingual (M = 81.10 years) than the bilingual (M = 79.31) group. Overall, bilingual dementia cases were significantly better educated than monolinguals, but U.S. born bilinguals and monolinguals did not differ significantly in education. Delays in dementia symptomatology pertaining to bilingualism are less likely to be found in studies: (a) that use age of clinical diagnosis vs. retrospective report of first dementia symptom as the dependent variable; and (b) involve clinical cases derived from community samples rather than referrals to specialist memory clinics. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Experimental pain phenotyping in community-dwelling individuals with knee osteoarthritis.

    PubMed

    Cardoso, Josue S; Riley, Joseph L; Glover, Toni; Sibille, Kimberly T; Bartley, Emily J; Goodin, Burel R; Bulls, Hailey W; Herbert, Matthew; Addison, Adriana S; Staud, Roland; Redden, David T; Bradley, Laurence A; Fillingim, Roger B; Cruz-Almeida, Yenisel

    2016-09-01

    Pain among individuals with knee osteoarthritis (OA) is associated with significant disability in older adults, and recent evidence demonstrates enhanced experimental pain sensitivity. Although previous research showed considerable heterogeneity in the OA clinical pain presentation, less is known regarding the variability in responses to experimental pain. The present study included individuals with knee OA (n = 292) who participated in the Understanding Pain and Limitations in Osteoarthritic Disease study and completed demographic and psychological questionnaires followed by a multimodal quantitative sensory testing (QST) session. Quantitative sensory testing measures were subjected to variable reduction procedures to derive pain sensitivity index scores, which in turn were entered into a cluster analysis. Five clusters were significantly different across all pain sensitivity index variables (P < 0.001) and were characterized by: (1) low pain sensitivity to pressure pain (N = 39); (2) average pain sensitivity across most modalities (N = 88); (3) high temporal summation of punctate pain (N = 38); (4) high cold pain sensitivity (N = 80); and (5) high sensitivity to heat pain and temporal summation of heat pain (N = 41). Clusters differed significantly by race, gender, somatic reactivity, and catastrophizing (P < 0.05). Our findings support the notion that there are distinct subgroups or phenotypes based on experimental pain sensitivity in community-dwelling older adults with knee OA, expanding previous findings of similar cluster characterizations in healthy adults. Future research is needed to further understand the pathophysiological mechanisms underlying pain within these subgroups, which may be of added value in tailoring effective treatments for people with OA.

  19. The Relationship Between Health-Promoting Behaviors and Metabolic Syndrome in Community-Dwelling Older Adults.

    PubMed

    Wu, Tzu-Ting; Chen, I-Ju; Cho, Shu-Ling; Chiou, Ai-Fu

    2016-10-01

    Poor health-promoting behaviors increase the risk of chronic disease and disability in older adults. Nevertheless, the predictors of health-promoting behaviors and their relationship with metabolic syndrome have been poorly characterized in older Taiwanese adults. To explore the determinants of health-promoting behaviors in community-dwelling older adults in Taiwan and the relationship of health-promoting behaviors with metabolic syndrome. A cross-sectional design was used. A convenience sample of 200 community residents aged 60 years and over was recruited from two large communities in New Taipei City, Taiwan. Data collection included physical examination and a structured questionnaire including measures of health status, health-promoting behaviors, self-efficacy, social support, and metabolic syndrome. Metabolic syndrome was found in 60% of older Taiwanese adults. These participants had higher scores in interpersonal relationships but lower scores in physical activity. Half of the health-promoting behaviors were explained by behavior-specific cognitions and affect, and 44% of behavior-specific cognitions and affect was explained by the health status of the older adult. Physical activity should be promoted in older Taiwanese adults. Positive behavior-specific cognitions and affect and better health status might impact the health-promoting behaviors of these adults. © The Author(s) 2016.

  20. Sleep and Cognition in Community-Dwelling Older Adults: A Review of Literature

    PubMed Central

    Brewster, Glenna S.; Varrasse, Miranda; Rowe, Meredeth

    2015-01-01

    Changes in sleep and cognition occur with advancing age. While both may occur independently of each other, it is possible that alterations in sleep parameters may increase the risk of age-related cognitive changes. This review aimed to understand the relationship between sleep parameters (sleep latency, wake after sleep onset, sleep efficiency, sleep duration, general sleep complaints) and cognition in community-dwelling adults aged 60 years and older without sleep disorders. Systematic, computer-aided searches were conducted using multiple sleep and cognition-related search terms in PubMed, PsycINFO, and CINAHL. Twenty-nine manuscripts met the inclusion criteria. Results suggest an inconsistent relationship between sleep parameters and cognition in older adults and modifiers such as depressive symptoms, undiagnosed sleep apnea and other medical conditions may influence their association. Measures of sleep and cognition were heterogeneous. Future studies should aim to further clarify the association between sleep parameters and cognitive domains by simultaneously using both objective and subjective measures of sleep parameters. Identifying which sleep parameters to target may lead to the development of novel targets for interventions and reduce the risk of cognitive changes with aging. PMID:27066397

  1. Caregiver burden, health utilities and institutional service costs among community-dwelling paients with Alzheimer's disease

    PubMed Central

    Miller, Edward Alan; Rosenheck, Robert A.; Schneider, Lon S.

    2014-01-01

    This study examined the moderating effect of caregiver burden on the relationship between patients’ health status and institutional costs in Alzheimer's disease (AD). Data were obtained on whether 421 community-dwelling patients with AD in the CATIE-AD trial received institutional services in the month preceding baseline and at 3-, 6-, and 9-months follow-up. All participants had a caregiver who lived with or visited them regularly. Outcome variables include hospital, nursing home, residential, and combined institutional costs. Mixed models were employed to estimate the interaction of Health Utility Index (HUI)-III scores (a health status measure) and five measures of caregiver burden. Wherever significant, results indicate that greater caregiver burden weakens the inverse relationship between health utilities and institutional costs, leading to greater costs than would be expected at a given level of health. Altogether 45.0% of the models (9/20) showed this effect (positive coefficient on the burden-HUI interaction term). Interventions should be based on caregiver burden, regardless of care recipient health status, for even seemingly manageable patients may be at heightened risk for institutionalization if caregivers experience sufficiently high levels of burden. PMID:20625266

  2. Variability of the forward head posture in healthy community-dwelling older women.

    PubMed

    Nemmers, Theresa M; Miller, Janice Williams; Hartman, Merrillyn D

    2009-01-01

    The purpose of this research was to describe the variability of forward head posture in healthy older women, and to investigate the influence of age on variability. This cross-sectional descriptive study included 187 healthy community-dwelling women volunteers ranging in age from 65-96 years. The forward head posture (FHP) measurement was derived from a sagittal photograph. The subjects were asked to perform a series of standing activities, and the photograph was taken while the subjects were performing these activities. Data analysis included descriptive analysis, FHP measurement analysis for normalcy, one-factor ANOVA with FHP by age group, post-hoc Tukey analysis, and trend analysis for the age-FHP relationship. Three age-group normative FHP means were identified: 48.84 degrees (SE 0.97) for the 65-74 year old group, 41.20 degrees (SE 0.78) for the 75-84 year old group, and 35.60 degrees (SE 1.76) for the 85+ year group. Significant differences were found in the FHP between these age groups. A subsequent trend analysis demonstrated a linear relationship between age and the FHP, with older women demonstrating a more severe FHP. Age-associated variability in the FHP of healthy elderly women has been identified. The FHP values determined by this research may serve as normative guidelines for clinicians when conducting postural assessments, and in clinical decision-making regarding possible interventions.

  3. Physical activity levels of older community-dwelling adults are influenced by summer weather variables.

    PubMed

    Brandon, Caitlin A; Gill, Dawn P; Speechley, Mark; Gilliland, Jason; Jones, Gareth R

    2009-04-01

    Adequate daily physical activity (PA) is important for maintaining functional capacity and independence in older adults. However, most older adults in Canada do not engage in enough PA to sustain fitness and functional independence. Environmental influences, such as warmer daytime temperatures, may influence PA participation; however, few studies have examined the effect of summertime temperatures on PA levels in older adults. This investigation measured the influence of summertime weather variables on PA in 48 community-dwelling older adults who were randomly recruited from a local seniors' community centre. Each participant wore an accelerometer for a single 7-consecutive-day period (between 30 May and 9 August 2006) during waking hours, and completed a PA logbook to remark on major daily PA events. Local weather variables were collected from a national weather service and compared with PA counts per minute. Regression analysis revealed a curvilinear relationship between log-transformed PA and mean daily temperature (r2 = 0.025; p < 0.05). Linear mixed effects models that accounted for repeated measures nested within individuals were performed for monthly periods, meteorological variables, sex, age, and estimated maximal oxygen consumption, with PA as the dependent variable. Age and Air Quality Index remained significant variables within the model. Higher fitness levels had no effect on allowing individuals to perform more vigorous PA in warmer temperatures.

  4. Cellular Telephones Measure Activity and Lifespace in Community-Dwelling Adults: Proof of Principle

    PubMed Central

    Schenk, Ana Katrin; Witbrodt, Bradley C.; Hoarty, Carrie A.; Carlson, Richard H.; Goulding, Evan H.; Potter, Jane F.; Bonasera, Stephen J.

    2011-01-01

    OBJECTIVES To describe a system that uses off-the-shelf sensor and telecommunication technologies to continuously measure individual lifespace and activity levels in a novel way. DESIGN Proof of concept involving three field trials of 30, 30, and 21 days. SETTING Omaha, Nebraska, metropolitan and surrounding rural region. PARTICIPANTS Three participants (48-year-old man, 33-year-old woman, and 27-year-old male), none with any functional limitations. MEASUREMENTS Cellular telephones were used to detect in-home position and in-community location and to measure physical activity. Within the home, cellular telephones and Bluetooth transmitters (beacons) were used to locate participants at room-level resolution. Outside the home, the same cellular telephones and global positioning system (GPS) technology were used to locate participants at a community-level resolution. Physical activity was simultaneously measured using the cellular telephone accelerometer. RESULTS This approach had face validity to measure activity and lifespace. More importantly, this system could measure the spatial and temporal organization of these metrics. For example, an individual’s lifespace was automatically calculated across multiple time intervals. Behavioral time budgets showing how people allocate time to specific regions within the home were also automatically generated. CONCLUSION Mobile monitoring shows much promise as an easily deployed system to quantify activity and lifespace, important indicators of function, in community-dwelling adults. PMID:21288235

  5. Metabolic Syndrome and 16-year Cognitive Decline in Community-Dwelling Older Adults

    PubMed Central

    McEvoy, Linda K.; Laughlin, Gail A.; Barrett-Connor, Elizabeth; Bergstrom, Jaclyn; Kritz-Silverstein, Donna; Der-Martirosian, Claudia; von Mühlen, Denise

    2012-01-01

    PURPOSE To determine whether metabolic syndrome is associated with accelerated cognitive decline in community-dwelling older adults. METHODS Longitudinal study of 993 adults (mean 66.8 ± 8.7 years) from the Rancho Bernardo Study. Metabolic syndrome components, defined by 2001 NCEP-ATP III criteria, were measured in 1984–87. Cognitive function was first assessed in 1988–92. Cognitive assessments were repeated approximately every four years, for a maximum 16-year follow-up. Mixed-effects models examined longitudinal rate of cognitive decline by metabolic syndrome status, controlling for factors plausibly associated with cognitive function (diabetes, inflammation). RESULTS Metabolic syndrome was more common in men than women (14% vs. 9%, p=0.01). In women, metabolic syndrome was associated with greater executive function and long term memory decline. These associations did not differ by inflammatory biomarker levels. Diabetes did not alter the association of metabolic syndrome with long-term recall but modified the association with executive function: metabolic syndrome was associated with accelerated executive function decline in diabetic women only. Metabolic syndrome was not related to rate of decline on any cognitive measure in men. CONCLUSIONS Metabolic syndrome was a risk factor for accelerated cognitive decline, but only in women. Prevention of metabolic syndrome may aid in maintenance of cognitive function with age. PMID:22285865

  6. Development of a Short Questionnaire to Assess Diet Quality among Older Community-Dwelling Adults.

    PubMed

    Robinson, S M; Jameson, K A; Bloom, I; Ntani, G; Crozier, S R; Syddall, H; Dennison, E M; Cooper, C R; Sayer, A A

    2017-01-01

    To evaluate the use of a short questionnaire to assess diet quality in older adults. Cross-sectional study. Hertfordshire, UK. 3217 community-dwelling older adults (59-73 years). Diet was assessed using an administered food frequency questionnaire (FFQ); two measures of diet quality were defined by calculating participants' 'prudent diet' scores, firstly from a principal component analysis of the data from the full FFQ (129 items) and, secondly, from a short version of the FFQ (including 24 indicator foods). Scores calculated from the full and short FFQ were compared with nutrient intake and blood concentrations of vitamin C and lipids. Prudent diet scores calculated from the full FFQ and short FFQ were highly correlated (0.912 in men, 0.904 in women). The pattern of associations between nutrient intake (full FFQ) and diet scores calculated using the short and full FFQs were very similar, both for men and women. Prudent diet scores calculated from the full and short FFQs also showed comparable patterns of association with blood measurements: in men and women, both scores were positively associated with plasma vitamin C concentration and serum HDL; in women, an inverse association with serum triglycerides was also observed. A short food-based questionnaire provides useful information about the diet quality of older adults. This simple tool does not require nutrient analysis, and has the potential to be of value to non-specialist researchers.

  7. Exercise and sleep in community-dwelling older adults: evidence for a reciprocal relationship.

    PubMed

    Dzierzewski, Joseph M; Buman, Matthew P; Giacobbi, Peter R; Roberts, Beverly L; Aiken-Morgan, Adrienne T; Marsiske, Michael; McCrae, Christina S

    2014-02-01

    Exercise behaviour and sleep are both important health indicators that demonstrate significant decreases with age, and remain modifiable well into later life. The current investigation examined both the chronic and acute relationships between exercise behaviour and self-reported sleep in older adults through a secondary analysis of a clinical trial of a lifestyle intervention. Seventy-nine community-dwelling, initially sedentary, older adults (mean age = 63.58 years, SD = 8.66 years) completed daily home-based assessments of exercise behaviour and sleep using daily diary methodology. Assessments were collected weekly and continued for 18 consecutive weeks. Multilevel models revealed a small positive chronic (between-person mean-level) association between exercise and wake time after sleep onset, and a small positive acute (within-person, day-to-day) association between exercise and general sleep quality rating. The within-person exercise and general sleep quality rating relationship was found to be reciprocal (i.e. sleep quality also predicted subsequent exercise behaviour). As such, it appears exercise and sleep are dynamically related in older adults. Efforts to intervene on either sleep or exercise in late-life would be wise to take the other into account. Light exposure, temperature regulation and mood may be potential mechanisms of action through which exercise can impact sleep in older adults. Published 2013. This article is a U.S. Government work and is in the public domain in the U.S.A.

  8. Risk factors for mobility limitation in community-dwelling older adults: a social ecological perspective.

    PubMed

    Yeom, Hye A; Fleury, Julie; Keller, Colleen

    2008-01-01

    Although a variety of risk factors for mobility limitation in older adults have been examined, a collective review of relevant literature has not been reported. The purposes of this review are to report the intrapersonal, interpersonal, environmental, and organizational risk factors related to mobility limitation using a social ecological perspective and to discuss the direction of future clinical practice consistent with current literature on mobility limitation of community-dwelling older adults. Intrapersonal risk factors related to mobility limitation include advanced age, female gender, low socioeconomic status, comorbidity, lack of motivation (i.e., dependent personality, decreased self-efficacy), lifestyle factors (i.e., sedentary lifestyle, smoking, obesity), and physiological factors (i.e., vitamin D deficiency, inflammation, poor nutritional status). Interpersonal risk factors related to mobility limitation include weak social networks and limited social activities. Geriatric clients may also experience a decline in mobility when they encounter environmental challenges such as an inconvenient home environment and lack of availability of services in their community, as well as lack of organizational resources stemming from social policy. Potential intervention strategies focused on modifiable risk factors may include lifestyle modifications, social networking programs, and enhancing awareness of environmental and organizational resources in the community for older adults at risk for mobility limitation.

  9. Parental longevity correlates with offspring's optimism in two cohorts of community-dwelling older subjects.

    PubMed

    Rius-Ottenheim, Nathaly; Kromhout, Daan; de Craen, Anton J M; Geleijnse, Johanna M; van der Mast, Roos C; Zitman, Frans G; Westendorp, Rudi G; Slagboom, P Eline; Giltay, Erik J

    2012-04-01

    Dispositional optimism and other positive personality traits have been associated with longevity. Using a familial approach, we investigated the relationship between parental longevity and offspring's dispositional optimism among community-dwelling older subjects. Parental age of death was assessed using structured questionnaires in two different population-based samples: the Leiden Longevity Study (n = 1,252, 52.2% female, mean age 66 years, SD = 4) and the Alpha Omega Trial (n = 769, 22.8% female, mean age 69 years, SD = 6). Adult offspring's dispositional optimism was assessed with the Life Orientation Test-Revised (LOT-R). The association between parental age of death and levels of optimism in the offspring was analysed using linear regression analysis within each sample and a meta-analysis for the overall effect. In both samples, the parental mean age of death was positively associated with optimism scores of the offspring. The association remained significant after adjustment for age, gender, living arrangement, body mass index, smoking status, education and self-rated health of the offspring. The pooled B coefficient (increase in LOT-R score per 10-year increase in parental mean age of death) was 0.30 (SE = 0.08, p < 0.001). In conclusion, parental longevity was positively associated with optimism in adult offspring, suggesting a partial linked heritability of longevity and optimism.

  10. Micronutrient intakes and potential inadequacies of community-dwelling older adults: a systematic review.

    PubMed

    ter Borg, Sovianne; Verlaan, Sjors; Hemsworth, Jaimie; Mijnarends, Donja M; Schols, Jos M G A; Luiking, Yvette C; de Groot, Lisette C P G M

    2015-04-28

    Micronutrient deficiencies and low dietary intakes among community-dwelling older adults are associated with functional decline, frailty and difficulties with independent living. As such, studies that seek to understand the types and magnitude of potential dietary inadequacies might be beneficial for guiding future interventions. We carried out a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Observational cohort and longitudinal studies presenting the habitual dietary intakes of older adults (≥65 years) were included. Sex-specific mean (and standard deviation) habitual micronutrient intakes were extracted from each article to calculate the percentage of older people who were at risk for inadequate micronutrient intakes using the estimated average requirement (EAR) cut-point method. The percentage at risk for inadequate micronutrient intakes from habitual dietary intakes was calculated for twenty micronutrients. A total of thirty-seven articles were included in the pooled systematic analysis. Of the twenty nutrients analysed, six were considered a possible public health concern: vitamin D, thiamin, riboflavin, Ca, Mg and Se. The extent to which these apparent inadequacies are relevant depends on dynamic factors, including absorption and utilisation, vitamin and mineral supplement use, dietary assessment methods and the selection of the reference value. In light of these considerations, the present review provides insight into the type and magnitude of vitamin and mineral inadequacies.

  11. Life space and mental health: a study of older community-dwelling persons in Australia.

    PubMed

    Byles, Julie E; Leigh, Lucy; Vo, Kha; Forder, Peta; Curryer, Cassie

    2015-01-01

    The ability of older people to mobilise within and outside their community is dependent on a number of factors. This study explored the relationship between spatial mobility and psychological health among older adults living in Australia. The survey sample consisted of 260 community-dwelling men and women aged 75-80 years, who returned a postal survey measuring spatial mobility (using the Life Space Questionnaire) and psychological health (using the SF36 Health Related Quality of Life Profile). From the Life Space Questionnaire, participants were given a life-space score and multinomial regression was used to explore the potential effect of mental health on life-space score. The study found a significant association between mental health and life space. However, gender, physical functioning, and ability to drive were most strongly associated with the extent of life space and spatial mobility. Compared to men, older women are more likely to experience less spatial mobility and restricted life space, and hence are more vulnerable to social isolation. Mental health and life space were associated for the older people in this study. These findings have important implications for health policy and highlight the need to support older persons to maintain independence and social networks, and to successfully age in place within their community. This study also highlights the utility of the Life Space Questionnaire in terms of identifying older persons at risk of poorer mental health.

