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Sample records for community-dwelling elderly japanese

  1. 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.

  2. 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

  3. [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.

  4. 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.

  5. 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.

  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. 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.

  8. 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

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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

  19. 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.

  20. The Interaction Between β-3 Adrenergic Receptor and Peroxisome Proliferator-Activated Receptor Gamma Gene Polymorphism to Periodontal Disease in Community-Dwelling Elderly Japanese.

    PubMed

    Yoshihara, Akihiro; Sugita, Noriko; Iwasaki, Masanori; Wang, Yanming; Miyazaki, Hideo; Yoshie, Hiromasa; Nakamura, Kazutoshi

    2015-08-01

    It has been hypothesized that β-3 adrenergic receptor and peroxisome proliferator-activated receptor gamma (PPARγ) might have gene-environmental and gene-gene interactions in periodontal disease. The purpose of this study is to elucidate the interaction between β-3 adrenergic receptor and PPARγ gene polymorphism with periodontal disease. Three hundred thirty-two postmenopausal females were enrolled, and their serum high-sensitivity C-reactive protein (hsCRP) and hemoglobin A1c (HbA1c) were examined. β-3 adrenergic receptor and PPARγ genotypes were then determined. An oral examination was performed. The number of remaining teeth was counted, and the probing depth (PD) and clinical attachment level (CAL) were measured. Prevalence-rate ratios (PRRs) were calculated by multiple Poisson regression analyses to evaluate the relationship among periodontal disease markers, such as the number of sites with CAL 4 to 5 or ≥6 mm or PD 4 to 5 or ≥6 mm, and β-3 adrenergic receptor polymorphisms, PPARγ polymorphisms, and the interaction term adjusted by age, hsCRP, and HbA1c, after converting the number of remaining teeth (n) to an offset variable. In the participants with body mass index (BMI) ≥25, PRRs of β-3 adrenergic receptor genotype (Trp/Arg and Arg/Arg) for periodontal disease markers were 0.13 to 0.70 (P <0.0001 to 0.74), those of PPARγ genotype (Pro/Pro) were 0.66 to 3.14 (P = 0.01 to 0.68), and those of the interaction term for the two genotypes were 1.69 to 12.61 (P <0.0001 to 0.33). However, in the participants with BMI <25, a constant tendency was not observed. The results confirmed a positive relationship between the interaction term for β-3 adrenergic receptor genotype and PPARγ genotype and various periodontal markers in obese elderly females.

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. [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.

  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. [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.

  11. 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.

  12. 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

  13. Assessment of mental competency in community-dwelling elderly.

    PubMed

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

    1999-01-01

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

  14. 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

  15. 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.

  16. 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

  17. 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.

  18. 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

  19. Predictors of self-neglect in community-dwelling elders.

    PubMed

    Abrams, Robert C; Lachs, Mark; McAvay, Gail; Keohane, Denis J; Bruce, Martha L

    2002-10-01

    The study assessed the contribution of depressive symptoms and cognitive impairment to the prediction of self-neglect in elderly persons living in the community. Data were drawn from the New Haven Established Populations for Epidemiologic Studies of the Elderly cohort, which included 2,812 community residents age 65 years and older in 1982. The principal outcome examined was the incidence of self-neglect, corroborated by the state's investigation, during 9 years of follow-up (1982-1991). Among the 2,161 subjects included in the analysis, 92 corroborated cases of self-neglect occurred from 1982 to 1991. The prevalence of clinically significant depressive symptoms at baseline (score > or=16 on the Center for Epidemiologic Studies Depression Scale [CES-D]) was 15.4%, and the prevalence of clinically significant cognitive impairment (four or more errors on the Pfeiffer Short Portable Mental Status Questionnaire) was 7.5%. Subjects with clinically significant depressive symptoms and/or cognitive impairment were more likely than others to experience self-neglect. Clinically significant depressive symptoms and cognitive impairment remained significant predictors of self-neglect in a multivariate model that included age, gender, race, and income. A final model for self-neglect constructed with stepwise selection of risk factors included depressive symptoms and cognitive impairment, as well as male gender, older age, income less than $5,000 per year, living alone, history of hip fracture, and history of stroke. Elderly individuals living in the community who experience clinically significant depressive symptoms and/or cognitive impairment may be at risk for the development of self-neglect and may become candidates for intervention.

  20. 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.

  1. 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.

  2. [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

  3. 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.

  4. 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

  5. [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.

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. 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.

  11. [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.

  12. 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

  13. 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 .

  14. 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.

  15. 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.

  16. 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.

  17. 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…

  18. 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…

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. 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

  6. 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

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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

  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. 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.

  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. 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.