  12. Associations between environmental characteristics and life-space mobility in community-dwelling older people.

    PubMed

    Rantakokko, Merja; Iwarsson, Susanne; Portegijs, Erja; Viljanen, Anne; Rantanen, Taina

    2015-06-01

    To examine the association between perceived environmental barriers to and facilitators for outdoor mobility with life-space among older people. Community-dwelling, 75- to 90-year-old people (n = 848) were interviewed face-to-face using standard questionnaires. The Life-Space Assessment (LSA), indicating distance and frequency of moving and assistance needed in moving (range 0-120), was used. Environmental barriers and facilitators outdoors were self-reported. Altogether, 41% (n = 348) of the participants had restricted life-space (LSA score < 60). Those reporting one or more environmental barriers had more than double the odds for restricted life-space compared with those reporting no barriers after adjustments for ill health, functioning, and socioeconomic status (SES) differences. Similarly, those reporting four to seven facilitators had lower odds for restricted life-space compared with those reporting three or fewer facilitators. Perceptions of one's environment may either constrain or extend older people's life-space. Longitudinal studies are needed to study the causality of the findings. © The Author(s) 2014.

  13. Cellular telephones measure activity and lifespace in community-dwelling adults: proof of principle.

    PubMed

    Schenk, Ana Katrin; Witbrodt, Bradley C; Hoarty, Carrie A; Carlson, Richard H; Goulding, Evan H; Potter, Jane F; Bonasera, Stephen J

    2011-02-01

    To describe a system that uses off-the-shelf sensor and telecommunication technologies to continuously measure individual lifespace and activity levels in a novel way. Proof of concept involving three field trials of 30, 30, and 21 days. Omaha, Nebraska, metropolitan and surrounding rural region. Three participants (48-year-old man, 33-year-old woman, and 27-year-old male), none with any functional limitations. Cellular telephones were used to detect in-home position and in-community location and to measure physical activity. Within the home, cellular telephones and Bluetooth transmitters (beacons) were used to locate participants at room-level resolution. Outside the home, the same cellular telephones and global positioning system (GPS) technology were used to locate participants at a community-level resolution. Physical activity was simultaneously measured using the cellular telephone accelerometer. This approach had face validity to measure activity and lifespace. More importantly, this system could measure the spatial and temporal organization of these metrics. For example, an individual's lifespace was automatically calculated across multiple time intervals. Behavioral time budgets showing how people allocate time to specific regions within the home were also automatically generated. Mobile monitoring shows much promise as an easily deployed system to quantify activity and lifespace, important indicators of function, in community-dwelling adults. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

  14. Urinary incontinence in community-dwelling older Mexican American and European American women.

    PubMed

    Markland, Alayne D; Gerety, Meghan B; Goode, Patricia S; Kraus, Stephen R; Cornell, John; Hazuda, Helen P

    2009-01-01

    The aim was to measure prevalence and correlates of urinary incontinence in community-dwelling Mexican American (MA) and European American (EA) women from a cross-sectional analysis of baseline data from a longitudinal cohort. Participants were MA and EA women, aged 65 years and older, in the San Antonio Longitudinal Study of Aging (SALSA), of whom 421 (97.4%) responded to the question "How often do you have difficulty holding your urine until you can get to a toilet." Measurements included sociodemographic, functional, cognitive, psychosocial, and clinical status variables derived from bilingual interviews and performance-based tests. Urinary incontinence prevalence was 36.6% (n=154). MA women reported less incontinence than did EAs (29% versus 45%, p=0.001). In multivariable analyses in MA women, urinary incontinence correlated with the presence of fecal incontinence (OR 4.0, 95% CI 1.1-14.0) and more dependency in activities of daily living (1.4, 1.1-1.8) after controlling for significant sociodemographic factors. In EA women, only age >75 (4.2, 1.4-12.4) was associated with urinary incontinence. MA women were less likely to report incontinence compared to EAs, despite MAs having increased number of children, less education, higher BMI, and more diabetes. Further research is needed to evaluate risk factors for urinary incontinence among MA women.

  15. Toward a better understanding of loneliness in community-dwelling older adults.

    PubMed

    Smith, Judith M

    2012-01-01

    The purpose of this interpretive phenomenological study was to explore the meaning of loneliness in community-dwelling older adults and to understand their daily practices in coping with loneliness. The sample consisted of 8 women and 4 men. Interviews were conducted with the 12 participants utilizing several tools, including 3 separate interview guides and the UCLA Loneliness Scale, Version 3 (Russell, 1996). A critical finding was that many participants experienced loneliness as a result of disrupted meaningful engagement, due to age-related changes, as well as other losses, including death of spouse, retirement, and giving up the car. Two paradigm cases and themes representing the loneliness and coping experience emerged. Participant coping practices with loneliness included reaching out to others, helping those in need, and seeking companionship with pets. Many older adults are at risk for loneliness because of declining health and other age-related losses that prevent them from remaining engaged in meaningful relationships. Health care professionals can screen for loneliness to identify those at risk and can intervene to help older adults maintain connections. Recommendations for those caring for lonely older adults include active listening, vision and hearing screenings, transportation needs, pet therapy, volunteering, and engagement in social activities.

  16. White matter hyperintensities are an independent predictor of physical decline in community-dwelling older people.

    PubMed

    Zheng, Jacqueline J J; Delbaere, Kim; Close, Jacqueline C T; Sachdev, Perminder; Wen, Wei; Brodaty, Henry; Lord, Stephen R

    2012-01-01

    Ageing is associated with physical disability, but little is known about the influence of white matter hyperintensities (WMHs) on physical function decline in older people. To investigate the role of WMHs as a predictor of decline in physical function in cognitively intact older people. 287 community-dwelling people aged 70-90 years underwent the Physiological Profile Assessment (PPA) and assessments of total and regional WMH volumes, cognitive function and comorbidities. Participants underwent reassessment of the PPA 12 months later, and those in the top quartile for increases in PPA scores over the year were regarded as having declined physically. Multivariate logistic regression analyses revealed that people with WMH volumes in the 4th quartile showed greater physical decline (odds ratio 3.02, 95% confidence interval 1.02-8.95) while controlling for age, baseline physical function, general health, physical activity and cognitive function. Subsequent univariate analyses indicated that WMHs in the deep fronto-parietal and periventricular parieto-occipital regions had the strongest associations with physical decline. These findings indicate that WMHs are an independent predictor of decline in physical function and suggest that interventions that focus on preventing the development or progression of white matter lesions may help preserve physical function in older people. Copyright © 2012 S. Karger AG, Basel.

  17. [Functional parameters and their association with gait speed in Chilean community-dwelling older adults].

    PubMed

    Rybertt, Christopher; Cuevas, Silvia; Winkler, Ximena; Lavados, Pamela; Martínez, Sergio

    2015-01-01

    Gait speed is a test to measure functional capacity in older adults. Nevertheless, the factors influencing this variable are not well described in South American populations. To determine the relationship between usual and maximal walking speed and functional parameters among Chilean community-dwelling older adults. An observational, descriptive and cross-sectional study including 69 older adults was conducted. The usual and maximal gait speeds were associated with body composition (body mass index), upper limbs muscle strength (arm curl-ups), lower limbs muscle strength (30 seconds sit-to-stand test), global function (Barthel index), ankle flexibility (range of motion), dynamic balance (timed Up & Go test) and aerobic capacity (2 minutes walking test). The ankle flexibility, lower limbs strength and aerobic capacity influenced the maximal speed (R2 =0.65; p <0.001), while the usual speed was influenced by upper limbs and lower limbs strength and by the aerobic capacity (R2 = 0.51; p <0.001). The usual and maximal gait speeds are mostly influenced by the lower limbs muscle strength plus aerobic capacity.

  18. [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.

  19. [Chronic diseases, functional ability, social involvement and satisfaction in community-dwelling elderly: the Fibra study].

    PubMed

    Pinto, Juliana Martins; Neri, Anita Liberalesso

    2013-12-01

    The scope of this article is to describe variations in the measurement of chronic diseases, functional ability, social involvement and satisfaction with respect to memory, problem solving, social relationships, environment, health services and transportation. This is done according to gender, age and income. It analyzes correlations between social involvement and functional ability in independent community dwelling-elderly aged 65 and above. 2,472 seniors without cognitive deficit, from probabilistic samples of seven Brazilian locations, were submitted to self-reported measurement concerning all variables, with the exception of grip strength and gait speed assessed by objective tests. Mean age was 72.2 ± 5.5 years and mean income was 3.9 ± 4.9 MW; 65.7% were women, who had more diseases, worse functional performance and greater social involvement than men; those aged 80 and above and the poorest participants had worse functional performance and less social involvement. Correlations were observed between functional ability and social involvement. Level of income was related to satisfaction concerning memory, problem solving, health and transport services. Health, functionality and satisfaction interact in old age, influencing patterns of activity and social involvement.

  20. How To Build an Integrated Neighborhood Approach to Support Community-Dwelling Older People?

    PubMed Central

    Cramm, Jane Murray; Nieboer, Anna Petra

    2016-01-01

    Background: Although the need for integrated neighborhood approaches (INAs) is widely recognized, we lack insight into strategies like INA. We describe diverse Dutch INA partners’ experiences to provide integrated person- and population-centered support to community-dwelling older people using an adapted version of Valentijn and colleagues’ integrated care model. Our main objective was to explore the experiences with INA participation. We sought to increase our understanding of the challenges facing these partners and identify factors facilitating and inhibiting integration within and among multiple levels. Methods: Twenty-one interviews with INA partners (including local health and social care organizations, older people, municipal officers, and a health insurer) were conducted and subjected to latent content analysis. Results: This study showed that integrated care and support provision through an INA is a complex, dynamic process requiring multilevel alignment of activities. The INA achieved integration at the personal, service, and professional levels only occasionally. Micro-level bottom-up initiatives were not aligned with top-down incentives, forcing community workers to establish integration despite rather than because of meso- and macro-level contexts. Conclusions: Top-down incentives should be better aligned with bottom-up initiatives. This study further demonstrated the importance of community-level engagement in integrated care and support provision. PMID:27616960

  1. Anxiety, depression, and fall-related psychological concerns in community-dwelling older people.

    PubMed

    Hull, Samantha L; Kneebone, Ian I; Farquharson, Lorna

    2013-12-01

    Establish the association between affect and fall-related psychological concerns (fear of falling, fall-related self-efficacy, balance confidence, and outcome expectancy). A total of 205 community-dwelling older people (mean age 81, SD 7.5 years) completed the Geriatric Depression Scale-15, Geriatric Anxiety Inventory, Modified Survey of Activities and Fear of Falling, Falls-Efficacy Scale- International, Activity-Specific Balance Confidence Scale, and the Consequences of Falling Scale. Hierarchical regression models showed that anxiety was independently associated with all fall-related psychological concerns; depression was only associated with falls efficacy. Associations between fall-related psychological concerns and age, gender, accommodation,medications, self-rated physical health, falls history, mobility, and sensory aids are also discussed. This is the first study that investigates the association between affect and the four fall-related psychological concerns. Anxiety was a significant factor associated with all four, whereas depression was only associated with activity avoidance. Implications for healthcare providers are discussed. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  2. Validation of the Pittsburgh sleep quality index in community dwelling Ethiopian adults.

    PubMed

    Salahuddin, Mohammed; Maru, Tarekegn Tesfaye; Kumalo, Abera; Pandi-Perumal, Seithikurippu R; Bahammam, Ahmed S; Manzar, Md Dilshad

    2017-03-27

    The applicability of the Pittsburgh Sleep Quality Index (PSQI) in screening of insomnia is demonstrated in various populations. But, the tool has not been validated in a sample of Ethiopians. Therefore, this study aimed to assess its psychometric properties in community dwelling Ethiopian adults. Participants (n = 311, age = 25.5 ± 6.0 years and body mass index = 22.1 ± 2.3 kg/m(2)) from Mizan-Aman town, Southwest Ethiopia completed the PSQI and a semi-structured questionnaire for socio-demographics. Clinical interview for screening of insomnia according to the International Classification of Sleep Disorders was carried out as a concurrent validation measure. Overall, the PSQI scale did not have floor effect and ceiling effects. Moderate internal consistency (Cronbach's alpha was 0.59) and sufficient internal homogeneity as indicated by correlation coefficient between component scores and the global PSQI score was found. The PSQI was of good value for screening insomnia with optimal cut-off scores of 5.5 (sensitivity 82%, specificity 56.2%) and the area under the curve, 0.78 (p < 0.0001). The PSQI has unidimensional factor structure in the Ethiopian community adults for screening insomnia. The PSQI has good psychometric validity in screening for insomnia among Ethiopians adults.

  3. Suicidal Ideation Among Community-Dwelling Adults in the United States

    PubMed Central

    McKeon, Richard; Gfroerer, Joe

    2014-01-01

    Objectives. We examined the prevalence and correlates of past-year suicidal ideation among US community-dwelling adults. Methods. We examined data from 183 100 persons aged 18 years or older (including 9800 sampled adults with past-year suicidal ideation) who participated in the 2008–2011 National Survey on Drug Use and Health. We applied descriptive analyses and pooled and stratified (by age and major depression) multivariate logistic regression models. Results. The prevalence of past-year suicidal ideation among younger adults (6.6% among those aged 18–25 years and 4.0% among those aged 26–49 years) was higher than was that among adults aged 50 years or older (2.5%). The prevalence of suicidal ideation was high among adults with major depression (26.3%), adults with both major depression and substance use disorder (37.7%), and adults who received mental health treatment but perceived unmet treatment need (33.5%). Conclusions. Many risk and protective factors of suicidal ideation are dynamic and vary by age or major depression. These results have important implications for developing specific suicide prevention strategies that help screen, assess, and treat suicidal adults at the earliest possible time. PMID:24432951

  4. Mental health-promoting dialogues from the perspective of community-dwelling seniors with multimorbidity

    PubMed Central

    Grundberg, Åke; Ebbeskog, Britt; Gustafsson, Sanna Aila; Religa, Dorota

    2014-01-01

    Mental health promotion needs to be studied more deeply within the context of primary care, because persons with multiple chronic conditions are at risk of developing poor mental health. In order to make progress in the understanding of mental health promotion, the aim of this study was to describe the experiences of health-promoting dialogues from the perspective of community-dwelling seniors with multimorbidity – what these seniors believe is important for achieving a dialogue that may promote their mental health. Seven interviews with six women and one man, aged 83–96 years, were analyzed using qualitative content analysis. The results were summarized into nine subcategories and three categories. The underlying meaning of the text was formulated into an overarching theme that embraced every category, “perceived and well-managed as a unique individual”. These seniors with multimorbidity missed someone to talk to about their mental health, and needed partners that were accessible for health dialogues that could promote mental health. The participants missed friends and relatives to talk to and they (crucially) lacked health care or social service providers for health-promoting dialogues that may promote mental health. An optimal level of care can be achieved through involvement, continuity, and by providing a health-promoting dialogue based on seniors’ needs and wishes, with the remembrance that general health promotion also may promote mental health. Implications for clinical practice and further research are discussed. PMID:24812516

  5. Validation of an index to estimate the prevalence of frailty among community-dwelling seniors.

    PubMed

    Hoover, Melanie; Rotermann, Michelle; Sanmartin, Claudia; Bernier, Julie

    2013-09-01

    This study validates cut-points for a frailty index (FI) to identify seniors at risk of a hospital-related event and estimates the number of frail seniors living in the community. The FI developed by Rockwood and Mitnitski defines levels of frailty based on scores of 0 to 1.0. The cut-point validation was conducted using Stratum-Specific Likelihood Ratios applied to combined 2003 and 2005 Canadian Community Health Survey (CCHS) data, linked to hospital records from the Discharge Abstract Database (2002 to 2007). Based on the validated cut-points, frailty prevalence was estimated using 2009/2010 CCHS data. Seniors scoring more than 0.21 on the FI were considered to be at elevated risk of hospital-related events. Four additional frailty levels were identified: non-frail (0 to ≤0.1), pre-frail (>0.1 to ≤0.21), more frail (>0.30 to ≤0.35) (women only), and most frail (frail-group subset) (0.45 or more). The number of community-dwelling seniors considered to be frail was estimated at about 1 million (24%) in 2009/2010; another 1.4 million (32%) could be considered pre-frail. Frailty prevalence rose with age; was higher among women than among men; and varied by geographic location. A cut-point of more than 0.21 can be used to identify frail seniors living in the community.

  6. Neighborhood food environment and obesity in community-dwelling older adults: individual and neighborhood effects.

    PubMed

    Pruchno, Rachel; Wilson-Genderson, Maureen; Gupta, Adarsh K

    2014-05-01

    We tested hypotheses about the relationship between neighborhood-level food sources and obesity, controlling for individual-level characteristics. Data (collected November 2006-April 2008) derived from a random-digit-dial sample of 5688 community-dwelling adults aged 50 to 74 years residing in 1644 census tracts in New Jersey. Using multilevel structural equation models, we created latent constructs representing density of fast-food establishments and storefronts (convenience stores, bars and pubs, grocery stores) and an observed indicator for supermarkets at the neighborhood level, simultaneously modeling obesity and demographic characteristics (age, gender, race, education, household income) at the individual level. When we controlled for individual-level age, gender, race, education, and household income, densities of fast-food establishments and storefronts were positively associated with obesity. Supermarkets were not associated with obesity. Because people living in neighborhoods with a higher density of fast food and storefronts are more likely to be obese, these neighborhoods may be optimal sites for interventions.

  7. Physical function and associated factors in community-dwelling elderly people in Jalisco, Mexico.

    PubMed

    Arias-Merino, Elva Dolores; Mendoza-Ruvalcaba, Neyda Ma; Ortiz, Genaro Gabriel; Velázquez-Brizuela, Irma E; Meda-Lara, Rosa Martha; Cueva-Contreras, Jazmin

    2012-01-01

    To determine the prevalence of disability in Basic Activities of Daily Living and Instrumental Activities of Daily Living (ADL and IADL, respectively), as well as associated factors in the Mexican community-dwelling elderly population. This is a cross-sectional study of a population 60 years and older who live in the State of Jalisco (Mexico). A total of 2553 persons were assessed regarding their functional and health conditions. The ADL and IADL were classified as dependent and non-dependent, and crude and adjusted Odds Ratio (OR) were calculated. Mean age of participants was 71.6±8.7, 61.2% were women. A disability prevalence of 9.6% was found to perform ADL and of 31.5% for the IADL, 14.3% had cognitive impairment and 30.9% depression. Risk factors were found for dependence: being a woman, being ≥75 years old, low education level, having at least one chronic disease, cognitive impairment, depression, previous history of disability, and having been a lifelong housewife. Functional difficulties are common in Mexican elderly population. These data show key variables for functional disability risk. A better understanding of functional capabilities, as well as of risk factors older adults face every day provide us with a guide to devise a prevention plan, to implement adequate interventions, or to provide appropriate care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Correlates of well-being among caregivers of long-term community-dwelling stroke survivors.

    PubMed

    Dankner, Rachel; Bachner, Yaacov G; Ginsberg, Gary; Ziv, Arnona; Ben David, Hadar; Litmanovitch-Goldstein, Dalit; Chodick, Gabriel; Balicer, Ran; Tanne, David; Greenberg, Dan

    2016-12-01

    Although caregiving for stroke survivors is usually long-term, most studies on caregivers have generally involved only the first year following the event. We assessed and compared the long-term level of well-being measures among stroke survivors and their caregivers at more than 1 year following the stroke event and examined the associations between well-being, survivors' characteristics, and caregiver burden. We interviewed a convenience sample of 51 community-dwelling stroke survivors, at least 1 year after the last stroke event, and their primary caregivers. Disability of survivors was assessed using the Barthel index and the modified Rankin Scale; health-related quality of life by the SF-36 questionnaire; and depression and anxiety using the Hospital Anxiety Depression Scale. Caregivers filled the SF-36 questionnaire, Hospital Anxiety Depression Scale questionnaire, and the Zarit Burden Interview, which assesses caregiver burden. Caregivers reported low levels of health-related quality of life and high levels of burden, anxiety, and depression. Caregivers' anxiety level was higher than that of the survivors (7.7±5.1 vs. 5.8±4.5, respectively; P=0.02). Anxiety was the only characteristic of caregivers that was associated with overall caregiver burden. Our study suggests that there is a spillover effect of the disease on stroke patients' primary caregivers. Intervention programs for caregivers should focus on their mental state and address their specific needs.