  17. [Functional changes in one-year and related factors among community-dwelling frail elderly].

    PubMed

    Kono, A; Kanagawa, K

    2000-06-01

    The purpose of this study was to investigate physical and psychosocial characteristics together with life activities related to functional changes among frail elderly, including J-rank individuals able to walk outdoors and take a bus as well as people of A-rank capable of moving around inside the house but incapable of going outside. The study design was of longitudinal type. Participants were community-dwelling frail elderly, 61 J-rank and 90 A-rank individuals aged over 65-years and caregivers. Nurses conducted home interviews as Wajima City, Ishikawa Prefecture in Japan, in 1998 at the baseline and 1999 at follow-up, and evaluated the degree of independence of the frail elderly. With the baseline survey, physical function, psychosocial characteristics, and life activities were assessed. At the follow-up survey, 3.3% people of J-rank elderly had died and 83.6% were at home. Among the A-rank elderly, 11.1% had died and 80.6% were at home. Functional change in one-year was as follows: 31.4% people of J-rank had declined and 68.6% remained the same. 19.4% people of A-rank improved, 65.3% unchanged, and 15.3% declined. Among J-rank elderly, functional decline was significantly related to low ADL level and less verbal contact with their caregivers. Life activities such as getting out to the garden or around the house, worshipping at a temple, doing house chores, shopping, and gardening, related to maintained function. Among A-rank elderly with the low ADL, function similarity declined. Life activities such as visiting friends, gardening, and performing self-care chores were significantly linked to improvement. The results suggest that the degree of independence of frail elderly may easily change. ADL is related to functional change among frail elderly of both A and J rank. It is recommended that facilitating activities like house chores or getting out the house for J-rank individuals and self-care for A-rank elderly is important to prevent functional decline

  18. 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

  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. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  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. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. [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.

  13. [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.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. 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

  2. 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.

  3. Determinants of Living Situation in a Population of Community-Dwelling and Assisted-Living Dwelling Elders

    PubMed Central

    Avery, Erika; Kleppinger, Alison; Feinn, Richard; Kenny, Anne M

    2010-01-01

    Objective To determine what variables separate community-dwelling elders from assisted-living dwelling elders. Design Cross-sectional Setting Community and assisted living facilities in Connecticut Participants 114 individuals (77 community-dwelling, 37 assisted living) Assessments Nutritional survey, 6 minute walk, Mini-Mental Status Exam (MMSE), Center of Epidemiologic Studies (CES)-Depression Scale, 25-OH vitamin D Results At baseline, assisted-living dwelling elders appeared to have lower serum 25-OH vitamin D levels, lower MMSE scores, higher CES-depression scale scores, and walked shorter distances in the six minute walk. Serum 25-OH vitamin D levels and six minute walk were significantly different between the two groups using logistic regression analysis. As serum 25-OH vitamin D levels increased, the probability of an elder living in an ALF decreased, and as distance walked during the six minute walk increased, the probability of an elder living in an ALF decreased. Conclusions Elders living in assisted living facilities had significantly lower 25-OH vitamin D levels and walked shorter distances during the six minute walk. These variables can be used to predict the probability of an elder living in an assisted living facility. The lack of effect of nutrition suggests that the role of vitamin D in this setting is in physical function. PMID:20142070

  4. [Consequence and risk factors of falls-related injuries in community-dwelling elderly in Beijing].

    PubMed

    Zhou, Bai-Yu; Shi, Jing; Yu, Pu-Lin

    2013-08-01

    To investigate the incidence of falls during the past year,as well as the consequence of falls so as to explore the risk factors for fall-related injuries in the community-dwelling elderly in Beijing. A cross-sectional study was conducted in a community in Beijing. A total of 1512 persons aged 60 years and over were selected using stratified cluster sampling method. Information related to all kinds of falls was collected with a standardized structured questionnaire through face-to-face interview. Binary logistic regression was used to explore the related factors for consequence of any falls, especially falls-related injuries in the elderly. 272 older adults had one falling episode at the baseline study, with the incidence rate of fall and the frequency of falls as 18.0% (272/1512) and 379 times respectively. Among the 1512 interviewees, 8.7% (131) suffered from injuries as a result of falls. Out of the total 379 times of falls, 143 resulted in injuries. Most common injuries appeared to be soft tissue related (84 times, 58.7%) and epidermal abrasion (57 times, 39.9%), followed by fracture (20 times, 14.0%) and open wound (9 times, 6.3%). The most common injured areas were lower limbs (67 times, 46.9%), followed by upper limbs (39 times, 27.3%), head (27 times, 18.9%), face (19 times, 13.3%), hip (11 times,2.9%), waist/abdomen (10 times, 2.6%), chest (6 times, 1.6%) ,vertebral column (5 times, 1.3%) and neck (3 times, 0.8%). Data from logistic regression analysis showed that being female (OR = 2.09), with proper bench height (OR = 1.94), being alcoholic (OR = 3.10), being able to walk more than 400 meters (OR = 2.11), fear of falls (OR = 3.30) etc. were risk factors, while enough handrails provided in surrounding areas (OR = 0.41) showed as the protective factor for falls-related injuries in the elderly. The incidence rates of falls and falls-related injuries among elderly community-dwellers in urban areas of Beijing were considered to be high. Falls and its related

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

    PubMed Central

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

    2015-01-01

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

  6. 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

  7. 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

  8. [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.

  9. 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

  10. 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

  11. Prevalence of falls among community-dwelling elderly and its associated factors: A cross-sectional study in Perak, Malaysia.

    PubMed

    Yeong, U Y; Tan, S Y; Yap, J F; Choo, W Y

    2016-01-01

    Fall is a major cause of injuries and can increase the risk of early mortality among elderly. The objective of this study was to determine the prevalence of falls among community-dwelling elderly in rural Malaysia and its associated factors. Data were obtained from a cross-sectional survey in five randomly selected districts in the state of Perak, Malaysia. A total of 250 households were randomly selected. A total of 811 individuals aged 60 years or more were recruited and interviewed using a structured questionnaire. Information about socio-demographic, history of falls in the past 1 year, medical history, drug history and physical activity level were enquired. The prevalence of falls in the past 1 year among community-dwelling elderly was reported to be 4.07%. Indigenous elderly (Adjusted odd ratio, AOR = 6.06, 95% CI = 1.10-33.55, p = 0.039) and living alone (AOR = 2.60, 95% CI = 1.04-6.50, p = 0.042) were shown to be factors associated with falls. Physical activity level, number of co-morbidities and number of medications used were not associated with falls. Elderly of indigenous ethnicity and living alone are the main factors associated with falls in this population. Indigenous people may be at higher risk, which warrant further investigation with a larger sample to improve the precision of estimates.

  12. Changes in drug prescribing to Italian community-dwelling elderly people: the EPIFARM-Elderly Project 2000-2010.

    PubMed

    Franchi, Carlotta; Tettamanti, Mauro; Pasina, Luca; Djignefa, Codjo Djade; Fortino, Ida; Bortolotti, Angela; Merlino, Luca; Nobili, Alessandro

    2014-04-01

    To investigate the changes in the last decade (2000-2010) in drug prescribing among community-dwelling elderly people aged 65-94 years, in relation to age and sex. We analyzed the data of nearly two million subjects ranging in age from 65 to 94 years recorded in the Drug Administrative Database of the Lombardy Region (Italy) from 2000 to 2010. Associations between drug use (at least one drug, one chronic drug, polypharmacy or chronic polypharmacy) and age, sex, and year of prescription were analyzed by logistic regression analysis. We also analyzed differences in changes linked to sex and age. Between 2000 and 2010, the prescriptions of at least one drug or one chronic drug increased by 2 % (from 88.0 to 90.3 %; p < 0.0001) and 8 % (from 73.8 to 82.0 %; p < 0.0001), respectively, while the mean number of packages/person/year rose from 34.6 [standard deviation (SD) 32.4] to 48.5 (SD 42.2). During this same period, there was a 10 % increase in the prevalence of elderly people exposed to polypharmacy (≥5 different active substances) (from 42.8 to 52.7 %; p < 0.0001), and the prevalence of those exposed to chronic polypharmacy (≥5 different chronic drugs) doubled (from 14.9 to 28.5 %; p < 0.0001). Males were less frequently treated than females, except for chronic polypharmacy. People aged ≥80 years showed the largest increase in all prescribing patterns. Drug consumption in ATC groups A, H, and N (women) and in B and C (men) increased most, with the greatest absolute differences occurring in the consumption of proton pump inhibitors (31.1 %), platelet aggregation inhibitors (30.1 %), and statins (23.8 %). Prescriptions to community-dwelling elderly people have increased substantially during the last 10 years. Although this might indicate an improvement in care, the large increase in the number of elderly people exposed to polypharmacy and chronic polypharmacy should be carefully analyzed in terms of quality of care, patient safety, and costs.