  9. Trajectory of declines in physical activity in community-dwelling older women: social cognitive influences.

    PubMed

    McAuley, Edward; Hall, Katherine S; Motl, Robert W; White, Siobhan M; Wójcicki, Thomas R; Hu, Liang; Doerksen, Shawna E

    2009-09-01

    Studies examining physical activity behavior suggest that activity levels decline with age. Such declines are particularly problematic among older adults in light of the research suggesting a protective effect of physical activity on numerous physical health outcomes associated with independent living. Despite a growing recognition of the importance of a physically active lifestyle, little is known about the role of demographic and psychosocial variables on this trajectory of change. In this study, the roles played by outcome expectations, self-efficacy, and functional limitations on changes in physical activity levels over a 2-year period in older women were assessed using latent growth curve modeling. Data were obtained from 249 community-dwelling older women (M age = 68.12, n = 81 Black, and n = 168 White). Demographic, health status, and psychosocial data were collected via self-report upon entry into the study. Self-reported physical activity was assessed at baseline and again at 12 and 24 months. As expected, physical activity declined over the 2-year period. Self-efficacy demonstrated an indirect association with the trajectory of decline in physical activity through functional limitations. Importantly, the pattern of relationships appears independent of demographic factors and chronic health conditions.

  10. [Investigation of urinary incontinence in community dwelling women of Fuzhou city].

    PubMed

    Song, Yan-feng; Li, Ya-qin; Xu, Bo; Song, Jian; Hao, Lan

    2004-04-01

    The aim was to assess the prevalence of urinary incontinence in Gulou community dwelling women in Fuzhou China. One of the communities was selected at random and questionnaires were sent to women living there. After completed the questionnaires were collected and statistics software SPSS 10.0 was used for analysis. We sent 5871 questionnaires and collected 5392 ones. The response rate was 91.8%. The prevalence of urinary incontinence was 18.5%, while it was 51.1% in women who were 65 years or older, and the prevalence of stress urinary incontinence (SUI), urge urinary incontinence (UUI) and mix urinary incontinence (MUI) was 9.1%, 2.4%, and 7.0% respectively. Their structural proportion was 49%:13%:38%. In terms of the incidence of the disease, mild urinary incontinence was prominent. Among the surveyed women, 32.4% did not know where to consult a doctor for help, 45.5%went to urologists, and 22.1% went to gynecologists for help. Urinary incontinence is highly prevalent, especially among aged women. However, they seldom consult a doctor about their urinary leakage.

  11. Dietary protein intake is associated with lean body mass in community-dwelling older adults.

    PubMed

    Geirsdottir, Olof G; Arnarson, Atli; Ramel, Alfons; Jonsson, Palmi V; Thorsdottir, Inga

    2013-08-01

    Lean body mass (LBM) is important to maintain physical function during aging. We hypothesized that dietary protein intake and leisure-time physical activity are associated with LBM in community-dwelling older adults. To test the hypothesis, participants (n = 237; age, 65-92 years) did 3-day weighed food records and reported physical activity. Body composition was assessed using dual-energy x-ray absorptiometry. Protein intake was 0.98 ± 0.28 and 0.95 ± 0.29 g/kg body weight in male and female participants, respectively. Protein intake (in grams per kilogram of body weight) was associated with LBM (in kilograms); that is, the differences in LBM were 2.3 kg (P < .05) and 2.0 kg (P = .054) between the fourth vs the first and the fourth vs the second quartiles of protein intake, respectively. Only a minor part of this association was explained by increased energy intake, which follows an increased protein intake. Our study shows that dietary protein intake was positively associated with LBM in older adults with a mean protein intake higher than the current recommended daily allowance of 0.8 g/kg per day. Leisure-time physical activity, predominantly consisting of endurance type exercises, was not related to LBM in this group.

  12. Efficacy of Ba Duan Jin in Improving Balance: A Study in Chinese Community-Dwelling Older Adults.

    PubMed

    Liu, Xiao-Yun; Gao, Jing; Yin, Bing-Xiang; Yang, Xiang-Yu; Bai, Ding-Xi

    2016-05-01

    The current quasiexperimental study was intended to determine the efficacy of Ba Duan Jin (translation: eight-section brocade) in improving balance ability of Chinese community-dwelling older adults. The trial group (n = 47) engaged in a Ba Duan Jin exercise program for 12 weeks, whereas the control group (n = 48) participated in a 12-week walking exercise program. After the intervention, participants' balance ability was evaluated using the Timed Up and Go Test (TUGT), One Leg Standing Test (OLST), Berg Balance Scale (BBS), and Modified Falls Efficacy Scale (MFES). Ba Duan Jin was associated with increased TUGT and OLST scores at Week 6 with continuous increases reported through Week 12. Ba Duan Jin was also associated with increased BBS and MFES scores at Week 12. Ba Duan Jin may be an effective means for improving balance ability in Chinese community-dwelling older adults. [Journal of Gerontological Nursing, 42(5), 38-46.]. Copyright 2016, SLACK Incorporated.

  13. 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

  14. Nursing home nurses' and community-dwelling older adults' reported knowledge, attitudes, and behavior toward antibiotic use.

    PubMed

    Kistler, Christine E; Beeber, Anna; Becker-Dreps, Sylvia; Ward, Kimberly; Meade, Megan; Ross, Brittany; Sloane, Philip D

    2017-01-01

    Antibiotic overuse causes antibiotic resistance, one of the most important threats to human health. Older adults, particularly those in nursing homes, often receive antibiotics when they are not indicated. To understand knowledge, attitudes, and behaviors of nursing home (NH) nurses and community-dwelling older adults towards antibiotic use, especially in clinical situations consistent with antibiotic overuse, we conducted a mixed-method survey in two NHs and one Family Medicine clinic in North Carolina, among English-speaking nurses and community-dwelling, cognitively intact adults aged 65 years or older. Based on the Knowledge-Attitude-Practice model, the survey assessed knowledge, attitudes, and behavior towards antibiotic use, including three vignettes designed to elicit possible antibiotic overuse: asymptomatic bacteriuria (ASB), a viral upper respiratory illness (URI), and a wound from a fall. Of 31 NH nurses and 66 community-dwelling older adults, 70% reported knowledge of the dangers of taking antibiotics. Nurses more often reported evidence-based attitudes towards antibiotics than older adults, except 39% agreed with the statement "by the time I am sick enough to go to the doctor with a cold, I expect an antibiotic", while only 28% of older adults agreed with it. A majority of nurses did not see the need for antibiotics in any of the three vignettes: 77% for the ASB vignette, 87% for the URI vignette, and 97% for the wound vignette. Among older adults, 50% did not perceive a need for antibiotics in the ASB vignette, 58% in the URI vignette, and 74% in the wound vignette. While a substantial minority had no knowledge of the dangers of antibiotic use, non-evidence-based attitudes towards antibiotics, and behaviors indicating inappropriate management of suspected infections, most NH nurses and community-dwelling older adults know the harms of antibiotic use and demonstrate evidence-based attitudes and behaviors. However, more work is needed to improve the

  15. Association of Neuromuscular Attributes With Performance-Based Mobility Among Community-Dwelling Older Adults With Symptomatic Lumbar Spinal Stenosis.

    PubMed

    Schmidt, Catherine T; Ward, Rachel E; Suri, Pradeep; Kiely, Dan K; Ni, Pengsheng; Anderson, Dennis E; Bean, Jonathan F

    2017-07-01

    To identify differences in health factors, neuromuscular attributes, and performance-based mobility among community-dwelling older adults with symptomatic lumbar spinal stenosis; and to determine which neuromuscular attributes are associated with performance-based measures of mobility. Cross-sectional; secondary data analysis of a cohort study. Outpatient rehabilitation center. Community-dwelling adults aged ≥65 years with self-reported mobility limitations and symptomatic lumbar spinal stenosis (N=54). Not applicable. Short Physical Performance Battery score, habitual gait speed, and chair stand test. Symptomatic lumbar spinal stenosis was classified using self-reported symptoms of neurogenic claudication and imaging. Among 430 community-dwelling older adults, 54 (13%) met criteria for symptomatic lumbar spinal stenosis. Compared with participants without symptomatic lumbar spinal stenosis, those with symptomatic lumbar spinal stenosis had more comorbidities, higher body mass index, greater pain, and less balance confidence. Participants with symptomatic lumbar spinal stenosis had greater impairment in trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion range of motion (ROM), knee extension ROM, and ankle ROM compared with participants without symptomatic lumbar spinal stenosis. Five neuromuscular attributes were associated with performance-based mobility among participants with symptomatic lumbar spinal stenosis: trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry. Community-dwelling older adults with self-reported mobility limitations and symptomatic lumbar spinal stenosis exhibit poorer health characteristics, greater neuromuscular impairment, and worse mobility when compared with those without symptomatic lumbar spinal stenosis. Poorer trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry

  16. Concomitant use of acetylcholine esterase inhibitors and urinary antispasmodics among Finnish community-dwelling persons with Alzheimer disease.

    PubMed

    Torvinen-Kiiskinen, Sanna; Taipale, Heidi; Tanskanen, Antti; Tiihonen, Jari; Hartikainen, Sirpa

    2014-12-01

    Concomitant use of acetylcholine esterase inhibitors (AChEIs) and anticholinergic drugs, such as urinary antispasmodics (UA), is generally considered as inappropriate because of their opposite pharmacological actions. However, prevalence and the duration or factors associated with concomitant use have not been previously studied among community-dwelling persons with Alzheimer disease (AD). The aim of this study was to examine the prevalence and duration of concomitant use of AChEIs and UAs among community-dwelling persons with AD and factors associated with concomitant use. Register-based data of the MEDALZ-2005 Study included all community-dwelling persons with clinically diagnosed AD at the end of year 2005 in Finland. Persons using AChEI drugs during the 4-year follow-up (2006-2009) were included in the present study (n = 20,442). Among AChEI users, 1576 persons used UA during the follow-up. Prevalence of concomitant use of AChEIs and UAs was 7.3% (n = 1491) during the 4-year follow-up. The median duration of concomitant use was 236 days. Factors associated with concomitant use were age younger than 80 years (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.08-1.34), male sex (OR, 1.16; 95% CI, 1.04-1.30), Parkinson disease (OR, 1.98; 95% CI, 1.55-2.52), diabetes (OR, 1.25; 95% CI, 1.08-1.45), and prostatic cancer (OR, 1.54; 95% CI, 1.13-2.09). Despite their antagonizing action, concomitant use of AChEIs and UAs was quite common among Finnish community-dwelling persons with AD. In addition, duration of concomitant use was comparatively long. It is recommended to consider some other options than UAs to treat urinary incontinence among persons with AD.

  17. 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.

  18. Comparison of the Berg Balance Scale and Fullerton Advanced Balance Scale to predict falls in community-dwelling adults.

    PubMed

    Jeon, Yong-Jin; Kim, Gyoung-Mo

    2017-02-01

    [Purpose] The purpose of this study was to investigate and compare the predictive properties of Berg Balance Scale and Fullerton Advanced Balance Scales, in a group of independently-functioning community dwelling older adults. [Subjects and Methods] Ninety-seven community-dwelling older adults (male=39, female=58) who were capable of walking independently on assessment were included in this study. A binary logistic regression analysis of the Berg Balance Scale and Fullerton Advanced Balance Scale scores was used to investigate a predictive model for fall risk. A receiver operating characteristic analysis was conducted for each, to determine the cut-off for optimal levels of sensitivity and specificity. [Results] The overall prediction success rate was 89.7%; the total Berg Balance Scale and Fullerton Advanced Balance Scale scores were significant in predicting fall risk. Receiver operating characteristic analysis determined that a cut-off score of 40 out of 56 on the Berg Balance Scale produced the highest sensitivity (0.82) and specificity (0.67), and a cut-off score of 22 out of 40 on the Fullerton Advanced Balance Scale produced the highest sensitivity (0.85) and specificity (0.65) in predicting faller status. [Conclusion] The Berg Balance Scale and Fullerton Advanced Balance Scales can predict fall risk, when used for independently-functioning community-dwelling older adults.

  19. 2D:4D digit ratio is associated with cognitive decline but not frailty in community-dwelling older adults.

    PubMed

    Gonçalves, Celina; Coelho, Tiago; Machado, Sérgio; Rocha, Nuno Barbosa

    2017-09-10

    To understand the relation between 2D:4D ratio, frailty, and cognitive decline in community-dwelling elderly people. A total of 175 community-dwelling elderly people were included. To determine frailty, participants completed the Tilburg Frailty Indicator (TFI) and the Survey of Health, Ageing and Retirement in Europe (SHARE-FI). Cognitive functioning was determined using the Mini-Mental State Examination (MMSE). 2D and 4D finger lengths of each hand were measured using a scanner. Barthel Index, Lawton, and Brody scale were also completed for each participant to determine the level of daily living functioning. We did not find any correlations between 2D:4D ratio and frailty measures. We found a significant correlation between 2D:4D ratio and MMSE scores in the women sampled. We cannot ascertain any contribution of prenatal exposure to androgens to the frailty status of community-dwelling elderly people. We found that reduced prenatal exposure to testosterone in women may contribute to the prevention of cognitive decline in elderly women. © 2017 Wiley Periodicals, Inc.

  20. Effects of a dietetic treatment in older, undernourished, community-dwelling individuals in primary care: a randomized controlled trial.

    PubMed

    Schilp, Janneke; Kruizenga, Hinke M; Wijnhoven, Hanneke A H; van Binsbergen, Jaap J; Visser, Marjolein

    2013-12-01

    Undernutrition is a prevalent problem in older, community-dwelling individuals. Aim of this study was to determine the effects of a dietetic treatment in older, undernourished, community-dwelling individuals. A parallel randomized controlled trial was performed in 146 non-institutionalized, undernourished individuals aged ≥65 years in primary care. Participants were randomly assigned to the intervention (referral to and treatment by a trained dietitian) or control group (no referral). Body weight, physical performance, handgrip strength, energy intake, protein intake and fat-free mass were assessed at baseline, after 3 months and after 6 months. All randomized participants (n = 146) were included in the intention-to-treat generalized estimating equations analysis (72 in intervention and 74 in control group). No treatment effect was found on the primary outcomes body weight (β = 0.49 kg, 95% CI: -0.15-1.12), physical performance (β = 0.15 points, 95% CI: -0.33-0.64) and handgrip strength (β = 0.49 kg, 95% CI: -0.62-1.60). Furthermore, no treatment effect was found for the secondary outcomes. Predefined subgroup analyses showed a treatment effect on body weight in physically active participants (β = 1.25 kg, 95% CI: 0.70-2.11) and not in inactive participants (β = -0.20 kg, 95% CI: -1.16-0.75). After 6 months, a dietetic treatment by trained dietitians does not lead to increases in body weight and physical functioning in older, undernourished, community-dwelling individuals.

  1. The relation between social network site usage and loneliness and mental health in community-dwelling older adults.

    PubMed

    Aarts, S; Peek, S T M; Wouters, E J M

    2015-09-01

    Loneliness is expected to become an even bigger social problem in the upcoming decades, because of the growing number of older adults. It has been argued that the use of social network sites can aid in decreasing loneliness and improving mental health. The purpose of this study was to examine whether and how social network sites usage is related to loneliness and mental health in community-dwelling older adults. The study population included community-dwelling older adults aged 60 and over residing in the Netherlands (n = 626) collected through the LISS panel (www.lissdata.nl). Univariate and multivariate linear regression analyses, adjusted for potentially important confounders, were conducted in order to investigate the relation between social network sites usage and (emotional and social) loneliness and mental health. More than half of the individuals (56.2%) reported to use social network sites at least several times per week. Social network sites usage appeared unrelated to loneliness in general, and to emotional and social loneliness in particular. Social network sites usage also appeared unrelated to mental health. Several significant associations between related factors and the outcomes at hand were detected. In this sample, which was representative for the Dutch population, social network sites usage was unrelated to loneliness and/or mental health. The results indicate that a simple association between social network site usage and loneliness and mental health as such, cannot automatically be assumed in community-dwelling older adults. Copyright © 2014 John Wiley & Sons, Ltd.

  2. Prevention of falls in community-dwelling older adults: U.S. Preventive Services Task Force recommendation statement.

    PubMed

    Moyer, Virginia A

    2012-08-07

    Update of the 1996 U.S. Preventive Services Task Force (USPSTF) recommendation statement on counseling to prevent household and recreational injuries, including falls. The USPSTF reviewed new evidence on the effectiveness and harms of primary care-relevant interventions to prevent falls in community-dwelling older adults. The interventions were grouped into 5 main categories: multifactorial clinical assessment (with or without direct intervention), clinical management (with or without screening), clinical education or behavioral counseling, home hazard modification, and exercise or physical therapy. The USPSTF recommends exercise or physical therapy and vitamin D supplementation to prevent falls in community-dwelling adults aged 65 years or older who are at increased risk for falls. (Grade B recommendation)The USPSTF does not recommend automatically performing an in-depth multifactorial risk assessment in conjunction with comprehensive management of identified risks to prevent falls in community-dwelling adults aged 65 years or older because the likelihood of benefit is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of the circumstances of prior falls, comorbid medical conditions, and patient values. (Grade C recommendation).

  3. Are stress and mixed urinary incontinence associated with impaired executive control in community-dwelling older women?

    PubMed

    Lussier, Maxime; Renaud, Mélanie; Chiva-Razavi, Sima; Bherer, Louis; Dumoulin, Chantale

    2013-01-01

    To assess whether stress or mixed urinary incontinence (UI) is associated with deficits in executive functioning among community-dwelling women. An observational study comparing the performance, using multivariate analyses of variance (MANOVAs) and Bonferroni post hoc test, of continent women and women with stress or mixed UI during executive control tasks. The research center of the Institut universitaire de gériatrie de Montréal. One hundred and fifty-five community-dwelling women aged 60 and older participated in the study. Based on the Urogenital Distress Inventory (UDI), participants were split into three groups: 35 continent women, 43 women with stress UI, and 78 women with mixed UI. Participants completed a battery of neuropsychological tests and a computerized dual-task test. Women with mixed UI showed poorer performances than continent and stress UI women in executive control functions. Deficits were specific to tests involving switching and sharing/dividing attention between two tasks. Results of this study suggest that mixed UI can be associated with executive control deficits in community-dwelling older women. Future intervention studies in the treatment of UI should take the higher risk of an executive control deficit in women with UI under consideration.

  4. 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.

  5. Comparison of the Berg Balance Scale and Fullerton Advanced Balance Scale to predict falls in community-dwelling adults

    PubMed Central

    Jeon, Yong-Jin; Kim, Gyoung-Mo

    2017-01-01

    [Purpose] The purpose of this study was to investigate and compare the predictive properties of Berg Balance Scale and Fullerton Advanced Balance Scales, in a group of independently-functioning community dwelling older adults. [Subjects and Methods] Ninety-seven community-dwelling older adults (male=39, female=58) who were capable of walking independently on assessment were included in this study. A binary logistic regression analysis of the Berg Balance Scale and Fullerton Advanced Balance Scale scores was used to investigate a predictive model for fall risk. A receiver operating characteristic analysis was conducted for each, to determine the cut-off for optimal levels of sensitivity and specificity. [Results] The overall prediction success rate was 89.7%; the total Berg Balance Scale and Fullerton Advanced Balance Scale scores were significant in predicting fall risk. Receiver operating characteristic analysis determined that a cut-off score of 40 out of 56 on the Berg Balance Scale produced the highest sensitivity (0.82) and specificity (0.67), and a cut-off score of 22 out of 40 on the Fullerton Advanced Balance Scale produced the highest sensitivity (0.85) and specificity (0.65) in predicting faller status. [Conclusion] The Berg Balance Scale and Fullerton Advanced Balance Scales can predict fall risk, when used for independently-functioning community-dwelling older adults. PMID:28265146

  6. 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.

  7. The role of high-intensity physical exercise in the prevention of disability among community-dwelling older people.

    PubMed

    Etman, Astrid; Pierik, Frank H; Kamphuis, Carlijn B M; Burdorf, Alex; van Lenthe, Frank J

    2016-11-09

    Moderate to vigorous physical activity (MVPA) is considered important to prevent disability among community-dwelling older people. To develop MVPA programs aimed at reducing or preventing disability more insight is needed in the contributions of exercise duration and intensity and the interplay between the two. Longitudinal data of 276 Dutch community-dwelling persons aged 65 years and older participating in the Elderly And their Neighbourhood (ELANE) study were used. MVPA exercise (yes/no), duration (hours per two weeks), intensity (Metabolic Equivalent of Task; METs), and energy expenditure (MET-hours per two weeks), and disability in instrumental activities of daily living (range 0-8) were measured twice within 9 months to account for fluctuations over time. Associations between the four exercise measures and disability were tested with longitudinal tobit regression analyses. MVPA exercise was associated with fewer disabilities. While exercise duration was not associated with disability, whereas an increase of one MET in exercise intensity was associated with 0.14 fewer disabilities (95 % CI: -0.26 to -0.02). For exercise energy expenditure, an increase of one MET-hour exercise per two weeks was associated with 0.03 fewer disabilities (95 % CI: -0.05 to -0.01). Higher-intensity exercise may help to prevent disability among community-dwelling older people. Further investigation is needed to explore the preventive effects in more detail.