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

    PubMed Central

    2012-01-01

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

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

    PubMed

    Castrejón-Pérez, Roberto Carlos; Borges-Yáñez, S Aída; Gutiérrez-Robledo, Luis M; Avila-Funes, J Alberto

    2012-09-12

    Oral health is an important component of general well-being for the elderly. Oral health-related problems include loss of teeth, nonfunctional removable dental prostheses, lesions of the oral mucosa, periodontitis, and root caries. They affect food selection, speaking ability, mastication, social relations, and quality of life. Frailty is a geriatric syndrome that confers vulnerability to negative health-related outcomes. The association between oral health and frailty has not been explored thoroughly. This study sought to identify associations between the presence of some oral health conditions, and frailty status among Mexican community-dwelling elderly. Analysis of baseline data of the Mexican Study of Nutritional and Psychosocial Markers of Frailty, a cohort study carried out in a representative sample of people aged 70 and older residing in one district of Mexico City. Frailty was defined as the presence of three or more of the following five components: weight loss, exhaustion, slowness, weakness, and low physical activity. Oral health variables included self-perception of oral health compared with others of the same age; utilization of dental services during the last year, number of teeth, dental condition (edentate, partially edentate, or completely dentate), utilization and functionality of removable partial or complete dentures, severe periodontitis, self-reported chewing problems and xerostomia. Covariates included were gender, age, years of education, cognitive performance, smoking status, recent falls, hospitalization, number of drugs, and comorbidity. The association between frailty and dental variables was determined performing a multivariate logistic regression analysis. Final models were adjusted by socio-demographic and health factors Of the 838 participants examined, 699 had the information needed to establish the criteria for diagnosis of frailty. Those who had a higher probability of being frail included women (OR = 1.9), those who reported

  15. 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

  16. Depression and elder abuse and neglect among a community-dwelling Chinese elderly population.

    PubMed

    Dong, XinQi; Simon, Melissa A; Odwazny, Richard; Gorbien, Martin

    2008-01-01

    Our recent survey of an elderly cohort in mainland China suggests that elder abuse and neglect are common. Unfortunately, there is minimal knowledge about the risk factors for elder abuse and neglect among this population. We aimed to examine depression as a risk factor for elder abuse and neglect among Chinese elderly. A cross-sectional study was performed in a major urban medical center in NanJing, China. Depression was assessed using the Geriatric Depression Scale and direct questions were asked regarding abuse and neglect experienced by the elderly since the age of 60; 412 patients completed the survey. The mean age of the participants was 70 and 34% were female. Depression was found in 12% of the participants and elder abuse and neglect was found in 35% of the participants. After multiple logistical regression, feeling of dissatisfaction with life (OR, 2.92; 95% CI, 1.51-5.68, p < 0.001), often being bored (OR, 2.91; CI, 1.53-5.55, p < 0.001), often feeling helpless (OR, 2.79; CI, 1.35-5.76, p < 0.001), and feeling worthless (OR, 2.16; CI, 1.10-4.22, p < 0.001) were associated with increased risk of elder abuse and neglect. Multiple logistic regression modeling showed that depression is independently associated with elder abuse and neglect (OR, 3.26; CI, 1.49-7.10, p < 0.003). These findings suggest that depression is a significant risk factor associated with elder abuse and neglect among Chinese elderly.

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

    PubMed

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

    2015-01-01

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

  18. [Utility of color-changeable chewing gum to evaluate masticatory ability in community-dwelling elderly persons].

    PubMed

    Tanimoto, Yoshimi; Watanabe, Misuzu; Kono, Rei; Hirota, Chika; Takasaki, Kyosuke; Kono, Koichi

    2009-06-01

    The masticatory ability of community-dwelling elderly persons is often evaluated using subjective questionnaires. However, an objective evaluation would clearly be beneficial so that problems can be adequately addressed. The purpose of this study was to determine the utility of color-changeable chewing gum to evaluate masticatory ability in community-dwelling elderly persons. We analyzed the reliability of the chewing gum for assessment of masticatory ability in 5 individuals who were examined on 5 occasions at 2 hour intervals. We also analyzed the validity of color-change of the chewing gum for assessment of masticatory ability by means of a four-part examination of 210 community-dwelling elderly persons. The four parts were as follows: evaluation of masticatory ability with the gum, determination of the number of residual teeth, measurement of maximum bite force, and a questionnaire in which participants were asked to assess their own masticatory ability. Color changes in the gum after chewing were measured with a color-reader and quantified with the a* color space defined by the Commission Internationale de l'Eclairage. A higher a* value indicates a higher degree of mastication. With respect to reliability, the coefficient of variation for the a* of the color-changeable chewing gum was 2.15-3.75%. There were no significant a* value differences between men and women in any age group. Decrease with age was significantly only in women. With respect to validity, the a* value of the color-changeable chewing gum had a significant positive correlation with the number of residual teeth and maximum bite force in both men and women. In addition, men and women who reported good masticatory ability in response to the questionnaire had significantly high a* values. We found the use of color-changeable chewing gum to be a highly reliable and valid method for evaluating masticatory ability. Our results indicate that this method could be useful for monitoring masticatory

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

    PubMed Central

    2014-01-01

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

  20. Correlation between manual muscle strength and interleukin-6 (IL-6) plasma levels in elderly community-dwelling women.

    PubMed

    Pereira, Leani Souza Máximo; Narciso, Fabrícia Mendes Silva; Oliveira, Daniela Matos Garcia; Coelho, Fernanda Matos; Souza, Danielle da Glória de; Dias, Rosângela Corrêa

    2009-01-01

    Sarcopenia is a loss of muscle mass related to aging and leads to muscle performance decline. An increase in inflammatory mediator levels, especially of IL-6, has been associated to reduced muscle strength in the elderly. The aim of the present cross-sectional study was to correlate IL-6 plasma levels with manual muscle strength (MMS) in 63 community-dwelling elderly women. (71.2+/-7.4years). IL-6 was measured using enzyme-linked immunosorbent assay (ELISA) and MMS was measured using the JAMAR dynamometer. Pearson's test was used to explore the relationship between the outcomes at the significance level of alpha=0.05. IL-6 levels (2.56+/-3.44pg/ml) and MMS (22.86+/-4.62kgf) exhibited an inverse correlation (r=-0.2673 and p=0.0373). The increase in IL-6 plasma levels possibly contributed toward the reduction in manual muscle strength among the elderly women studied.

  1. Physical Function Decline and the Risk of Elder Self-neglect in a Community-Dwelling Population

    PubMed Central

    Dong, XinQi; Simon, Melissa; Fulmer, Terry; Mendes de Leon, Carlos F.; 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 primary predictor was objectively assessed physical function using decline in physical performance testing. Secondary predictors were assessed using the decline in self-reported Katz, Nagi, and Rosow–Breslau scales. Outcome of interest was elder self-neglect. Logistic and linear regression models were used to assess these associations. Results: After adjusting for confounding factors, every 1-point decline in physical performance testing was associated with increased risk of reported elder self-neglect (odds ratio [OR], 1.05, confidence interval [CI], 1.03–1.07, p < .001). Decline in Katz (OR, 1.05, CI, 1.00–1.10, p < .05) and decline in Rosow–Breslau (OR, 1.19, CI, 1.11–1.27, p < .001) were associated with increased risk of reported elder self-neglect. Decline in physical performance testing (standardized parameter estimate [PE]: 0.19, SE: 0.06, p = .002), Katz (PE: 0.65, SE: 0.14, p < .001), Nagi (PE: 0.48, SE: 0.14, p < .001), and Rosow–Breslau (PE: 0.57, SE: 0.21, p = .006) scales were associated with increased risk of greater self-neglect severity. Implications: Decline in physical function was associated with increased risk of reported elder self-neglect and greater self-neglect severity in this community-dwelling population. PMID:20019180

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

    PubMed Central

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

    2016-01-01

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

  3. Duplicate use of angiotesin-converting enzyme (ACE) inhibitors in a community-dwelling elderly population in Poland.

    PubMed

    Rajska-Neumann, A; Wieczorowska-Tobis, K; Schulz, M; Breborowicz, A; Grzeskowiak, E; Oreopoulos, D G

    2007-01-01

    In this paper the data on the duplicate use of ACE inhibitors among a community-dwelling elderly population are presented. Using a questionnaire, 1000 subjects were interviewed concerning the use of drugs, 654 females, mean+/-SD age: 72.6+/-6.5 years. They were divided into two groups: Group A (5%) taking at least two ACE inhibitors (n=50) and Group B: those who used either a single ACE inhibitor or no ACE inhibitor (n=950). In Group A, 49 individuals were taking two different ACE inhibitors concomitantly and one was using three. The most commonly used ACE inhibitor was enalapril (29 of 50 subjects). Subjects in Group A consumed significantly more drugs, both of prescription (Rx) and nonprescription (OTC), compared to those in Group B (total means: 8.4+/-2.8 vs. 6.7+/-3.2; p<0.01, Rx means: 6.3+/-2.5 vs. 5.2+/-2.8, p<0.05, OTC means: 2.0+/-1.6 vs. 1.6+/-1.5, p<0.05). Also, they were more likely to have consulted a cardiologist (17/50 vs. 201/950, p<0.05). The duplicate use of ACE inhibitors in 5% of a population of community-dwelling elderly patients seems to be caused by both poor doctor-doctor communication and polypharmacy. This phenomenon could possibly be dangerous especially when potential additive adverse effects are taken into account.