  8. A systematic review of intervention studies to prevent hospitalizations of community-dwelling older adults with dementia.

    PubMed

    Phelan, Elizabeth A; Debnam, Katrina J; Anderson, Lynda A; Owens, Steven B

    2015-02-01

    To conduct a systematic literature review to determine if there were any intervention strategies that had any measurable effect on acute-care hospitalizations among community-dwelling adults with dementia. Studies were identified by a professional research librarian and content experts. Community dwelling. Participants were diagnosed with dementia, severity ranging from mild to severe, and were recruited from health care and community agencies. A study met the inclusion criteria if it: (a) was published in English; (b) included a control or comparison group; (c) published outcome data from the intervention under study; (d) reported hospitalization as one of the outcomes; (e) included community-dwelling older adults; and (f) enrolled participants with dementia. Ten studies met all inclusion criteria. Of the 10 studies included, most assessed health services use (ie, hospitalizations) as a secondary outcome. Participants were recruited from a range of health care and community agencies, and most were diagnosed with dementia with severity ratings ranging from mild to severe. Most intervention strategies consisted of face-to-face assessments of the persons living with dementia, their caregivers, and the development and implementation of a care plan. A significant reduction in hospital admissions was not found in any of the included studies, although 1 study did observe a reduction in hospital days. The majority of studies included hospitalizations as a secondary outcome. Only 1 intervention was found to have an effect on hospitalizations. Future work would benefit from strategies specifically designed to reduce and prevent acute hospitalizations in persons with dementia.

  9. [Life-space of community-dwelling older adults using preventive health care services in Japan and the validity of composite scoring methods for assessment].

    PubMed

    Harada, Kazuhiro; Shimada, Hiroyuki; Sawyer, Patricia; Asakawa, Yasuyoshi; Nihei, Kenji; Kaneya, Satomi; Furuna, Taketo; Ishizaki, Tatsuro; Yasumura, Seiji

    2010-07-01

    Life-space is a spatial measure of mobility defined by the distance a person routinely travels to perform activities over a specific time period. Life-space assessment (LSA) has been widely applied, but measurement properties have not been investigated in a Japanese population. The purpose of this cross-sectional study was to describe distributions of maximal life-space and to clarify the validity of composite scores of an LSA scale among community-dwelling older adults using preventive health care services in Japan. Surveys were conducted between November 2007 and February 2008 with a specially prepared Japanese LSA version. The sample was composed of 2,147 participants using preventive health care services provided by the Japanese long-term care insurance system, all being aged 65 and over, with adequate cognitive functions and living at home in the community (29.5% men, mean age +/- [SD] 79.4 +/- 6.9 years). First, the levels of life-space, based on how far a person had travelled on leaving his or her place of residence during the month preceding the assessment, were investigated. Second, LSA scores were calculated considering the degree of independence as well as frequencies for individuals at each level, then descriptive statistics were checked. Finally, it was tested whether the scores could be related to external criteria and functional or socio-psychological variables stated in previous studies. Sixty-four percent of individuals attained the highest level of life-space (i.e. outside town). The average of the composite scores was 51.4 +/- 25.2 points and the distribution was almost normal. The dispersion of the scores tended to be large. Values correlated with the hierarchical mobility level classification as an external criterion (0.539). As hypothesized, the scores were correlated with age (-0.296), functional mobility (time up and go test) (-0.387), and instrumental activities of daily living (0.533), and were discriminated by sex, depressive mood, and

  10. 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

  11. Association between employee benefits and frailty in community-dwelling older adults.

    PubMed

    Avila-Funes, José Alberto; Paniagua-Santos, Diana Leticia; Escobar-Rivera, Vicente; Navarrete-Reyes, Ana Patricia; Aguilar-Navarro, Sara; Amieva, Hélène

    2016-05-01

    The phenotype of frailty has been associated with an increased vulnerability for the development of adverse health-related outcomes. The origin of frailty is multifactorial and financial issues could be implicated, as they have been associated with health status, well-being and mortality. However, the association between economic benefits and frailty has been poorly explored. Therefore, the objective was to determine the association between employee benefits and frailty. A cross-sectional study of 927 community-dwelling older adults aged 70 years and older participating in the Mexican Study of Nutritional and Psychosocial Markers of Frailty was carried out. Employee benefits were established according to eight characteristics: bonus, profit sharing, pension, health insurance, food stamps, housing credit, life insurance, and Christmas bonus. Frailty was defined according to a slightly modified version of the phenotype proposed by Fried et al. Multinomial logistic regression models were run to determine the association between employee benefits and frailty adjusting by sociodemographic and health covariates. The prevalence of frailty was 14.1%, and 4.4% of participants rated their health status as "poor." Multinomial logistic regression analyses showed that employee benefits were statistically and independently associated with the frail subgroup (OR 0.85; 95% CI 0.74-0.98; P = 0.027) even after adjusting for potential confounders. Fewer employee benefits are associated with frailty. Supporting spreading employee benefits for older people could have a positive impact on the development of frailty and its consequences. Geriatr Gerontol Int 2016; 16: 606-611. © 2015 Japan Geriatrics Society.

  12. Falls in rural and remote community dwelling older adults: a review of the literature.

    PubMed

    Boehm, Jackie; Franklin, Richard C; King, Jemma C

    2014-08-01

    Falls in older adults represent a significant challenge in Australia; however, the focus is often on urban-dwelling older adults. The aim of this review was to explore the literature on falls epidemiology and falls prevention interventions (FPI). A literature review was conducted searching Medline, Scopus, Social Sciences Citation Index, Google Scholar, Google and the Australian Institute of Health and Welfare publication catalogue. Rural and remote Australia. Rural and remote community dwelling Australians aged 50 years and older. Literature review. Falls epidemiology and effective falls prevention interventions. Twenty references were identified: 14 related to falls epidemiology and 7 to FPI. No significant differences were found between rural, remote and major cities residents in relation to falls hospitalisation, falls mortality or fall-related injuries sustained. There are a wide assortment of health professionals and non-health professionals who are involved in providing FPI in rural and remote Australia. However, there was limited information on the effectiveness of these interventions in influencing falls outcomes. Few studies explored falls and their prevention in rural and remote Australia. The limited literature on the topic suggests that a change in focus to one that utilises existing services and resources will be required to create sustainable outcomes. Four areas are proposed for concentrated effort to reduce the impact of fall-related injury in rural and remote Australia: integration and collaboration among health professionals, promotion of physical activity across the lifespan, community involvement and ownership of interventions, and evaluation and publication of findings. © 2014 National Rural Health Alliance Inc.

  13. Arthritis and associated limitations in community-dwelling Canadians living with stroke.

    PubMed

    Patterson, Kara K; Sibley, Kathryn M

    2016-07-26

    Residual impairments and gait deviations post-stroke may lead to secondary musculoskeletal complications such as arthritis. This study explored the prevalence of arthritis and associated functional limitations in community-dwelling Canadians with and without stroke. Secondary analysis of the Canadian Community Health Survey; a population-based, cross-sectional survey conducted by Statistics Canada in 2011 and 2012. Respondents >50 years old who reported a stroke diagnosis (n = 1892) were age- and gender-matched with controls randomly selected from survey respondents who did not report a stroke (n = 1892). Stroke and control groups were compared on presence of arthritis (yes/no) and secondary variables including pain, perceived health and assistance required (5 point scales) using the Rao-Scott X(2) test. Within the stroke group, logistic regression was used to investigate the effect of arthritis on life satisfaction, pain limiting activities and perceived health with age, gender, BMI, comorbidities and socioeconomic status used as covariates in the model. A greater proportion of the stroke group (53%) reported arthritis compared to controls (43%). These groups also differed in reports of perceived health and pain. Within the stroke group, those with arthritis were significantly more likely to report pain limiting activities (OR 3.89) and less likely to report satisfaction with life (OR 0.59). This preliminary work suggests that arthritis is more prevalent in individuals with stroke compared to individuals without stroke and that this co-morbidity is associated with worse reports of pain and perceived health. A limitation is that it is not possible to determine if the arthritis pre-dated or followed the stroke. This work provides support for a longitudinal investigation of the development of secondary musculoskeletal issues post-stroke.

  14. Differences in life satisfaction among older community-dwelling Hispanics and non-Hispanic Whites.

    PubMed

    Marquine, María J; Maldonado, Yadira; Zlatar, Zvinka; Moore, Raeanne C; Martin, Averria Sirkin; Palmer, Barton W; Jeste, Dilip V

    2015-01-01

    Hispanics are the fastest growing ethnic/racial group of the older adult population in the United States, yet little is known about positive mental health in this group. We examined differences in life satisfaction between demographically matched groups of older Hispanics and non-Hispanic Whites, and sought to identify specific factors associated with these differences Participants included 126 community-dwelling English-speaking Hispanics aged 50 and older, and 126 age-, gender-, and education-matched non-Hispanic Whites. Participants completed standardized measures of life satisfaction and postulated correlates, including physical, cognitive, emotional and social functioning, as well as positive psychological traits and religiosity/spirituality. Hispanics reported greater life satisfaction than non-Hispanic Whites (p < 0.001). Ethnic groups were comparable on most postulated correlates of life satisfaction, except that Hispanics had lower levels of cognitive performance, and higher levels of daily spiritual experiences, private religious practices and compassion (ps < 0.001). Among these factors, spiritual experiences, religious practices, and compassion were significantly associated with life satisfaction in the overall sample. Multivariable analyses testing the influence of these three factors on the association between ethnicity and life satisfaction showed that higher spirituality among Hispanics accounted for ethnic differences in life satisfaction. English-speaking Hispanics aged 50 and older appeared to be more satisfied with their lives than their non-Hispanic White counterparts, and these differences were primarily driven by higher spirituality among Hispanics. Future studies should examine positive mental health among various Hispanic subgroups, including Spanish speakers, as an important step toward development of culturally sensitive prevention and intervention programs aimed at promoting positive mental health.

  15. Differences in Life Satisfaction among Older Community-Dwelling Hispanics and non-Hispanic Whites

    PubMed Central

    Marquine, María J.; Maldonado, Yadira; Zlatar, Zvinka; Moore, Raeanne C.; Martin, Averria Sirkin; Palmer, Barton W.; Jeste, Dilip V.

    2014-01-01

    Objectives Hispanics are the fastest growing ethnic/racial group of the older adult population in the U.S., yet little is known about positive mental health in this group. We examined differences in life satisfaction between demographically-matched groups of older Hispanics and non- Hispanic Whites, and sought to identify specific factors associated with these differences. Methods Participants included 126 community-dwelling English-speaking Hispanics ages 50 and older, and 126 age-, gender-, and education-matched non-Hispanic Whites. Participants completed standardized measures of life satisfaction and postulated correlates, including physical, cognitive, emotional and social functioning, as well as positive psychological traits and religiosity/spirituality. Results Hispanics reported greater life satisfaction than non-Hispanic Whites (p<0.001). Ethnic groups were comparable on most postulated correlates of life satisfaction, except that Hispanics had lower levels of cognitive performance, and higher levels of daily spiritual experiences, private religious practices and compassion (ps<0.001). Among these factors, spiritual experiences, religious practices, and compassion were significantly associated with life satisfaction in the overall sample. Multivariable analyses testing the influence of these three factors on the association between ethnicity and life satisfaction showed that higher spirituality among Hispanics accounted for ethnic differences in life satisfaction. Conclusion English-speaking Hispanics ages 50 and older appeared to be more satisfied with their lives than their non-Hispanic White counterparts, and these differences were primarily driven by higher spirituality among Hispanics. Future studies should examine positive mental health among various Hispanic subgroups, including Spanish-speakers, as an important step toward development of culturally-sensitive prevention and intervention programs aimed at promoting positive mental health. PMID

  16. Relationship between Social Support Networks and Physical Functioning in Older Community-Dwelling Mexicans.

    PubMed

    Mendoza-Núñez, Víctor Manuel; González-Mantilla, Fabiola; Correa-Muñoz, Elsa; Retana-Ugalde, Raquel

    2017-08-31

    Some studies have demonstrated the relationship between social support networks (SSNs) and health status. In this sense, it has been considered that physical and mental functioning is a key indicator of the health in the age people. The aim of this study was to determine the association between social support networks and physical functioning. A cross-sectional study was carried out including a convenience sample of 150 older community-dwelling Mexicans. We assessed the familial, extra-familial and institutional SSNs; social contacts; the activities of daily living (ADL); the instrumental activities of daily living (IADLs); and physical functioning task (PFT) performance among study participants. Of the 150 older subjects, 53 reported living alone (35%), 113 (75%) reported having few SSNs, and 37 (25%) reported having enough SSNs. Persons with few familial SSNs were at increased odds of demonstrating dependence in at least one of the ADL (OR = 3.25, 95% CI 1.06-9.92, p < 0.05). Likewise, persons with few institutional SSNs and few social contacts were at increased odds of demonstrating dependence in at least one of the IADL (OR = 6.96, 95% CI 1.57-30.7, p < 0.01; OR = 5.02, 95% CI 1.44-17.5, p < 0.01, respectively). We also observed that having few extra-familial SSNs and few social contacts were the main risk factors for PFT dependence, with ORs of 3.70 (95% CI 1.21-11.2, p < 0.05) and 3.85 (95% CI 1.10-13.5, p < 0.05), respectively. Our findings suggest that having few SSNs could be a significant risk factor for reduced physical functioning in older adults.

  17. Predictors of outcomes following reablement in community-dwelling older adults.

    PubMed

    Tuntland, Hanne; Kjeken, Ingvild; Langeland, Eva; Folkestad, Bjarte; Espehaug, Birgitte; Førland, Oddvar; Aaslund, Mona Kristin

    2017-01-01

    Reablement is a rehabilitation intervention for community-dwelling older adults, which has recently been implemented in several countries. Its purpose is to improve functional ability in daily occupations (everyday activities) perceived as important by the older person. Performance and satisfaction with performance in everyday life are the major outcomes of reablement. However, the evidence base concerning which factors predict better outcomes and who receives the greatest benefit in reablement is lacking. The objective of this study was to determine the potential factors that predict occupational performance and satisfaction with that performance at 10 weeks follow-up. The sample in this study was derived from a nationwide clinical controlled trial evaluating the effects of reablement in Norway and consisted of 712 participants living in 34 municipalities. Multiple linear regression was used to investigate possible predictors of occupational performance (COPM-P) and satisfaction with that performance (COPM-S) at 10 weeks follow-up based on the Canadian Occupational Performance Measure (COPM). The results indicate that the factors that significantly predicted better COPM-P and COPM-S outcomes at 10 weeks follow-up were higher baseline scores of COPM-P and COPM-S respectively, female sex, having a fracture as the major health condition and high motivation for rehabilitation. Conversely, the factors that significantly predicted poorer COPM-P and COPM-S outcomes were having a neurological disease other than stroke, having dizziness/balance problems as the major health condition and having pain/discomfort. In addition, having anxiety/depression was a predictor of poorer COPM-P outcomes. The two regression models explained 38.3% and 38.8% of the total variance of the dependent variables of occupational performance and satisfaction with that performance, respectively. The results indicate that diagnosis, functional level, sex and motivation are significant predictors of

  18. Predictors of outcomes following reablement in community-dwelling older adults

    PubMed Central

    Tuntland, Hanne; Kjeken, Ingvild; Langeland, Eva; Folkestad, Bjarte; Espehaug, Birgitte; Førland, Oddvar; Aaslund, Mona Kristin

    2017-01-01

    Background Reablement is a rehabilitation intervention for community-dwelling older adults, which has recently been implemented in several countries. Its purpose is to improve functional ability in daily occupations (everyday activities) perceived as important by the older person. Performance and satisfaction with performance in everyday life are the major outcomes of reablement. However, the evidence base concerning which factors predict better outcomes and who receives the greatest benefit in reablement is lacking. Objective The objective of this study was to determine the potential factors that predict occupational performance and satisfaction with that performance at 10 weeks follow-up. Methods The sample in this study was derived from a nationwide clinical controlled trial evaluating the effects of reablement in Norway and consisted of 712 participants living in 34 municipalities. Multiple linear regression was used to investigate possible predictors of occupational performance (COPM-P) and satisfaction with that performance (COPM-S) at 10 weeks follow-up based on the Canadian Occupational Performance Measure (COPM). Results The results indicate that the factors that significantly predicted better COPM-P and COPM-S outcomes at 10 weeks follow-up were higher baseline scores of COPM-P and COPM-S respectively, female sex, having a fracture as the major health condition and high motivation for rehabilitation. Conversely, the factors that significantly predicted poorer COPM-P and COPM-S outcomes were having a neurological disease other than stroke, having dizziness/balance problems as the major health condition and having pain/discomfort. In addition, having anxiety/depression was a predictor of poorer COPM-P outcomes. The two regression models explained 38.3% and 38.8% of the total variance of the dependent variables of occupational performance and satisfaction with that performance, respectively. Conclusion The results indicate that diagnosis, functional level

  19. Antipsychotic doses among community-dwelling persons with Alzheimer disease in Finland.

    PubMed

    Taipale, Heidi; Koponen, Marjaana; Tanskanen, Antti; Tolppanen, Anna-Maija; Tiihonen, Jari; Hartikainen, Sirpa

    2014-08-01

    Use of antipsychotics for treatment of behavioral and psychological symptoms of dementia is frequent among persons with Alzheimer disease (AD). Doses used in long-term therapy have not been previously reported. We describe antipsychotic doses used among community-dwelling persons with AD and investigate factors associated with high-dose use. The MEDALZ-2005 (Medication use and Alzheimer disease) cohort is a nationwide sample including all persons with clinically diagnosed AD at the end of year 2005 in Finland (n = 28,093). Data including prescriptions, comorbidities, and hospital discharge diagnoses were collected from nationwide registers. Antipsychotic doses in monotherapy were investigated during 2006 to 2009. Among 8920 antipsychotic users, 4% (n = 336) used antipsychotics with high dose. Typical antipsychotics were more often used with high dose than atypical antipsychotics. High-dose use was associated with younger age (<80 years) (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.36-2.15]), male sex (OR, 1.52; CI, 1.21-1.91), history of psychiatric disorder (OR, 3.25; CI, 2.54-4.15), and inversely associated with Charlson Comorbidity Index score (score 1: OR, 0.74; CI, 0.57-0.97; score ≥2: OR, 0.68; CI, 0.47-0.97). In conclusion, the majority of persons with AD used antipsychotics with low or medium dose. Typical antipsychotics were more often used with high dose than atypical antipsychotics, which indicates a need for precise dosing instructions in the treatment of behavioral and psychological symptoms of dementia. Clinicians should regularly assess dosing levels especially among men and those with history of psychiatric disorder.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. Sexual Activity and Satisfaction in Healthy Community-dwelling Older Women

    PubMed Central

    Trompeter, Susan E.; Bettencourt, Ricki; Barrett-Connor, Elizabeth

    2011-01-01

    BACKGROUND Female sexual dysfunction is a focus of medical research but few studies describe the prevalence and covariates of recent sexual activity and satisfaction in older community-dwelling women. METHODS 1303 older women from the Rancho Bernardo Study were mailed a questionnaire on general health, recent sexual activity, sexual satisfaction, and the Female Sexual Function Index (FSFI). RESULTS 806 of 921 respondents (87.5%) age ≥40 years answered questions about recent sexual activity. Their median age was 67; mean years since menopause, 25; most were upper-middle class; 57% had attended at least one year of college; 90% reported good to excellent health. Half (49.8%) reported sexual activity within the past month with or without a partner, the majority of whom reported arousal (64.5%), lubrication (69%), and orgasm (67.1%) at least most of the time, although one-third reported low, very low, or no sexual desire. Although frequency of arousal, lubrication, and orgasm decrease with age, the youngest (<55 yrs) and oldest (>80 yrs) women reported a higher frequency of orgasm satisfaction. Emotional closeness during sex was associated with more frequent arousal, lubrication, and orgasm; estrogen therapy was not. Overall, two-thirds of sexually active women were moderately or very satisfied with their sex life, as were almost half of sexually inactive women. CONCLUSION Half these women were sexually active, with arousal, lubrication, and orgasm maintained into old age, despite low libido in one-third. Sexual satisfaction increased with age and did not require sexual activity. PMID:22195529

  5. Controlled whole-body vibration training reduces risk of falls among community-dwelling older adults.

    PubMed

    Yang, Feng; King, George A; Dillon, Loretta; Su, Xiaogang

    2015-09-18

    The primary purpose of this study was to systematically examine the effects of an 8-week controlled whole-body vibration training on reducing the risk of falls among community-dwelling adults. Eighteen healthy elderlies received vibration training which was delivered on a side alternating vibration platform in an intermittent way: five repetitions of 1 min vibration followed by a 1 min rest. The vibration frequency and amplitude were 20 Hz and 3.0mm respectively. The same training was repeated 3 times a week, and the entire training lasted for 8 weeks for a total of 24 training sessions. Immediately prior to (or pre-training) and following (or post-training) the 8-week training course, all participants' risk of falls were evaluated in terms of body balance, functional mobility, muscle strength and power, bone density, range of motion at lower limb joints, foot cutaneous sensation level, and fear of falling. Our results revealed that the training was able to improve all fall risk factors examined with moderate to large effect sizes ranging between 0.55 and 1.26. The important findings of this study were that an 8-week vibration training could significantly increase the range of motion of ankle joints on the sagittal plane (6.4° at pre-training evaluation vs. 9.6° at post-training evaluation for dorsiflexion and 45.8° vs. 51.9° for plantar-flexion, p<0.05 for both); reduce the sensation threshold of the foot plantar surface (p<0.05); and lower the fear of falling (12.2 vs. 10.8, p<0.05). These findings could provide guidance to design optimal whole-body vibration training paradigm for fall prevention among older adults. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Nationwide study of antipsychotic use among community-dwelling persons with Alzheimer's disease in Finland.