  4. [Structural equation modeling on case management outcomes and factors influencing outcomes in the community-dwelling vulnerable elders].

    PubMed

    Moon, Hyunjung; Lee, In Sook

    2013-12-01

    This study was done to test a structural equation modeling of case management outcomes in order to identify parameters affecting case management outcomes for the community-dwelling vulnerable elders. Data were collected from 309 nurses (case managers) and community-dwelling vulnerable elders (clients) from public health centers. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and covariance structure analysis were performed using SPSS Version 18.0 for Windows and Amos 16.0. The hypothetical model had an acceptable fit: GFI=.97, CFI=.95, RMSEA=.02, SRMR=.05. The factor "case managers' singularity" had the greatest impact on case management outcomes in this model. In addition, the factor "case management practice" influenced case management outcomes; however, client characteristics did not. Case managers' singularity affected case management outcomes directly and indirectly, with case management practice mediating the latter effect. These results suggest that the causal relationship between case management outcomes and factors influencing these outcomes should be clarified through longitudinal research including a variety of client characteristics. In addition, in future studies, analysis of the effects of programs to improve manpower quality and examine the relationships among case management outcomes should be done.

  5. 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.

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

    PubMed

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

    2016-05-25

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

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

    PubMed

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

    2013-06-01

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

  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. Prevalence and correlates of elder mistreatment in a community-dwelling population of U.S. Chinese older adults.

    PubMed

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

    2014-10-01

    This study aimed to examine the prevalence and correlates of elder mistreatment among U.S. Chinese older adults. Data were drawn from the Population-Based Study of ChINese Elderly (PINE) study, a population-based epidemiological survey of 3,159 U.S. Chinese older adults in the Greater Chicago area. The study design was guided by a community-based participatory research approach. This study found a prevalence of 15.0% for elder mistreatment among community-dwelling Chinese older adults. In addition, higher levels of education (r = .16, p< .001), fewer children (r = .1, p< .001), lower health status (r = .11, p< .001), poorer quality of life (r = .05, p< .01), and worsening health over the past year (r = .08, p< .001) were positively correlated with any elder mistreatment. Elder mistreatment is prevalent among U.S. Chinese older adults. The findings point to a pressing need for researchers, community service workers, health care providers, and policy makers to increase efforts on reducing elder mistreatment in U.S. Chinese communities. © The Author(s) 2014.

  10. Near-Falls in Elderly Community-Dwelling Blacks From Two Out-Patient Clinics in Harlem.

    PubMed

    Basler, Geraldine V; O'Connell, Kathleen A; Bundy, Kristen

    Near-falls are a frequent, but not commonly studied, occurrence in the elderly Black population and may be related to prospective falls. The purpose of this paper is to examine the relationship of near-falls to demographic characteristics, use of assistive devices, gait, and physical activity levels in elderly Blacks. Community-dwelling, elderly Black patients aging 65 and older and attending two clinics of the Mount Sinai Hospital in Harlem in New York City were recruited. The number of near-falls during the past year was self-reported using the Elderly Falls Screening Test. The Rapid Assessment of Physical Activity was used to assess aerobic and anaerobic activity levels. Backward stepwise logistic regression was used to identify predictors of near-falls. A total of 120 elderly Black adults took part in the study. Prevalence of occasional or frequent near-falls was 52.5%. In the final trimmed model, time of the 5-m observed walk (OR = 1.41, p = .001) and being male (OR = 3.68, p = .02) were significant predictors of near-fall experiences. Future research needs to be done in elderly Black populations to determine what factors may contribute to men experiencing more near-falls and on the relation between near-falls and falls.

  11. 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

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

    PubMed

    Takai, Itsushi

    2012-01-01

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

  13. 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.

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  16. 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.

  17. [Effects of exercise intervention on exercise behavior in community-dwelling elderly subjects: a randomized controlled trial].

    PubMed

    Inaba, Yasuko; Obuchi, Shuichi; Arai, Takeshi; Shiba, Yoshitaka; Oka, Koichiro; Watanabe, Shuichiro; Kimura, Ken; Nagasawa, Hiroshi

    2013-01-01

    The objective of the present study was to evaluate the long-term effectiveness of an exercise program in modifying the exercise behavior of the community-dwelling elderly subjects. This study was a single-blinded randomized controlled trial. The subjects included 52 males and 65 females 65 years of age or over who were randomly assigned to an exercise-intervention group or a health-education group. The stages of change in exercise behavior were evaluated before and one-year after the intervention period. The subjects' physical function (muscle strength, balance, walking speed) and self-efficacy in each domain of the physical function were measured during the intervention period. There were no significant differences in the stages of change before the intervention between the two groups. Significant differences in the stages of change were observed in "relapse" of stages at two points in time between the two groups (p<.01). A logistic regression analysis showed that "progression" of stages was associated with improvements in the timed up and go test (AOR 2.7; 95% CI 1.3-5.8) and sit and reach (AOR 1.14; 95%CI 1.0-1.3), while "relapse" of stages was associated with the group allocation (AOR 4.6; 95%CI 1.1-18.8), self-efficacy in "Walking" (AOR 1.54; 95%CI 1.0-2.3) and "Stair climbing" (AOR 0.68; 95%CI 0.5-0.9) with respect to physical activity during the intervention period. The results suggest that exercise intervention in community-dwelling elderly subjects is effective in preventing "relapse" of exercise behavior over long periods.

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

    PubMed

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

    2015-11-01

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

  19. Leisure-Time Physical Inactivity Associated with Vascular Depression or Apathy in Community-Dwelling Elderly Subjects: The Sefuri Study.

    PubMed

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

    2015-11-01

    Although physical inactivity is a major public health problem, the causative factors for physical inactivity per se are poorly understood. To address this issue, we investigated the relationship between deep white matter lesions (DWMLs) on magnetic resonance imaging, apathy, and physical activities using structural equation modeling (SEM). We examined 317 community-dwelling elderly subjects (137 men and 180 women with a mean age of 64.5 years) without dementia or clinically apparent depression. Physical activity was assessed with a questionnaire consisting of 3 components (leisure-time, work, and sport activities). The mean score from the apathy scale (a visual analogue version of Starkstein's apathy scale) of the Grades 2-3 DWML group was 420 (95% confidence interval [CI] 379-461), which was lower (more apathetic) than the Grade 0 DWML group score of 478 (95% CI 463-492) after adjustment for education as a covariate. SEM showed that the direct paths from DWMLs or education to apathy were significant, and the direct path from apathy to leisure-time activity was highly significant (β = .25, P < .001). The degree of apathetic behavior was negatively associated with sport activity in female subjects and positively associated with TV watching in male subjects. The results of the study show that DWMLs are one of the major factors that cause apathetic behavior and that apathy has significant negative effects on leisure-time physical activity in community-dwelling elderly subjects. Even a minor level of apathy without major depression would have a significant impact on activities of daily living and quality of life. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  20. 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.

  1. 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.

  2. 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

  3. Validation of the Aging Perceptions Questionnaire Short on a sample of community-dwelling Turkish elderly migrants.

    PubMed

    Slotman, Anne; Cramm, Jane M; Nieboer, Anna P

    2017-02-21

    Aging perceptions have been found to be major contributors to health in old age. To quantitatively explore aging perceptions among elderly Turkish migrants, valid and reliable Turkish-language instruments are needed. The objective of the current study was to examine the construct validity and reliability of the Turkish-language version of the seven-dimension Aging Perceptions Questionnaire Short version (APQ-S) in a sample of community-dwelling elderly Turkish migrants in the Netherlands. A questionnaire including the Turkish-language APQ-S was administered to 438 community-dwelling Turkish migrants aged 65-99 years who resided in Rotterdam, the Netherlands. The APQ-S includes 21 items in seven dimensions (timeline chronic and cyclical, consequence positive and negative, control positive and negative, and emotional representations). The questionnaire also contained items measuring well-being, physical and mental health-related quality of life, and number of chronic conditions. The latent factor model of the Turkish APQ-S was found to have an acceptable fit (root mean square error of approximation = .06; standardized root mean square residual = .07; comparative fit index = .90). Each indicator loaded significantly on its corresponding latent factor, and standardized factor loadings > .40 supported the convergent validity of the Turkish APQ-S dimensions. The APQ-S was also found to have acceptable construct validity in terms of its inter-factor structure and its expected associations with various health measures and age, gender, educational level, and marital status. Contrary to expectations, income level was not associated with any APQ-S dimension. With the exception of timeline cyclical (α = .56), each APQ-S dimension had acceptable reliability, with Cronbach's alpha values ranging from .75 (timeline chronic) to .88 (control positive). Most APQ-S dimension scores differed significantly between elderly Turkish migrants and a general population

  4. 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.

  5. Effect of Individual and District-level Socioeconomic Disparities on Cognitive Decline in Community-dwelling Elderly in Seoul.