    PubMed

    Laitinen, Marja-Liisa; Bell, J Simon; Lavikainen, Piia; Lönnroos, Eija; Sulkava, Raimo; Hartikainen, Sirpa

    2011-12-01

    Antipsychotics continue to be widely used in the treatment of behavioral and psychological symptoms of dementia despite their limited effectiveness and well-known risks, including increased mortality. Our aim was to investigate the national pattern of antipsychotic use among community-dwelling persons with and without Alzheimer's disease (AD) in Finland. The Social Insurance Institution of Finland (SII) identified all persons with a verified diagnosis of AD in Finland on 31 December 2005. A control for each person with AD, matched in terms of age, sex and region of residence, was also identified. Data on reimbursed drug purchases in 2005 were extracted from the Finnish National Prescription Register. Conditional logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the use of antipsychotics. The study population comprised 28,089 matched pairs of persons with and without AD (mean age 80.0 years, SD 6.8, 32.2% men). The annual prevalence of antipsychotic use was higher among persons with than without AD (22.1% vs. 4.4%, adjusted OR = 5.91; 95% CI 5.91-6.31). Among persons with AD, the prevalence of antipsychotic use was similar across all age groups. Of the antipsychotic users, 85.2% with AD and 51.3% without AD purchased second generation antipsychotics. Most antipsychotic prescriptions - 67.8% in the AD and 62.9% in the non-AD group - were generated in primary care situations. One-fifth of persons with AD used antipsychotic drugs. Antipsychotic use was six times more prevalent among persons with AD than without AD. Most antipsychotics were prescribed by primary care physicians.

  7. HYPERTENSION AND INCIDENT DEMENTIA IN COMMUNITY-DWELLING ELDERLY YORUBA NIGERIANS

    PubMed Central

    Ogunniyi, A.; Lane, K.A.; Baiyewu, O.; Gao, S.; Gureje, O.; Unverzagt, F.W.; Murrell, J.R.; Smith-Gamble, V.; Hall, K.S.; Hendrie, H.C.

    2011-01-01

    Objectives To investigate the relationship between hypertension and dementia incidence in community-dwelling elderly Yoruba (age 70 years and above) because of sparse information on dementia and its risk factors in developing countries. Materials & Methods Community-based, prospective study of consenting elderly Yoruba using 2-stage design. Blood pressure was measured during the baseline evaluation at 2001 and hypertension was defined as BP ≥ 140/90 mmHg. Diagnosis of dementia and normal cognition was by consensus using standard criteria. Non-demented subjects from the 2001 evaluation wave were re-evaluated during the 2004 and 2007 waves for dementia. Logistic regression was used to examine the association of baseline hypertension and incident dementia, after adjusting for age, gender, education, and histories of stroke and smoking. P-values <0.05 were considered significant. Results During the six year follow-up, 120 individuals developed dementia while 1633 remained non-demented. The frequency of hypertension in the demented group was significantly higher than in the non-demented (70.0% vs. 60.2%, p = 0.034). Baseline hypertension was a significant risk factor for dementia (OR = 1.52; 95% CI 1.01 – 2.30). Higher systolic, diastolic or pulse pressure was associated with increased risk (p<0.05). Participants with diastolic BP ≥ 90 mm Hg were at a significantly greater risk than those with readings below 70 mm Hg (OR = 1.65; 95% CI 1.01–2.69). Conclusions Hypertension was associated with increased risk of dementia in elderly Yoruba and its appropriate treatment may lower the risk. PMID:21303353

  8. Inflammation, sleep disturbances, and depressed mood among community-dwelling older men

    PubMed Central

    Smagula, Stephen F.; Ancoli-Israel, Sonia; Barrett-Connor, Elizabeth; Lane, Nancy E.; Redline, Susan; Stone, Katie L.; Cauley, Jane A.

    2014-01-01

    Objective High rates of sleep disturbances occur in depression. Sleep disturbances are linked to heightened inflammation. We sought to determine if sleep disturbances explain a portion of the putative inflammation – depression association among older adults. In late life, age-related immunoregulation changes may modify the inflammation-depression relationship. Methods Cross-sectional associations of a panel of serum inflammatory markers with probable depression (measured with the Geriatric Depression Scale) were assessed among 2,560 community-dwelling older men. We tested whether inflammatory marker - probable depression associations were independent of chronic diseases, as well as objective and subjectively measured sleep disturbances. We also tested whether inflammation-probable depression associations were moderated by age. Results Inflammatory markers were not independently associated with higher odds of probable depression. A significant age by C - reactive protein (CRP) interaction (p=0.01) was detected such that the strength of the CRP - probable depression association decreased with age. When stratifying by the median age of 76, elevated odds of probable depression were found for men with CRP levels above the median only among the younger group (OR = 2.08, 95% CI 1.18–3.69). In the final adjusted model, independent effects of chronic diseases and subjective sleep disturbances contributed to a total of 37% attenuation of the original OR (adjusted OR = 1.68, 95% CI 0.911–3.10, p = .09). Conclusions In late-life, associations between inflammatory markers and mood may be explained by both chronic diseases and subjectively reported sleep disturbances. Our findings indicate that the association of CRP with probable depression diminishes in strength with age. PMID:24745777

  9. Social isolation, C-reactive protein, and coronary heart disease mortality among community-dwelling adults.

    PubMed

    Heffner, Kathi L; Waring, Molly E; Roberts, Mary B; Eaton, Charles B; Gramling, Robert

    2011-05-01

    Social isolation confers increased risk for coronary heart disease (CHD) events and mortality. In two recent studies, low levels of social integration among older adults were related to higher levels of C-reactive protein (CRP), a marker of inflammation, suggesting a possible biological link between social isolation and CHD. The current study examined relationships among social isolation, CRP, and 15-year CHD death in a community sample of US adults aged 40 years and older without a prior history of myocardial infarction. A nested case-cohort study was conducted from a parent cohort of community-dwelling adults from the southeastern New England region of the United States (N = 2321) who were interviewed in 1989 and 1990. CRP levels were measured from stored sera provided by the nested case-cohort (n = 370), which included all cases of CHD death observed through 2005 (n = 48), and a random sample of non-cases. We found that the most socially isolated individuals had two-and-a-half times the odds of elevated CRP levels compared to the most socially integrated. In separate logistic regression models, both social isolation and CRP predicted later CHD death. The most socially isolated continued to have more than twice the odds of CHD death compared to the most socially integrated in a model adjusting for CRP and more traditional CHD risk factors. The current findings support social isolation as an independent risk factor of both high levels of CRP and CHD death in middle-aged adults without a prior history of myocardial infarction. Prospective study of inflammatory pathways related to social isolation and mortality are needed to fully delineate whether and how CRP or other inflammatory markers contribute to mechanisms linking social isolation to CVD health.

  10. Insomnia Subtypes and Their Relationship to Excessive Daytime Sleepiness in Brazilian Community-Dwelling Older Adults

    PubMed Central

    Hara, Cláudia; Stewart, Robert; Lima-Costa, Maria Fernanda; Rocha, Fábio Lopes; Fuzikawa, Cíntia; Uchoa, Elizabeth; Firmo, Josélia O.A.; Castro-Costa, Érico

    2011-01-01

    Study Objectives: To investigate the association between different types of insomnia as exposures and excessive daytime sleepiness (EDS) as a binary outcome in older Brazilian residents. Design: The baseline examination of the Bambuí Health and Ageing Study (BHAS), which is an ongoing population-based prospective cohort study of older adults. Setting: Bambuí (15,000 inhabitants), a city in the State of Minas Gerais, Southeast Brazil Participants: All residents aged ≥ 60 years were eligible to take part in the BHAS baseline. Of 1742 residents identified who were ≥ 60 years, 1606 (92.2%) were interviewed and received comprehensive examinations of health status. Interventions: None Measurements and Results: EDS was defined as the presence of sleepiness ≥ 3 times per week in the last month, causing any interference in usual activities. All insomnia subtypes were significantly associated with EDS in unadjusted analyses, and these associations were only modestly altered after adjusting incrementally for the other covariates. In a final model, the 3 insomnia subtypes were entered into a fully adjusted model simultaneously to investigate mutual independence, giving prevalence ratios of 1.63 (95% CI 1.14-2.31) for initial insomnia, 2.13 (95% CI 1.48-3.07) for middle insomnia, and 1.36 (95% CI 0.94-1.96) for terminal insomnia. The population attributable fractions for initial, middle, and terminal insomnia on prevalence of EDS were 17.6%, 32.9%, and 9.7%, respectively. Conclusions: Middle insomnia emerged as the insomnia subtype most strongly associated with EDS. Further research is required to clarify causal pathways underlying this cross-sectional association. Citation: Hara C; Stewart R; Lima-Costa MF; Rocha FL; Fuzikawa C; Uchoa E; Firmo JOA; Castro-Costa E. Insomnia subtypes and their relationship to excessive daytime sleepiness in Brazilian community-dwelling older adults. SLEEP 2011;34(8):1111-1117. PMID:21804673

  11. 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

  12. Relationship between subjective assessment of oral health and medical expenses in community-dwelling elderly persons

    PubMed Central

    Harada, Eriko; Moriya, Shingo; Murata, Ayumi; Muramatsu, Masumi; Kashiwazaki, Haruhiko; Kobayashi, Kunihiko; Notani, Kenji; Inoue, Nobuo

    2012-01-01

    Objectives The increasing medical expenses of elderly persons in Japan’s rapidly ageing society have become a major concern. It is therefore important to elucidate the factors associated with such escalation. Here, we focused on the relationship between subjective self-assessment of oral health, as an index of general health, and medical expenses (excluding dental repair) under the hypothesis that oral health contributes to general medical expenses. Several studies have shown that oral health status is correlated with general health status among elderly persons. We speculated that oral health status might show a relation with medical costs among elderly persons. However, few studies have investigated this relationship to date. Materials and Methods Participants were 259 elderly subjects (range: 65–84 years; 120 men, 139 women) residing independently. Subjective assessment of oral health was evaluated by their responses (‘Good’, ‘Not good’ and ‘Not at all good’) on a survey questionnaire. The correlation between subjective assessment of oral health and medical expenditure was analysed using Spearman’s rank method, the Mann–Whitney U-test and the Kruskal–Wallis test. Medical expenses were used as the dependent variable in multinomial logistic regression analysis with background and intraoral factors as independent variables. Results A slight yet statistically significant correlation was observed between subjective assessment of oral health and outpatient treatment fees. Conclusion The findings revealed that subjective assessment of oral health is significantly and independently related to the medical expenses of community-dwelling elderly persons after adjusting for social background, living environment and physical factors. PMID:21306431

  13. Prospective study of progression of kidney dysfunction in community-dwelling older adults.

    PubMed

    Sesso, Ricardo; Prado, Fernando; Vicioso, Belinda; Ramos, Luiz R

    2008-04-01

    Few prospective studies have assessed renal dysfunction in older persons. We sought to define kidney dysfunction among a community-based cohort of elderly subjects and to determine the factors for its progression. The Epidemiologia do Idoso (EPIDOSO) Study is a prospective study of individuals > or =65 years old (mean 72.6 +/- 0.3), living in the community in the city of São Paulo. The creatinine clearance (CrCl) of 269 individuals of this cohort was estimated during 8 years of follow-up. The rate of decline in CrCl was calculated using linear regression analysis and dividing the group into tertiles of CrCl change. Overall mean change in CrCl was -2.37 +/- 0.23 mL/min per year. Mean age increased with the greatest degree of decline in renal function (71.1 +/- 0.59, 72.5 +/- 0.54 and 74.3 +/- 0.58, for the first, second and third CrCl change tertiles, respectively, P < 0.01). A higher value of baseline CrCl was associated with progressive decline in CrCl (P < 0.01). Diastolic BP was greater in the second versus the first estimated glomerular filtration rate tertile (83 +/- 1 vs 80 +/- 1 mmHg, P < 0.05). High-density lipoprotein (HDL) cholesterol was inversely associated with CrCl decline (P < 0.05). Progression of kidney dysfunction occurs in most community-dwelling elderly. Strategies aimed at slowing the progression should be considered for possible risk factors of older age, baseline CrCl, BP and HDL.

  14. Prevalence of urinary incontinence in community dwelling men: a cross sectional nationwide epidemiological survey.

    PubMed

    Diokno, Ananias C; Estanol, Maria Victoria C; Ibrahim, Ibrahim Awad; Balasubramaniam, Mamtha

    2007-01-01

    Epidemiological studies on urinary incontinence (UI) in adult men of all ages are scarce. We aim to describe the UI phenomenon among community dwelling adult males in the United States (US). We analyzed data from male respondents to a 14-item mailed UI symptoms questionnaire to the National Family Opinion (NFO) World Group Panel of 45,000 households matching the US 2000 census population on five key demographic elements. A total of 29,903 households responded, of which 21,590 were male heads of household (mean age 50 +/-15.2 years old). A total of 2,059 men (12.7%) reported symptoms of UI during the last 30 days. Symptoms of urge urinary incontinence (UUI), stress urinary incontinence (SUI), mixed urinary incontinence (MUI) symptoms, and other types of urinary incontinence (OUI) symptoms, were reported by 44.6%, 24.5%, 18.8%, and 12.3%, respectively. Among those with UI symptoms, the proportion of UUI and MUI symptoms increases with age while SUI symptoms decrease as age increases. Of those with UI symptoms, 44% consulted a physician of whom 57% did so within 6 months of the onset of symptoms. Treatments reported included absorbent pads (48%), prescription medication (30%), surgical procedure (18%), and intermittent catheterization (4%). Almost 1 in 10 males reported symptoms of UI. The UI prevalence rate increases with age and UUI symptoms is the most prevalent type reported. Less than half of men with UI symptoms sought professional help and half of them did so within 6 months of onset of UI symptoms.

  15. Associations of Perceived Stress, Resilience and Social Support with Sleep Disturbance Among Community-dwelling Adults.

    PubMed

    Liu, Xiaohua; Liu, Chunqin; Tian, Xiaohong; Zou, Guiyuan; Li, Guopeng; Kong, Linghua; Li, Ping

    2016-12-01

    Sleep disturbance is often described as sleeping poorly, difficulty falling asleep and maintaining sleep, and waking early. Currently, most studies examining sleep disturbance have focused on negative psychological variables; however, few studies have combined both negative and positive psychosocial factors to assess sleep. The aim of this study was to investigate the prevalence of sleep disturbance and psychosocial correlates in Chinese community-dwelling adults. A total of 1471 adults, between 18 and 60 years old, from eight selected community settings in Jinan, China, were surveyed using the Pittsburgh Sleep Quality Index, Perceived Stress Scale, 10-item Connor-Davidson Resilience Scale and Multidimensional Scale of Perceived Social Support and provided sociodemographic information. We found that the prevalence of sleep disturbance was 33.9%. After adjusting for age, employment status and physical co-morbidity, perceived stress was significantly associated with sleep disturbance [odds ratio (OR) = 1.14, p < 0.001], while resilience and social support were associated with a low likelihood of sleep disturbance (OR = 0.90, p < 0.001; OR = 0.97, p < 0.001). Furthermore, regression analysis showed that the interaction between perceived stress and resilience was significant (p < 0.05). Resilience buffered the negative impact of perceived stress on sleep disturbance. Given the close relationship between sleep disturbance and psychosocial correlates, the development of effective intervention programmes to improve sleep quality in this population should be considered. Copyright © 2015 John Wiley & Sons, Ltd.

  16. Effect of therapeutic horseback riding on balance in community-dwelling older adults with balance deficits.

    PubMed

    Homnick, Douglas N; Henning, Kim M; Swain, Charlene V; Homnick, Tamara D

    2013-07-01

    Falls are an important cause of morbidity in older adults. Equine-assisted activities including therapeutic riding (TR) benefit balance and neuromuscular control in patients with neurological disabilities but have not been systematically studied in older adults at greater risk for falls due to balance deficits. The effect of an 8-week TR program on measures of balance and quality of life in community-dwelling older adults with established balance deficits was evaluated. This was a pretest-post-test single-group trial of a TR program on measures of balance and quality of life. The study was conducted at a Professional Association of Therapeutic Horsemanship (PATH) International Premier riding center. The subjects comprised 9 adults (5 female, 4 males) with a mean age 76.4 years (range 71-83 years). This included an 8-week observation period followed by an 8-week TR program consisting of 1 hour per week of supervised horseback riding and an 8-week follow-up period. SUBJECTS received balance testing at weeks 0, 8, 16, and 24 using the Fullerton Advanced Balance Scale (FABS), and quality of life was measured at weeks 8 and 16 using the Rand SF (short form) 36 quality-of-life measure. OUTCOME MEASURES were change in the FABS and Rand SF 36. There was no significant difference in balance scores between the start and end of the observation period. There was a significant improvement in the balance score and perception of general health from the start to the end of the intervention period, and no significant difference between the end of the intervention and the end of study, suggesting that improvements may have been sustained. TR is a safe activity for older adults with mild to moderate balance deficits and leads to both improvements in balance and quality of life. Longer and larger studies to assess the benefit of equine-assisted activities on improvements in balance and reduction in fall risk are needed.

  17. Dyadic interventions for community-dwelling people with dementia and their family caregivers: a systematic review.

    PubMed

    Van't Leven, Netta; Prick, Anna-Eva J C; Groenewoud, Johanna G; Roelofs, Pepijn D D M; de Lange, Jacomine; Pot, Anne Margriet

    2013-10-01

    In this review, we study the effects of dyadic psychosocial interventions focused on community-dwelling people with dementia and their family caregivers, and the relationship of the effects with intervention components of programs. A search from January 2005 to January 2012 led to 613 hits, which we reviewed against our inclusion criteria. We added studies from 1992 to 2005 reviewed by Smits et al. (Smits, C. H. M., De Lange, J., Droes, R.-M., Meiland, F., Vernooij-Dassen, M. and Pot, A. M. (2007). Effects of combined intervention programs for people with dementia living at home and their caregivers: a systematic review. International Journal of Geriatric Psychiatry, 22, 1181–1193). We assessed the methodological quality of 41 programs with the Cochrane criteria and two items of the Oxford Centre of Evidence-based Medicine guidelines. Studies of moderate to high quality concerning 20 different dyadic psychosocial programs for people with dementia and caregivers were included. Nineteen of these programs show significant effects on the patient with dementia, the caregiver, or both. Due to differences in the programs and the studies, this study does not provide an unequivocal answer about which programs are most effective. Programs with intervention components that actively train one or more specific functional domains for the person with dementia and/or the caregiver seem to have a beneficial impact on that domain, although there are exceptions. Reasons can be found in the program itself, the implementation of the program, and the study design. Dyadic psychosocial programs are effective, but the outcomes for the person with dementia and the caregiver vary. More attention is needed for matching the targeted functional domains, intervention components, and delivery characteristics of a program with the needs of the person with dementia and the family caregiver.

  18. Moderate, Regular Alcohol Consumption is Associated with Higher Cognitive Function in Older Community-Dwelling Adults

    PubMed Central

    Reas, E.T.; Laughlin, G.A.; Kritz-Silverstein, D.; Barrett-Connor, E.; McEvoy, L.K.

    2016-01-01

    BACKGROUND Evidence suggests that moderate alcohol consumption may protect against cognitive decline and dementia. However, uncertainty remains over the patterns of drinking that are most beneficial. OBJECTIVE To examine associations between amount and frequency of alcohol consumption with multiple domains of cognitive function in a well-characterized cohort of older community-dwelling adults in southern California. DESIGN Observational, cross-sectional cohort study. SETTING A research visit between 1988–1992 in Rancho Bernardo, California. PARTICIPANTS 1624 participants of the Rancho Bernardo Study (mean age ± SD = 73.2 ± 9.3 years). Measurements Participants completed a neuropsychological test battery, self-administered questionnaires on alcohol consumption and lifestyle, and a clinical health evaluation. We classified participants according to average amount of alcohol intake into never, former, moderate, heavy and excessive drinkers, and according to frequency of alcohol intake, into non-drinkers, rare, infrequent, frequent and daily drinkers. We examined the association between alcohol intake and cognitive function, controlling for age, sex, education, exercise, smoking, waist-hip ratio, hypertension and self-assessed health. RESULTS Amount and frequency of alcohol intake were significantly associated with cognitive function, even after controlling for potentially related health and lifestyle variables. Global and executive function showed positive linear associations with amount and frequency of alcohol intake, whereas visual memory showed an inverted U-shaped association with alcohol intake, with better performance for moderate and infrequent drinkers than for non-drinkers, excessive drinkers or daily drinkers. CONCLUSIONS In several cognitive domains, moderate, regular alcohol intake was associated with better cognitive function relative to not drinking or drinking less frequently. This suggests that beneficial cognitive effects of alcohol intake may be

  19. Physical fitness and oral function in community-dwelling older people: a pilot study.

    PubMed

    Izuno, Hiromi; Hori, Kazuhiro; Sawada, Misao; Fukuda, Masayo; Hatayama, Chikako; Ito, Kayoko; Nomura, Yoshio; Inoue, Makoto

    2016-12-01

    The aim of the present study was to quantify the relation between physical fitness and oral function, including tongue and lip movements. Physical fitness and oral function influence quality of life and activities of daily living in older individuals. Occlusal contact and mastication performance are associated with physical fitness, but the association between tongue and lip movements and physical fitness is unclear. Sixty-six independent community-dwelling older individuals (24 men, 42 women; mean age, 70.3 ± 5.9 years) participated in this study. Measures of physical fitness were the one-leg standing time with eyes open, the functional reach test, anteflexion, the timed up and go test, and grip strength. Measures of oral function were tongue pressure, lip pressure, tongue movement from side to side, the repetitive saliva-swallowing test (RSST), oral diadochokinesis and masticatory efficiency. Multiple regression analysis was used to quantify the relation between physical fitness and oral function. After adjustment for age, sex, BMI, exercise habits and number of remaining teeth, the tongue movement from side to side and/or oral diadochokinesis were chosen as significant factors in each physical fitness measurement. Furthermore, the lip pressure and masticatory efficiency were associated with handgrip strength. Oral function, including tongue and lip movements, was associated with physical fitness in older people in this study. Tongue dexterity as characterised by tongue movement from side to side and oral diadochokinesis particularly associated with physical fitness. © 2015 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  20. Potentially Inappropriate Medication in Community-Dwelling Primary Care Patients who were Screened Positive for Dementia

    PubMed Central

    Wucherer, Diana; Eichler, Tilly; Hertel, Johannes; Kilimann, Ingo; Richter, Steffen; Michalowsky, Bernhard; Thyrian, Jochen René; Teipel, Stefan; Hoffmann, Wolfgang

    2016-01-01

    Background: Potentially inappropriate medication (PIM) in older people is a risk factor for adverse drug effects. This risk is even higher in older people with dementia (PWD). Objective: Our study aimed to determine (1) the prevalence of PIM among primary care patients who were screened positive for dementia and (2) the sociodemographic and clinical variables associated with the use of PIM. Methods: DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg–Western Pomerania) is a general practitioner-based, cluster-randomized, controlled intervention study to implement and evaluate an innovative concept of collaborative dementia care management in Germany. The comprehensive baseline assessment includes a home medication review. The present analyses are based on the data from 448 study participants (age 70+, DemTect <9). PIMs were identified using the list of Potentially Inappropriate Medications in the Elderly (Priscus). Results: (1) A total of 99 study participants (22%) received at least one PIM. The highest prevalence was found for antidepressants, benzodiazepines, and analgetics. The most frequently prescribed PIMs were amitriptyline, etoricoxib, and doxazosin. (2) Use of a PIM was significantly associated with a diagnosis of a mental or behavioral disorder. Conclusions: The prescription rate of PIMs for community-dwelling PWD was comparable with the rates found for the general population of older people in Germany (20–29%). Antidepressants with anticholinergic properties and long-acting benzodiazepines were the most prescribed PIMs, despite having an unfavorable benefit-risk ratio. This high prevalence of PIM prescriptions in a vulnerable population of PWD indicates that standard care for dementia should include careful medication review and management. PMID:27716668

  1. Weight loss and rapid cognitive decline in community-dwelling patients with Alzheimer's disease.

    PubMed

    Soto, Maria E; Secher, Marion; Gillette-Guyonnet, Sophie; Abellan van Kan, Gabor; Andrieu, Sandrine; Nourhashemi, Fati; Rolland, Yves; Vellas, Bruno

    2012-01-01

    Weight loss is a frequent complication of Alzheimer's disease (AD) and a strong predictor of adverse outcomes in patients suffering from this disease. The aim of this study was to determine whether weight loss was a predictor of rapid cognitive decline (RCD) in AD. Four hundred fourteen community-dwelling ambulatory patients with a diagnosis of probable AD and a Mini-Mental State Examination (MMSE) score between 10 and 26 from the REAL.FR (REseau sur la maladie d'ALzheimer FRançais) cohort were studied and followed up during 4 years. Patients were classified in 2 groups according to weight loss defined by a loss of 4% or more during the first year of follow-up. RCD was defined as the loss of 3 points or more in MMSE over 6 months. The incidence of RCD was determined among both groups over the last 3 years of follow-up. MMSE, Katz's Activity of Daily Living scale, Mini-Nutritional Assessment scale, co-morbidities, behavioral and psychological symptoms of dementia, medication, level of education, living arrangement, and caregiver's burden were assessed every 6 months. Eighty-seven patients (21.0%) lost 4% or more of their initial weight during the first year. The incidence of RCD for all patients was 57.6 (95% confidence interval (CI) = 51.6-64.8) per 100 person-year (median follow-up of 15.1 months). In Cox proportional hazards models, after controlling for potential confounders, weight loss was a significant predictor factor of RCD (adjusted hazard ratio (HR) = 1.50, 95% CI = 1.04-2.17). In conclusion, weight loss predicted RCD in this cohort. Whether the prevention of weight loss (by improving nutritional status) impacts cognitive decline remains an open question.

  2. Physiological complexity underlying heart rate dynamics and frailty status in community-dwelling older women.

    PubMed

    Chaves, Paulo H M; Varadhan, Ravi; Lipsitz, Lewis A; Stein, Phyllis K; Windham, B Gwen; Tian, Jing; Fleisher, Lee A; Guralnik, Jack M; Fried, Linda P

    2008-09-01

    To assess whether less physiological complexity underlying regulation of heart rate dynamics, as indicated by lower approximate entropy for heart rate (ApEn(HR)), is associated with frailty. For supporting validity, relationships between frailty and traditional linear indices of heart rate variability (HRV) were also assessed. Cross-sectional. Women's Health and Aging Study I, a community-based observational study, 1992 to 1995. Subset of 389 community-dwelling women aged years and older with moderate to severe disability with ApEn(HR) data (convenience sampling). Electrocardiographic Holter recordings obtained over 2- to 3-hour periods were processed for ApEn(HR) and HRV measures. ApEn(HR) is a nonlinear statistic that quantifies the regularity of heart rate fluctuations over time. Lower ApEn(HR) is characteristic of heart rate time series containing a high proportion of repetitive patterns. Frailty was defined according to validated phenotype criteria. Median ApEn(HR) was lower in frail than in nonfrail subjects (P=.02). Lower ApEn(HR) (top quartile) was associated with lower likelihood of frailty than higher ApEn(HR) (bottom three quartiles) (odds ratio=0.47, 95% confidence interval=0.26-0.86), even after adjustment for major confounders. Frailty was consistently associated with lower HRV as assessed using time- and frequency-domain indices. This study supports the notion that less physiological complexity marks frailty and provides an empirical basis to the concept of frailty as a syndrome of homeostatic impairment. Future research will determine whether noninvasive measures of physiological complexity underlying heart rate dynamics might be useful for screening and monitoring of clinical vulnerability in older adults.

  3. CHRONIC MEDICAL CONDITIONS AND REPRODUCIBILITY OF SELF-REPORTED AGE AT MENOPAUSE AMONG COMMUNITY DWELLING WOMEN

    PubMed Central

    de Vries, Heather F.; Northington, Gina M.; Kaye, Elise M.; Bogner, Hillary R.

    2011-01-01

    OBJECTIVE To examine the association between chronic medical conditions and reproducibility of self-reported age at menopause among community-dwelling women. METHOD Age at menopause was assessed in a population-based longitudinal survey of 240 women twice, in 1993 and 2004. Women who recalled age at menopause in 2004 within one year or less of the age at menopause recalled in 1993 (concordant) were compared with women who did not recall of age at menopause in 2004 within 1 year of age at menopause recalled in 1993 (discordant). Type of menopause (surgical or natural) and chronic medical conditions were assessed by self-report. RESULTS One hundred and forty three women (59.6%) reported surgical menopause and 97 (40.4%) reported natural menopause. In all, 130 (54.2%) of women recalled age at menopause in 2004 within one year or less of recalled age at menopause in 1994 while 110 (45.8%) women did not recall age at menopause in 2004 within one year or less of recalled age at menopause in 1994. Among women with surgical menopause, women with three or more medical conditions were less likely to have concordant recall of age at menopause than women with less than three chronic medical conditions (adjusted odds ratio (OR) = 0.36, 95% confidence interval (CI) [0.15, 0.91]) in multivariate models controlling for potentially influential characteristics including cognition and years from menopause. CONCLUSIONS Among women who underwent surgical menopause, the presence of three or more medical conditions is associated with decreased reproducibility of self-reported age at menopause. PMID:21971208

  4. Grey matter correlates of susceptibility to scams in community-dwelling older adults.

    PubMed

    Duke Han, S; Boyle, Patricia A; Yu, Lei; Arfanakis, Konstantinos; James, Bryan D; Fleischman, Debra A; Bennett, David A

    2016-06-01

    Susceptibility to scams is a significant issue among older adults, even among those with intact cognition. Age-related changes in brain macrostructure may be associated with susceptibility to scams; however, this has yet to be explored. Based on previous work implicating frontal and temporal lobe functioning as important in decision making, we tested the hypothesis that susceptibility to scams is associated with smaller grey matter volume in frontal and temporal lobe regions in a large community-dwelling cohort of non-demented older adults. Participants (N = 327, mean age = 81.55, mean education = 15.30, 78.9 % female) completed a self-report measure used to assess susceptibility to scams and an MRI brain scan. Results indicated an inverse association between overall grey matter and susceptibility to scams in models adjusted for age, education, and sex; and in models further adjusted for cognitive function. No significant associations were observed for white matter, cerebrospinal fluid, or total brain volume. Models adjusted for age, education, and sex revealed seven clusters showing smaller grey matter in the right parahippocampal/hippocampal/fusiform, left middle temporal, left orbitofrontal, right ventromedial prefrontal, right middle temporal, right precuneus, and right dorsolateral prefrontal regions. In models further adjusted for cognitive function, results revealed three significant clusters showing smaller grey matter in the right parahippocampal/hippocampal/fusiform, right hippocampal, and right middle temporal regions. Lower grey matter concentration in specific brain regions may be associated with susceptibility to scams, even after adjusting for cognitive ability. Future research is needed to determine whether grey matter reductions in these regions may be a biomarker for susceptibility to scams in old age.

  5. Effect of Home-Based Well-Rounded Exercise in Community-Dwelling Older Adults

    PubMed Central

    Yamauchi, Tomoko; Islam, Mohammod M.; Koizumi, Daisuke; Rogers, Michael E.; Rogers, Nicole L.; Takeshima, Nobuo

    2005-01-01

    The purpose of this study was to assess the efficacy of a home-based well-rounded exercise program (WREP) in older adults. Forty sedentary community-dwelling older adults were randomly assigned to an exercise group (n = 23; aged 62-80 yr, average: 69.2 ± 5.2; 12 men and 11 women) or a control group (n = 17; aged 63-85 yr, average: 70.1 ± 6.6; 5 men and 12 women). The exercise group performed a 12-wk WREP which included aerobic exercise (walking) on about 3 days·wk-1 for 37 min·day-1; elastic band-based resistance exercises for the major muscle groups on about 3 days·wk-1 for 26 min; and flexibility exercises (stretching) on about 4 days·wk-1 for 19 min·day-1. General physical characteristics, functional strength (Arm Curl [AC], Chair Stand [CS]), dynamic balance and agility (Up & Go [UG]), flexibility (Back Scratch [BS], Sit & Reach [SR]), and endurance (12-min walk [12-MW]) were measured. Following the 12-wk home-based WREP, improvements were observed in AC, CS, UG, BS, SR and 12-MW for the exercise group but not for the control group. These results suggest that the home-based WREP can improve overall fitness in older adults. Key Points Walking, elastic band exercise and stretching were prescribed as a Well-Rounded Exercise Program for older adults. By combining aerobic, resistance and flexibility exercises, a Well-Rounded Exercise Program was effective for improving endurance, functional strength, dynamic balance and agility, and flexibility. Community-based exercise classes motivated older adults to perform home-based exercises. PMID:24501569

  6. Relation of Late-Life Social Activity With Incident Disability Among Community-Dwelling Older Adults

    PubMed Central

    Boyle, Patricia A.; Buchman, Aron S.; Bennett, David A.

    2011-01-01

    Background. We tested the hypothesis that a higher level of social activity was associated with decreased risk of incident disability in older adults. Methods. Data came from older adults in the Rush Memory and Aging Project, an ongoing longitudinal cohort study of aging. Analyses were restricted to persons without clinical dementia and reporting no need for help performing any task in the particular functional domain assessed. Participants were followed for an average of 5.1 years (SD = 2.5). Social activity, based on 6 items (visiting friends or relatives; going to restaurants, sporting events, or playing games; group meetings; church/religious services; day or overnight trips; unpaid community/volunteer work), was assessed at baseline. Disability in basic activities of daily living, mobility disability, and instrumental activities of daily living was assessed annually. Proportional hazard models adjusted for age, sex, and education were used to examine the association between social activity and incident disability. Fully adjusted models included terms for depression, vascular diseases and risk factors, body mass index, social networks, and self-reported physical activity. Results. In fully adjusted models, among 954 persons without baseline disability, the risk of developing disability in activities of daily living decreased by 43% (hazard ratio = 0.57, 95% confidence interval = 0.46, 0.71) for each additional unit of social activity. Social activity was also associated with decreased risk of developing mobility disability (hazard ratio = 0.69, 95% confidence interval = 0.54, 0.88) and disability in instrumental activities of daily living (hazard ratio = 0.71, 95% confidence interval = 0.55, 0.93). Conclusions. Social activity is associated with a decreased risk of incident disability in activities of daily living, mobility, and instrumental activities of daily living, among community-dwelling older adults. PMID:21300745

  7. Determinants of health-related quality of life among community dwelling elderly.

    PubMed

    George, Pradeep P; Heng, Bee Hoon; Wong, Lai Yin; Ng, Charis W L

    2014-01-01

    This study determines the associations between self-reported chronic conditions, limitations in activities of daily living and health-related quality of life (HRQoL) among community dwelling elderly in Singapore. A population-based cross-sectional survey was conducted among a random sample of 4200 residents from 58 blocks of dwellings in Marine Parade housing estate between April and May 2011. A structured questionnaire was used to collect data on demographic characteristics; chronic disease profile, health screenings, healthcare utilisation, physical activity, activities of daily living (ADL) and functional ability and health related quality of life. Quality of life was assessed using European Quality of life 5 Domain (EQ-5D). Ordinary least squares (OLS) regression was used to identify independent predictors of health related quality of life. A total of 2454 respondents for included for analysis. Most of the respondents were females (57.2%) and aged between 65 and 74 years (48.5%). Among them, 79.1% of the respondents were Chinese. Approximately three-fourth (77.5%) of the survey respondents reported having at least one of the 13 chronic medical conditions; high blood pressure (57.7%), high blood cholesterol (51.6%), diabetes (22.9%) were the most commonly reported conditions. Independent predictors of HRQoL with greatest decrements in EQ-5D index and visual analog scores (VAS) were unemployment, self-reported depression, arthritis and osteoporosis and ADL limitations for activities such as "unable to shower", "unable to do housework" and elderly with depressive symptoms (GDS score≥5). The study had identified predictors of HRQoL in elderly Singapore residents and also provides community-based EQ-5D index and VAS scores associated with a wide variety of chronic conditions and ADL limitations.

  8. 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

  9. Drug-use patterns among black and nonblack community-dwelling elderly.

    PubMed

    Hanlon, J T; Fillenbaum, G G; Burchett, B; Wall, W E; Service, C; Blazer, D G; George, L K

    1992-05-01

    To describe and compare drug-use patterns among black and nonblack community-dwelling elderly. Survey. Five-county urban and rural region in Piedmont, NC. Stratified probability household sample of 4164 community residents aged 65 or older from the Piedmont Health Survey of the Elderly (65 percent women, 54 percent black, mean age 73.56 +/- 6.74 y). Prevalence of medication use and mean drug use; therapeutic medication category use. Data were weighted to represent the population in this geographic area. Fewer blacks reported the use of over-the-counter (OTC) medications and total medications than did nonblacks (66 vs. 76 percent and 88 vs. 92 percent, respectively; p less than 0.001). Compared with nonblacks, blacks reported using a lower mean number of prescription (2.02 vs. 2.35; p less than 0.001), OTC (1.12 vs. 1.42; p less than 0.001), and total (3.14 vs. 3.77; p less than 0.001) drugs. The therapeutic medication categories varied by race for prescription cardiovascular, analgesic, and central nervous system (CNS) drugs and OTC nutritional supplements. More nonblacks than blacks reported the use of analgesics (62.5 vs. 55.6 percent, respectively; p less than 0.001), CNS drugs (26.1 vs. 14.2 percent, respectively; p less than 0.001), nutritional supplements (27.5 vs. 16.9 percent, respectively; p less than 0.001), and gastrointestinal agents (29.0 vs. 23.5 percent, respectively; p less than 0.001). Blacks were more likely to report problems in managing their medications than were nonblacks (9.0 vs. 6.1 percent, respectively; p = 0.001). Our data suggest that there are distinct racial differences in medication-use patterns among the elderly.

  10. Symptomatic pelvic floor disorders in community-dwelling older Australian women.

    PubMed

    Zeleke, Berihun M; Bell, Robin J; Billah, Baki; Davis, Susan R

    2016-03-01

    To assess the prevalence, and factors associated with, pelvic floor disorders in a representative sample of community-dwelling older Australian women. 1548 women, aged 65-79 years, were recruited to this cross-sectional study between April and August 2014. Pelvic floor disorders, including urinary incontinence (UI), fecal incontinence (FI), and pelvic organ prolapse (POP), were assessed using validated questionnaires. Multivariable logistic regression was used to assess factors associated with each, and having one or more pelvic floor disorders. Among 1517 women (mean age=71.5 ± 4.1 SD years), 47.2% (95% CI, 44.7-49.7%) of women had one or more pelvic floor disorders, with 36.2% (95% CI, 33.8-38.6%) having UI, 19.8% (95% CI, 17.8-21.9%) having FI, and 6.8% (95% CI, 5.6-8.2%) having POP. Of the women with POP, 53.4% had UI, 33% had FI and 26.2% had both. The proportion of women with one or more pelvic floor disorders increased with parity from 34.6% (95% CI, 7.8-11.7%) for nulliparous women, to 45.3% (95% CI, 40.3-59.1%) for 1-2 births, and 52.1% (95% CI, 48.3-55.8%) for ≥ 3 births. Obese women were more likely to have at least one pelvic floor disorder (OR=1.77; 95% CI, 1.36-2.31, p<0.01). Pelvic floor disorders are common in older women. Physicians caring for older women should be mindful that older women presenting with symptoms of one pelvic floor disorder are likely to have another concurrent pelvic floor problem. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. 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.

  12. 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.

  13. Levels of Health Literacy in a Community-Dwelling Population of Chinese Older Adults

    PubMed Central

    Li, Yu; Dong, XinQi

    2014-01-01

    Background. Lower levels of health literacy have been associated with adverse health outcomes, especially for older adults. However, limited research has been conducted to understand health literacy levels among Chinese American older adults. Methods. The PINE study is an epidemiological cohort of 3,159 community-dwelling Chinese older adults, 95% of whom do not speak or read English. Chinese older adults’ health literacy levels were examined using the Chinese version of the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R) test. Kruskal–Wallis test and chi-square statistics were used to identify significant differences by sociodemographic and self-reported health characteristics. Pearson and Spearman correlation coefficients were used to examine correlations between personal characteristics and health literacy level. Results. The mean age among this sample of Chinese older adults was 72.8 years (SD = 8.3, range = 60–105) and the mean REALM-R test score was 6.9 [SD = 2.3, range (0–8)]. Health literacy was positively associated with education, marriage status, and number of people living with. Older age, being female, greater number of children, years in the United States, and preference for speaking Cantonese or Taishanese were negatively associated with health literacy. Health literary was not associated with self-reported health status or quality of life. Conclusions. In this Chicago Chinese population, older adults had reasonable levels of health literacy in Chinese. Future longitudinal research is needed to understand risk/protective factors associated with health literacy level in Chinese older adults. PMID:25378449

  14. Low vitamin K intakes in community-dwelling elders at an early stage of Alzheimer's disease.

    PubMed

    Presse, Nancy; Shatenstein, Bryna; Kergoat, Marie-Jeanne; Ferland, Guylaine

    2008-12-01

    An increasing body of evidence points to a role for vitamin K in brain physiology through its participation in sphingolipid metabolism and biological activation of the vitamin K-dependent protein Gas6. One hypothesis is that vitamin K may also play a role in the pathogenesis of Alzheimer's disease. A recent study found that patients with early-stage Alzheimer's disease consumed less vitamin K than did cognitively intact control subjects. To learn more about the dietary intakes and food sources of vitamin K in these patients, a detailed analysis was conducted. Dietary vitamin K intakes were assessed from 5 nonconsecutive days of food records collected from 31 community-dwelling patients with early-stage Alzheimer's disease and in 31 age- and sex-matched cognitively intact control subjects. Mean vitamin K intake on a person-day basis was 63+/-90 microg/day in patients and 139+/-233 microg/day in control subjects. Vitamin K intakes were significantly less in participants with Alzheimer's disease (P<0.0001), even after adjusting for energy intakes (P=0.0003). Vegetables, fats, and fruits contributed more than 70% of total vitamin K intake in both groups. The main source of vitamin K was green vegetables, which contributed 33% and 49% to total intakes in patients and control subjects, respectively. This lower consumption of green vegetables in participants with Alzheimer's disease explained their lower vitamin K intakes overall. Despite their limitations, results are in line with the most recent research in both vitamin K and Alzheimer's disease and suggest a need to consider vitamin K in future investigations on the role of diet in Alzheimer's disease.

  15. The Quality of Removable Prostheses in Dentate, Community-Dwelling Elderly Residing in Puerto Rico

    PubMed Central

    Aguilar, Maria L.; Psoter, Walter J.; Montero, Mauricio; Milord, Fabiola; Joshipura, Kaumudi J.

    2013-01-01

    Purpose Edentulism has been decreasing in the US elderly population; however, due to the increasing number of elderly, the need for prostheses has been projected to rise over the next several decades. One of the aims of the Puerto Rican Elderly Dental Health Study (PREDHS) was to assess the quality of removable prostheses (RP) in the Puerto Rican (PR) elderly (> 69 years of age) population. Methods A cross-sectional design, using a subgroup from the Puerto Rican Elderly: Health Conditions (PREHCO) study of dentate, community-dwelling older adults from the greater San Juan area was employed. Eligible participants were administered structured questionnaires and examined in their homes by three trained and calibrated dentists using National Institute of Dental and Craniofacial Research (NIDCR) criteria. Results One hundred and eighty three (183) participants were examined (61 males, 122 females) (p < 0.001). Overall, 64% were found to have a prosthetic problem with no statistical difference between genders. Unadjusted and age-adjusted logistic models were employed. Increasing age was associated with both upper and lower clinically defined abraded prostheses, (p = 0.007; p = 0.041, respectively). Maxillary (23%) and mandibular (27%) prostheses needed replacement due to deficiencies. Conclusion RP deficiencies were found in almost two-thirds of a representative sample of dentate 70+ year-old people residing in PR. There was no difference in the proportion of deficiencies between elderly who reported a dental visit in the preceding year or not having seen a dentist. A quarter of the prostheses required replacement. The findings from this and the NHANES studies demonstrate that an engaged and recognized prosthodontic dental school faculty continues to be as important now as it was a generation ago. PMID:23387934

  16. Salivary cortisol, brain volumes, and cognition in community-dwelling elderly without dementia

    PubMed Central

    Geerlings, Mirjam I.; Sigurdsson, Sigurdur; Eiriksdottir, Gudny; Garcia, Melissa E.; Harris, Tamara B.; Gudnason, Vilmundur

    2015-01-01

    Objective: We investigated the associations of morning and evening salivary cortisol levels with regional brain volumes and cognitive functioning in community-dwelling older persons without dementia. Method: From the Age, Gene/Environment Susceptibility (AGES)–Reykjavik Study, we included 4,244 persons without dementia (age 76 ± 5 years, 58% women) who had 1.5T brain MRI, assessment of cognitive functioning, and saliva collected at home 45 minutes after awakening and at night. Linear regression analysis was used to estimate the cross-sectional relationship among cortisol levels, brain volumes, and cognitive functioning, adjusting for covariates. Results: Higher evening cortisol was associated with smaller total brain volume (highest vs lowest tertile −16.0 mL; 95% confidence interval −19.7 to −12.2 mL, adjusted for age, sex, education, intracranial volume, smoking, steroid use, white matter lesions, and brain infarcts on MRI). The smaller volumes were observed in all brain regions, but were significantly smaller in gray matter than in white matter regions. Poorer cognitive functioning across all domains was also associated with higher evening cortisol. Higher levels of morning cortisol were associated with slightly greater normal white matter volume and better processing speed and executive functioning, but not with gray matter volume or with memory performance. Conclusions: In older persons, evening and morning cortisol levels may be differentially associated with tissue volume in gray and white matter structures and cognitive function. Understanding these differential associations may aid in developing strategies to reduce the effects of hypothalamic-pituitary-adrenal axis dysfunction on late-life cognitive impairment. PMID:26291281

  17. 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

  18. Correlates of excessive daytime sleepiness in community-dwelling older adults: an exploratory study.

    PubMed

    Lima, Camila Astolphi; Soares, Wuber Jefferson de Souza; Bilton, Tereza Loffredo; Dias, Rosângela Corrêa; Ferrioll, Eduardo; Perracini, Monica Rodrigues

    2015-01-01

    Excessive daytime sleepiness (EDS) imposes a wide range of adverse health-related outcomes in older people, such as disability, which impair everyday activities and may increase the risk of fall. Few studies have explored EDS in Brazilian older people living in the community who are typically cared in primary health services. This study aims to investigate the prevalence of EDS and its sociodemographic, physical and mental health correlates among community-dwelling older adults. This is an exploratory, population-based study derived from Frailty in Brazilian Older Adults (FIBRA) study including adults aged 65 years and older. Participants with a score ≥ 11 points on the Epworth Sleepiness Scale were considered as having excessive daytime sleepiness. A structured, multidimensional questionnaire was used to investigate sociodemographic, physical and mental health, and self-rated health variables. The sample was composed of 776 older adults, of whom 21% (n = 162) presented excessive daytime sleepiness. Multivariate regression analysis revealed that EDS is associated with obesity (OR = 1.50; 95%CI 1.02 - 2.20), urinary incontinence (OR = 1.53; 95%CI 1.01 - 2.31), poor self-rated health (OR = 1.54; 95%CI 1.06 - 2.24), and depression symptoms (OR = 1.49; 95%CI 1.00 - 2.20). Our results suggest that healthcare professionals should identify older adults with EDS and implement intervention strategies to minimize the negative impact of the co-occurrence of this condition with obesity, depression and urinary incontinence over health and quality of life.

  19. Generalized anxiety in community-dwelling elderly: Prevalence and clinical characteristics.

    PubMed

    Zhang, Xiaobin; Norton, Joanna; Carrière, Isabelle; Ritchie, Karen; Chaudieu, Isabelle; Ancelin, Marie-Laure

    2015-02-01

    Generalized anxiety disorder (GAD) is a chronic and disabling disorder with a low rate of full remission. As it is commonly assumed that cases in the elderly principally represent the continuing chronic course of early onset illness, there has been little research into the clinical characteristics, including comorbid psychiatric and physical conditions, which may be specific to older people. Lifetime GAD and psychiatric comorbidity were diagnosed in 1974 community-dwelling elderly people aged 65 or over using a standardized psychiatric examination, the MINI, based on DSM-IV criteria. Multivariate regression analyses were adjusted for socio-demographic, lifestyle, biological, and clinical variables, as well as adverse life events. The lifetime prevalence of GAD was 11% (95% CI=9.6-12.4%) of whom 24.6% reported a late onset with a first episode after 50 years of age. The 6-month current prevalence was 4.6% (95% CI=3.7-5.5%). Most of the prevalent cases were recurrent but only 36.3% were receiving treatment. Fourteen percent were comorbid with major depression and 34% with phobia but their associated factors differed. The factors associated with pure GAD were being female, having cognitive impairment, lower body mass index, reporting low affective support during childhood, taking a high number of somatic medications independently of other mental health factors, e.g. psychotropic medication use, major depression, and phobia. The study is limited by cross-sectional design. Our data indicate that GAD prevalence is high in elderly people with a late-life onset of GAD in 25% of cases. GAD in the elderly is not just a severity marker of depression and is clinically distinct from phobia, the other major anxiety disorder of the elderly. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. [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.

  1. Environmental barriers, person-environment fit and mortality among community-dwelling very old people

    PubMed Central

    2013-01-01

    Background Environmental barriers are associated with disability-related outcomes in older people but little is known of the effect of environmental barriers on mortality. The aim of this study was to examine whether objectively measured barriers in the outdoor, entrance and indoor environments are associated with mortality among community-dwelling 80- to 89-year-old single-living people. Methods This longitudinal study is based on a sample of 397 people who were single-living in ordinary housing in Sweden. Participants were interviewed during 2002–2003, and 393 were followed up for mortality until May 15, 2012. Environmental barriers and functional limitations were assessed with the Housing Enabler instrument, which is intended for objective assessments of Person-Environment (P-E) fit problems in housing and the immediate outdoor environment. Mortality data were gathered from the public national register. Cox regression models were used for the analyses. Results A total of 264 (67%) participants died during follow-up. Functional limitations increased mortality risk. Among the specific environmental barriers that generate the most P-E fit problems, lack of handrails in stairs at entrances was associated with the highest mortality risk (adjusted RR 1.55, 95% CI 1.14-2.10), whereas the total number of environmental barriers at entrances and outdoors was not associated with mortality. A higher number of environmental barriers indoors showed a slight protective effect against mortality even after adjustment for functional limitations (RR 0.98, 95% CI 0.96-1.00). Conclusion Specific environmental problems may increase mortality risk among very-old single-living people. However, the association may be confounded by individuals’ health status which is difficult to fully control for. Further studies are called for. PMID:23981906

  2. Environmental barriers, person-environment fit and mortality among community-dwelling very old people.

    PubMed

    Rantakokko, Merja; Törmäkangas, Timo; Rantanen, Taina; Haak, Maria; Iwarsson, Susanne

    2013-08-28

    Environmental barriers are associated with disability-related outcomes in older people but little is known of the effect of environmental barriers on mortality. The aim of this study was to examine whether objectively measured barriers in the outdoor, entrance and indoor environments are associated with mortality among community-dwelling 80- to 89-year-old single-living people. This longitudinal study is based on a sample of 397 people who were single-living in ordinary housing in Sweden. Participants were interviewed during 2002-2003, and 393 were followed up for mortality until May 15, 2012.Environmental barriers and functional limitations were assessed with the Housing Enabler instrument, which is intended for objective assessments of Person-Environment (P-E) fit problems in housing and the immediate outdoor environment. Mortality data were gathered from the public national register. Cox regression models were used for the analyses. A total of 264 (67%) participants died during follow-up. Functional limitations increased mortality risk. Among the specific environmental barriers that generate the most P-E fit problems, lack of handrails in stairs at entrances was associated with the highest mortality risk (adjusted RR 1.55, 95% CI 1.14-2.10), whereas the total number of environmental barriers at entrances and outdoors was not associated with mortality. A higher number of environmental barriers indoors showed a slight protective effect against mortality even after adjustment for functional limitations (RR 0.98, 95% CI 0.96-1.00). Specific environmental problems may increase mortality risk among very-old single-living people. However, the association may be confounded by individuals' health status which is difficult to fully control for. Further studies are called for.

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

    PubMed Central

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

    2017-01-01

    Background 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. Methods 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. Results 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). Conclusion 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. PMID:28358845

  4. Systematic review of EASY-care needs assessment for community-dwelling older people

    PubMed Central

    Craig, Christopher; Chadborn, Neil; Sands, Gina; Tuomainen, Helena; Gladman, John

    2015-01-01

    Background: undertaking comprehensive geriatric assessments (CGAs) combined with long-term health and social care management can improve the quality of life of older people [ 1]. The EASY-Care tool is a CGA instrument designed for assessing the physical, mental and social functioning and unmet health and social needs of older people in community settings or primary care. It has also been used as a frailty assessment tool and for gathering population-level data. Objective: to review the evidence of reliability, validity and acceptability of EASY-Care and its appropriateness for assessing the needs of community-dwelling older people. Methods: systematic search of literature databases using pre-defined search terms (January 1994—May 2014) for English language articles reporting on the reliability, validity, acceptability and implementation of EASY-Care in primary care and community settings. Eligible articles were critically reviewed. Discussion papers mapping professionals' use of the tool were also included as these could be considered an aspect of validity. Results: twenty-nine papers met the inclusion criteria and underwent data extraction. A narrative synthesis was performed, because there was a variety of quantitative and qualitative outcomes and characteristics. Reliability evidence for EASY-Care is minimal. Evidence for validity is good, and it has received numerous positive endorsements of acceptability in international settings from older people and practitioners. Conclusion: evidence supports the use of EASY-Care for individual needs assessment; further research is needed for other uses. Of the papers that made statements about who should administer EASY-Care, the majority indicated that nurses were preferable to self-completion. PMID:25911539

  5. 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

  6. Improving medication adherence among community-dwelling seniors with cognitive impairment: a systematic review of interventions.

    PubMed

    Kröger, Edeltraut; Tatar, Ovidiu; Vedel, Isabelle; Giguère, Anik M C; Voyer, Philippe; Guillaumie, Laurence; Grégoire, Jean-Pierre; Guénette, Line

    2017-08-01

    Background Medication non-adherence may lead to poor therapeutic outcomes. Cognitive functions deteriorate with age, contributing to decreased adherence. Interventions have been tested to improve adherence in seniors with cognitive impairment or Alzheimer disease (AD), but high-quality systematic reviews are lacking. It remains unclear which interventions are promising. Objectives We conducted a systematic review to identify, describe, and evaluate interventions aimed at improving medication adherence among seniors with any type of cognitive impairment. Methods Following NICE guidance, databases and websites were searched using combinations of controlled and free vocabulary. All adherence-enhancing interventions and study designs were considered. Studies had to include community dwelling seniors, aged 65 years or older, with cognitive impairment, receiving at least one medication for a chronic condition, and an adherence measure. Study characteristics and methodological quality were assessed. Results We identified 13 interventions, including six RCTs. Two studies were of poor, nine of low/medium and two of high quality. Seven studies had sample sizes below 50 and six interventions focused on adherence to AD medication. Six interventions tested a behavioral, four a medication oriented, two an educational and one a multi-faceted approach. Studies rarely assessed therapeutic outcomes. All but one intervention showed improved adherence. Conclusion Three medium quality studies showed better adherence with patches than with pills for AD treatment. Promising interventions used educational or reminding strategies, including one high quality RCT. Nine studies were of low/moderate quality. High quality RCTs using a theoretical framework for intervention selection are needed to identify strategies for improved adherence in these seniors.

  7. Relationship between functional vision and balance and mobility performance in community-dwelling older adults.

    PubMed

    Aartolahti, Eeva; Häkkinen, Arja; Lönnroos, Eija; Kautiainen, Hannu; Sulkava, Raimo; Hartikainen, Sirpa

    2013-10-01

    Vision is an important prerequisite for balance control and mobility. The role of objectively measured visual functions has been previously studied but less is known about associations of functional vision, that refers to self-perceived vision-based ability to perform daily activities. The aim of the study was to investigate the relationship between functional vision and balance and mobility performance in a community-based sample of older adults. This study is part of a Geriatric Multidisciplinary Strategy for the Good Care of the Elderly project (GeMS). Participants (576) aged 76-100 years (mean age 81 years, 70 % women) were interviewed using a seven-item functional vision questionnaire (VF-7). Balance and mobility were measured by the Berg balance scale (BBS), timed up and go (TUG), chair stand test, and maximal walking speed. In addition, self-reported fear of falling, depressive symptoms (15-item Geriatric Depression Scale), cognition (Mini-Mental State Examination) and physical activity (Grimby) were assessed. In the analysis, participants were classified into poor, moderate, or good functional vision groups. The poor functional vision group (n = 95) had more comorbidities, depressed mood, cognition decline, fear of falling, and reduced physical activity compared to participants with moderate (n = 222) or good functional vision (n = 259). Participants with poor functional vision performed worse on all balance and mobility tests. After adjusting for gender, age, chronic conditions, and cognition, the linearity remained statistically significant between functional vision and BBS (p = 0.013), TUG (p = 0.010), and maximal walking speed (p = 0.008), but not between functional vision and chair stand (p = 0.069). Poor functional vision is related to weaker balance and mobility performance in community-dwelling older adults. This highlights the importance of widespread assessment of health, including functional vision, to prevent balance impairment and maintain

  8. Levels of health literacy in a community-dwelling population of Chinese older adults.

    PubMed

    Simon, Melissa A; Li, Yu; Dong, XinQi

    2014-11-01

    Lower levels of health literacy have been associated with adverse health outcomes, especially for older adults. However, limited research has been conducted to understand health literacy levels among Chinese American older adults. The PINE study is an epidemiological cohort of 3,159 community-dwelling Chinese older adults, 95% of whom do not speak or read English. Chinese older adults' health literacy levels were examined using the Chinese version of the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R) test. Kruskal-Wallis test and chi-square statistics were used to identify significant differences by sociodemographic and self-reported health characteristics. Pearson and Spearman correlation coefficients were used to examine correlations between personal characteristics and health literacy level. The mean age among this sample of Chinese older adults was 72.8 years (SD = 8.3, range = 60-105) and the mean REALM-R test score was 6.9 [SD = 2.3, range (0-8)]. Health literacy was positively associated with education, marriage status, and number of people living with. Older age, being female, greater number of children, years in the United States, and preference for speaking Cantonese or Taishanese were negatively associated with health literacy. Health literary was not associated with self-reported health status or quality of life. In this Chicago Chinese population, older adults had reasonable levels of health literacy in Chinese. Future longitudinal research is needed to understand risk/protective factors associated with health literacy level in Chinese older adults. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Silver diamine fluoride and education to prevent and arrest root caries among community-dwelling elders.

    PubMed

    Zhang, W; McGrath, C; Lo, E C M; Li, J Y

    2013-01-01

    Root caries among elderly communities is of growing public health concern globally. This controlled clinical trial investigated the effectiveness of silver diamine fluoride and oral health education in preventing and arresting root caries. Two hundred sixty-six elderly subjects who had at least 5 teeth with exposed root surfaces and did not have serious life-threatening medical diseases were allocated to 3 groups according to a computer-generated random list: group 1 (the control group) received oral hygiene instructions (OHI) annually; group 2 received OHI and silver diamine fluoride (SDF) application annually, and group 3 was given OHI and SDF application annually, plus an oral health education (OHE) programme every 6 months. Two hundred twenty-seven elderly subjects were followed for 24 months. The mean numbers of new root caries surfaces in groups 1, 2 and 3 were 1.33, 1.00 and 0.70, respectively (ANOVA, p < 0.05). Group 3 had fewer root surfaces with new caries than group 1 (Scheffé multiple-comparison test, p < 0.05). The mean numbers of arrested root caries surfaces in groups 1, 2 and 3 were 0.04, 0.28 and 0.33, respectively (ANOVA, p < 0.01). Group 3 and group 2 had a greater number of active root caries surfaces which became arrested than group 1 (Scheffé multiple-comparison test, p < 0.05). Annual application of SDF together with biannual OHE was effective in preventing new root caries and arresting root caries among community-dwelling elderly subjects. Copyright © 2013 S. Karger AG, Basel.

  10. Depressive Symptoms and Subjective And Objective Sleep In Community-Dwelling Older Women

    PubMed Central

    Maglione, Jeanne E.; Ancoli-Israel, Sonia; Peters, Katherine W.; Paudel, Misti L.; Yaffe, Kristine; Ensrud, Kristine E.; Stone, Katie L.

    2012-01-01

    Objectives To examine the relationship between depressive symptoms and subjective and objective sleep in older women. Design Cross-sectional. Setting Four US clinical centers. Participants 3045 community-dwelling women ≥70 years. Measurements Depressive symptoms were assessed with the Geriatric Depression Scale categorizing participants as “normal” (0–2, referent), “some depressive symptoms” (3–5), or “depressed” (≥6). Subjective sleep quality and daytime sleepiness were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Objective sleep measures were assessed with wrist actigraphy. Results In multivariable-adjusted models, there were graded associations between increased level of depressive symptoms and both worse subjective sleep quality and more subjective daytime sleepiness (p-trends <0.001). Women with some depressive symptoms (OR 1.82, CI 1.48–2.24) and depressed (OR 2.84, CI 2.08–3.86) women had greater odds of reporting poor sleep (PSQI>5). Women with some depressive symptoms (OR 1.97, CI 1.47–2.64) and depressed women (OR 1.70, CI 1.12–2.58) had greater odds of reporting excessive daytime sleepiness (ESS>10). There were also graded associations between increased level of depressive symptoms and objectively measured wake after sleep onset (WASO) (p-trend = 0.030) and long wake episodes >5 minutes (p-trend 0.006). Depressed women had modestly increased odds of WASO ≥1 hour (OR 1.37, CI 1.03–1.83). Women with some depressive symptoms (OR 1.49, CI 1.19–1.86) and depressed women (OR 2.04, CI 1.52–2.74) had greater odds of being in the highest quartile for number of nap episodes >5 minutes. No associations between depressive symptom level and prolonged sleep latency, reduced sleep efficiency, or reduced or increased total sleep time were found. Conclusion Greater depressive symptom levels were associated with more subjective sleep disturbance and objective evidence of sleep

  11. Obstructive Sleep Apnea in Obese Community-Dwelling Children: The NANOS Study

    PubMed Central

    Alonso-Álvarez, María Luz; Cordero-Guevara, José Aurelio; Terán-Santos, Joaquin; Gonzalez-Martinez, Mónica; Jurado-Luque, María José; Corral-Peñafiel, Jaime; Duran-Cantolla, Joaquin; Kheirandish-Gozal, Leila; Gozal, David

    2014-01-01

    Introduction: Obesity in children is assumed to serve as a major risk factor in pediatric obstructive sleep apnea syndrome (OSAS). However, the prevalence of OSAS in otherwise healthy obese children from the community is unknown. Aim: To determine the prevalence of OSAS in obese children identified and recruited from primary care centers. Methods: A cross-sectional, prospective, multicenter study. Spanish children ages 3–14 y with a body mass index (BMI) greater than or equal to the 95th percentile for age and sex were randomly selected, and underwent medical history, snoring, and Pediatric Sleep Questionnaire (PSQ) assessments, as well as physical examination, nasopharyngoscopy, and nocturnal polysomnography (NPSG) recordings. Results: Two hundred forty-eight children (54.4% males) with mean age of 10.8 ± 2.6 y were studied with a BMI of 28.0 ± 4.7 kg/m2 corresponding to 96.8 ± 0.6 percentile when adjusted for age and sex. The mean respiratory disturbance index (RDI), obstructive RDI (ORDI), and obstructive apnea-hypopnea index (OAHI) were 5.58 ± 9.90, 5.06 ± 9.57, and 3.39 ± 8.78/h total sleep time (TST), respectively. Using ≥ 3/h TST as the cutoff for the presence of OSAS, the prevalence of OSAS ranged from 21.5% to 39.5% depending on whether OAHI, ORDI, or RDI were used. Conclusions: The prevalence of obstructive sleep apnea syndrome (OSAS) in obese children from the general population is high. Obese children should be screened for the presence of OSAS. ClinicalTrials.gov Identifier: NCT01322763. Citation: Alonso-Álvarez ML, Cordero-Guevara JA, Terán-Santos J, Gonzalez-Martinez M, Jurado-Luque MJ, Corral-Peñafiel J, Duran-Cantolla J, Kheirandish-Gozal L, Gozal D, for the Spanish Sleep Network. Obstructive sleep apnea in obese community-dwelling children: the NANOS study. SLEEP 2014;37(5):943-949. PMID:24790273

  12. Steps per day, peak cadence, body mass index, and age in community-dwelling older adults.

    PubMed

    Schuna, John M; Brouillette, Robert M; Foil, Heather C; Fontenot, Stephanie L; Keller, Jeffrey N; Tudor-Locke, Catrine

    2013-05-01

    The relationships between demographic and anthropometric indices and older adults' quantity and quality of ambulatory activity are uncertain. We examined the relationship between accelerometer-determined steps per day (quantity) and peak 30-min cadence (quality; mean steps per minute recorded for the 30 highest, but not necessarily consecutive, minutes in a day) in community-dwelling older adults relative to sex, age, and body mass index (BMI). Minute-by-minute accelerometer-determined step data for 5.8 ± 0.9 d were available for 100 women and 43 men (58-92 yr, BMI = 26.6 ± 4.2 kg·m). Sex-specific Spearman correlations compared steps per day with peak 30-min cadence and both to age and BMI. Partial correlations were computed controlling for 1) age, 2) BMI, 3) steps per day and age, or 4) steps per day and BMI. Significance was set at P < 0.05. Participants averaged 5605 ± 2588 steps per day with a peak 30-min cadence of 63.6 ± 24.6 steps per minute (mean ± SD). Correlations between these two variables were r = 0.883 (women) and r = 0.820 (men). Steps per day and peak 30-min cadence were significantly correlated with age (r = -0.442 and r = -0.327, respectively) and BMI (r = -0.248 and r = -0.286, respectively) in women. For men, steps per day and peak 30-min cadence were only significantly related to age (r = -0.665 and r = -0.381, respectively). Controlling for steps per day weakened all relationships with peak 30-min cadence to a point of nonsignificance with one exception: the partial correlation of age with peak 30-min cadence was weakened but remained significant (r = 0.335) after controlling for steps per day and BMI in men. The usefulness of peak 30-min cadence beyond steps per day is not apparent, at least in terms of sex, age, and BMI, and needs to be evaluated in larger and more diverse samples and against other parameters of interest, including those more theoretically linked to intensity of effort.

  13. Elder Self-neglect and Abuse and Mortality Risk in a Community-Dwelling Population

    PubMed Central

    Dong, XinQi; Simon, Melissa; de Leon, Carlos Mendes; Fulmer, Terry; Beck, Todd; Hebert, Liesi; Dyer, Carmel; Paveza, Gregory; Evans, Denis

    2010-01-01

    Context Both elder self-neglect and abuse have become increasingly prominent public health issues. The association of either elder self-neglect or abuse with mortality remains unclear. Objective To examine the relationship of elder self-neglect or abuse reported to social services agencies with all-cause mortality among a community-dwelling elderly population. Design, Setting, and Participants Prospective, population-based cohort study (conducted from 1993 to 2005) of residents living in a geographically defined community of 3 adjacent neighborhoods in Chicago, Illinois, who were participating in the Chicago Health and Aging Project (CHAP; a longitudinal, population-based, epidemiological study of residents aged ≥65 years). A subset of these participants had suspected elder self-neglect or abuse reported to social services agencies. Main Outcome Measures Mortality ascertained during follow-up and by use of the National Death Index. Cox proportional hazard models were used to assess independent associations of self-neglect or elder abuse reporting with the risk of all-cause mortality using time-varying covariate analyses. Results Of 9318 CHAP participants, 1544 participants were reported for elder self-neglect and 113 participants were reported for elder abuse from 1993 to 2005. All CHAP participants were followed up for a median of 6.9 years (interquartile range, 7.4 years), during which 4306 deaths occurred. In multivariable analyses, reported elder self-neglect was associated with a significantly increased risk of 1-year mortality (hazard ratio [HR], 5.82; 95% confidence interval [CI], 5.20–6.51). Mortality risk was lower but still elevated after 1 year (HR, 1.88; 95% CI, 1.67–2.14). Reported elder abuse also was associated with significantly increased risk of overall mortality (HR, 1.39; 95% CI, 1.07–1.84). Confirmed elder self-neglect or abuse also was associated with mortality. Increased mortality risks associated with either elder self-neglect or

  14. Cognitive impairment, decline and fluctuations in older community-dwelling subjects with Lewy bodies

    PubMed Central

    Arvanitakis, Z.; Yu, L.; Boyle, P. A.; Leurgans, S. E.; Bennett, D. A.

    2012-01-01

    Lewy bodies are common in the ageing brain and often co-occur with Alzheimer’s disease pathology. There is little known regarding the independent role of Lewy body pathology in cognition impairment, decline and fluctuations in community-dwelling older persons. We examined the contribution of Lewy body pathology to dementia, global cognition, cognitive domains, cognitive decline and fluctuations in 872 autopsied subjects (mean age = 87.9 years) from the Rush Religious Order Study (n = 491) and Memory and Aging Project (n = 381) longitudinal community-based clinical–pathological studies. Dementia was based on a clinical evaluation; annual cognitive performance tests were used to create a measure of global cognition and five cognitive domains. Lewy body type was determined by using α-synuclein immunostained sections of substantia nigra, limbic and neocortical regions. Statistical models included multiple regression models for dementia and cognition and mixed effects models for decline. Cognitive fluctuations were estimated by comparing standard deviations of individual residuals from mean trajectories of decline in those with and without Lewy bodies. All models controlled for age, sex, education, Alzheimer’s disease pathology and infarcts. One hundred and fifty-seven subjects (18%) exhibited Lewy body pathology (76 neocortical-type, 54 limbic-type and 27 nigra-predominant). One hundred and three (66%) subjects with Lewy body pathology had a pathologic diagnosis of Alzheimer’s disease. Neocortical-type, but not nigral-predominant or limbic-type Lewy body pathology was related to an increased odds of dementia (odds ratio = 3.21; 95% confidence interval = 1.78–5.81) and lower cognition (P < 0.001) including episodic memory function (P < 0.001) proximate to death. Neocortical-type Lewy body pathology was also related to a faster decline in global cognition (P < 0.001), decline in all five specific cognitive domains (all P-values < 0.001), and to fluctuations in

  15. Antihypertensive and Statin Medication Use and Motor Function in Community-Dwelling Older Adults

    PubMed Central

    Perlman, Amichai; Shah, Raj C.; Bennett, David A.; Buchman, Aron S.; Matok, Ilan

    2015-01-01

    Objectives To investigate whether the use of antihypertensive and statin medication in very old adults is associated with the level of motor performance. Design Cross sectional study. Settings A community-based study recruited from over 40 residential facilities across the metropolitan Chicago area. Participants Community dwelling very old adults (n=1520; mean age 80.2; SD 7.7). Measurements Eleven motor performances were summarized using a composite motor score. All prescription and over the counter medications taken by participants were inspected and coded using the Medi-Span Data Base System. Demographic characteristics and medical history were obtained via detailed interview and medical exams. Results In multiple linear regression models, antihypertensive medications were associated with global motor score (β=−0.075, S.E. 0.011, p<0.001). Thus, motor function in an individual with antihypertensive medication, was on average, about 7.5% lower than an age, sex and education matched individual without antihypertensive medication. The number of antihypertensive medications which were being used had an additive effect, such that a reduction in the level of motor function was observed with each additional medication, and receiving three or more antihypertensive medications was associated with about a 15% reduction in the level of motor function. The association between antihypertensive medications and motor function was robust, and remained unchanged after adjusting for confounding by indication using several potentially confounding variables: smoking, hypertension, diabetes, stroke, congestive heart-failure, myocardial infarction, and intermittent claudication (β=−0.05, S.E. 0.015, p=0.001). In contrast, the use of statin medications was not related to motor function (unadjusted: β=0.003, S.E.=0.015, p=0.826; fully adjusted: β=0.018, S.E. 0.014, p=0.216). Conclusion The use of antihypertensive medications is associated with a lower level of motor function in

  16. Association of Dynapenia, Sarcopenia, and Cognitive Impairment Among Community-Dwelling Older Taiwanese.

    PubMed

    Huang, Chung-Yu; Hwang, An-Chun; Liu, Li-Kuo; Lee, Wei-Ju; Chen, Liang-Yu; Peng, Li-Ning; Lin, Ming-Hsien; Chen, Liang-Kung

    2016-02-01

    A decline in physical and/or cognitive function is a common feature of aging, and frailty has been shown to be associated with cognitive impairment and dementia. This study aimed to evaluate the association between dynapenia, sarcopenia, and cognitive impairment among community-dwelling older people in Taiwan. Data from the I-Lan Longitudinal Aging Study (ILAS) were retrieved for study. Global cognitive function was assessed by Mini-Mental State Examination (MMSE), whereas the Chinese Version Verbal Learning Test, Boston Naming Test, Verbal Fluency Test, Taylor Complex Figure Test, Digits Backward Test, and Clock Drawing Test were used to assess different domains of cognitive function. Association between sarcopenia and global cognitive function as well as all different dimensions of cognitive function were evaluated. Data from 731 elderly participants (mean age 73.4 ± 5.4 years, 53.8% males) were used for study analysis. The overall prevalence of sarcopenia was 6.8%, which was significantly higher in men (9.3% versus 4.1%, p < 0.05). The mean MMSE score was 23.4 ± 4.4 for all participants, and 10.3% of the study participants were cognitively impaired. Sarcopenia was not significantly associated with global cognitive function (odds ratio [OR] = 1.55, p = 0.317), but global cognitive impairment was significantly associated with low physical performance (OR = 2.31, p = 0.003) and low muscle strength (OR = 2.59, p = 0.011). Nonetheless, sarcopenia was significantly associated with impairment in the verbal fluency test (OR = 3.96, p = 0.006) after adjustment for potential confounders. Dynapenia was significantly associated with cognitive impairment in multiple dimensions and global cognitive function, but sarcopenia was only associated with an impaired verbal fluency test. Reduced muscle strength and/or physical performance related to non-muscle etiology were strongly associated with cognitive impairment. More longitudinal

  17. Companion confidence in the balance of community-dwelling older adults: implications for physical activity promotion.

    PubMed

    Cavanaugh, James T; Dunfey, Julia C; Wyand, Megan K

    2014-01-01

    Positive social relationships may increase the intention of older adults to be physically active. In the presence of balance impairments, however, the potential influence of a familiar companion on an older adult's physical activity is not well understood. The purpose of this preliminary investigation was to explore companion confidence in the balance capability of an older adult as a potential determinant of older adult physical activity. The study employed a cross-sectional design, in which 40 dyads formed by a community-dwelling older adult and his or her close companion (eg, family member, friend, and caregiver) were recruited as a sample of convenience. Older adults completed the Activities-Specific Balance Confidence (ABC) scale and the Physical Activity Survey for the Elderly (PASE). Companions completed a modified version of the ABC scale, in which they were asked to rate their confidence in the older adult's balance. The agreement between and correspondence of paired ABC scores were analyzed using mean difference (95% confidence interval [CI]), dependent samples t test (α = 0.05), and the intraclass correlation coefficient 1-way random effects model. The Pearson product-moment correlation coefficient was used to characterize the relationship between companion confidence and older adult physical activity. Older adults were more confident in their balance capability (mean ABCOlder Adult = 70.0; 95% CI = 62.8-77.2) than their companions (mean ABCCompanion = 60.2; 95% CI = 50.6-69.8). The difference between group mean scores was significant (mean difference = 9.8; 95% CI = 2.3-17.3, t (39) = 2.38; P = 0.02). Discordance increased as the mean of paired ABC scores diminished. ABC scores were also significantly yet moderately associated (intraclass correlation coefficient (1,1) = 0.56; 95% CI = 0.31-0.74; P < 0.01). The association between ABCCompanion and PASE scores was stronger (r = 0.51; 95% CI = 0.23-0.79; P < 0.01) than the association between ABCOlder

  18. Companion Confidence in the Balance of Community-Dwelling Older Adults: Implications for Physical Activity Promotion.

    PubMed

    Cavanaugh, James T; Dunfey, Julia C; Wyand, Megan K

    2013-12-20

    Positive social relationships may increase the intention of older adults to be physically active. In the presence of balance impairments, however, the potential influence of a familiar companion on an older adult's physical activity is not well understood. The purpose of this preliminary investigation was to explore companion confidence in the balance capability of an older adult as a potential determinant of older adult physical activity. The study employed a cross-sectional design, in which 40 dyads formed by a community-dwelling older adult and his or her close companion (eg, family member, friend, and caregiver) were recruited as a sample of convenience. Older adults completed the Activities-Specific Balance Confidence (ABC) scale and the Physical Activity Survey for the Elderly (PASE). Companions completed a modified version of the ABC scale, in which they were asked to rate their confidence in the older adult's balance. The agreement between and correspondence of paired ABC scores were analyzed using mean difference (95% confidence interval [CI]), dependent samples t test (α= 0.05), and the intraclass correlation coefficient 1-way random effects model. The Pearson product-moment correlation coefficient was used to characterize the relationship between companion confidence and older adult physical activity. Older adults were more confident in their balance capability (mean ABCOlder Adult= 70.0; 95% CI = 62.8-77.2) than their companions (mean ABCCompanion= 60.2; 95% CI = 50.6-69.8). The difference between group mean scores was significant (mean difference = 9.8; 95% CI = 2.3-17.3, t (39) = 2.38; P= 0.02). Discordance increased as the mean of paired ABC scores diminished. ABC scores were also significantly yet moderately associated (intraclass correlation coefficient (1,1) = 0.56; 95% CI = 0.31-0.74; P< 0.01). The association between ABCCompanion and PASE scores was stronger (r= 0.51; 95% CI = 0.23-0.79; P< 0.01) than the association between ABCOlder Adult and

  19. Hip fracture prevention with a multifactorial educational program in elderly community-dwelling Finnish women.

    PubMed

    Pekkarinen, T; Löyttyniemi, E; Välimäki, M

    2013-12-01

    Guidelines suggest identification of women at fracture risk by bone density measurement and subsequently pharmacotherapy. However, most women who sustain a hip fracture do not have osteoporosis in terms of bone density. The present non-pharmacological intervention among elderly women unselected for osteoporosis reduced hip fracture risk by 55 % providing an alternative approach to fracture prevention. Hip fractures are expensive for society and cause disability for those who sustain them. We studied whether a multifactorial non-pharmacological prevention program reduces hip fracture risk in elderly women. A controlled trial concerning 60- to 70-year-old community-dwelling Finnish women was undertaken. A random sample was drawn from the Population Information System and assigned into the intervention group (IG) and control group (CG). Of the 2,547 women who were invited to the IG, 1,004 (39 %) and of the 2,120 invited to the CG, 1,174 (55 %) participated. The IG participated in a fracture prevention program for 1 week at a rehabilitation center followed by review days twice. The CG received no intervention. During the 10-year follow-up, both groups participated in survey questionnaire by mail. Outcome of interest was occurrence of hip fractures and changes in bone-health-related lifestyle. During the follow-up, 12 (1.2 %) women in the IG and 29 (2.5 %) in the CG sustained a hip fracture (P = 0.039). The determinants of hip fractures by stepwise logistic regression were baseline smoking (odds ratio (OR) 4.32 (95 % confidence interval [CI] 2.14-8.71), age OR 1.15/year (95 % CI 1.03-1.28), fall history OR 2.7 (95 % CI 1.24-5.9), stroke history OR 2.99 (95 % CI 1.19-7.54) and participating in this program OR 0.45 (95 % CI 0.22-0.93). Starting vitamin D and calcium supplement use was more common in the IG compared with the CG. The results suggest that this non-pharmacological fracture prevention program may reduce the risk of hip fractures in elderly

  20. 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