    PubMed

    Kim, Geon Ha; Lee, Hye Ah; Park, Hyesook; Lee, Dong Young; Jo, Inho; Choi, Seong Hye; Choi, Kyoung Gyu; Jeong, Jee Hyang

    2017-09-01

    This study was to investigate the effects of individual and district-level socioeconomic status (SES) on the development of cognitive impairment among the elderly. A 3-year retrospective observational analysis (2010-2013) was conducted which included 136,217 community-dwelling healthy elderly who participated in the Seoul Dementia Management Project. Cognitive impairment was defined as 1.5 standard deviations below the norms on the Mini-mental status examination. In the individual lower SES group, the cumulative incidence rate (CIR) of cognitive impairment was 8.7% (95% confidence interval [CI], 8.64-8.70), whereas the CIR in the individual higher SES group was 4.1% (95% CI, 4.08-4.10). The CIR for lower district-level SES was 4.7% (95% CI, 4.52-4.86), while that in the higher district-level SES was 4.3% (95% CI, 4.06-4.44). There were no additive or synergistic effects between individual and district-level SES. From this study, the individual SES contributed 1.9 times greater to the development of cognitive impairment than the district-level SES, which suggests that individual SES disparities could be considered as one of the important factors in public health related to cognitive impairment in the elderly. © 2017 The Korean Academy of Medical Sciences.

  6. Prevalence of sarcopenia estimated using a bioelectrical impedance analysis prediction equation in community-dwelling elderly people in Taiwan.

    PubMed

    Chien, Meng-Yueh; Huang, Ta-Yi; Wu, Ying-Tai

    2008-09-01

    To compare a bioelectrical impedance analysis (BIA) prediction equation for estimating skeletal muscle mass (SM) with magnetic resonance imaging (MRI)-measured SM and to investigate the prevalence of sarcopenia in community-dwelling elderly people in Taiwan. Cross-sectional survey. Communities in the district of Zhongzheng, Taipei. Forty-one volunteers (aged 22-90) for BIA equation validation; 302 individuals aged 65 and older and 200 adults aged 18 to 40 for the investigation of the prevalence of sarcopenia. Skeletal muscle mass was estimated using a BIA prediction equation and measured using MRI. No statistical difference between MRI-measured and BIA-derived SM was observed (difference of -0.44 +/- 1.55 kg, P=.08). The prevalence of sarcopenia in was 18.6% in elderly women and 23.6% in elderly men. Estimation of SM using a BIA equation was validated in Taiwanese volunteers. It was confirmed that sarcopenia is an emerging health problem in the aging population in Taiwan.

  7. The temporal relationship of thresholds between muscle activity and ventilation during bicycle ramp exercise in community dwelling elderly males

    PubMed Central

    Sasaki, Kentaro; Kimura, Tsuyoshi; Kojima, Satoshi; Higuchi, Hiroyuki

    2016-01-01

    [Purpose] To compare the appearance time of the ventilatory threshold point and the electromyographic threshold in the activity of the vastus lateralis, rectus femoris, biceps femoris long head and gastrocnemius lateral head muscles during ramp cycling exercise in elderly males. [Subjects and Methods] Eleven community dwelling elderly males participated in this study. Subjects performed exercise testing with an expiratory gas analyzer and surface electromyography to evaluate the tested muscle activities during ramp exercise. [Results] The electromyographic threshold for rectus femoris was not valid because the slope after electromyographic threshold was not significant as compared to that before electromyographic threshold. The slope of the regression line for vastus lateralis was significantly decreased after electromyographic threshold while biceps femoris and gastrocnemius were increased. The electromyographic threshold appearance times for vastus lateralis and gastrocnemius were significantly earlier than ventilatory threshold point. There were no difference in electromyographic threshold appearance times among three muscles. [Conclusion] These results suggest that the increase in the slope of the regression line after electromyographic threshold for vastus lateralis was decreased, possibly indicating to postpone muscular fatigue resulting from the activation of biceps femoris and gastrocnemius as biarticular antagonists. This recruitment pattern might be an elderly-specific strategy. PMID:27942152

  8. Ethics of using assistive technology in the care for community-dwelling elderly people: an overview of the literature.

    PubMed

    Zwijsen, Sandra A; Niemeijer, Alistair R; Hertogh, Cees M P M

    2011-05-01

    This article provides an overview of the international literature on the most important ethical considerations in the field of assistive technology (AT) in the care for community-dwelling elderly people, focused on dementia. A systematic literature review was performed. A total of 46 papers met the inclusion criteria. Three main themes were found. The first theme, personal living environment, involves the subthemes privacy, autonomy and obtrusiveness. The second theme, the outside world, involves the subthemes stigma and human contact. The third theme, the design of AT devices, involves the subthemes individual approach, affordability and safety. The often referred to umbrella term of 'obtrusiveness' is frequently used by many authors in the discussion, while a clear description of the concept is mostly absent. When it comes to AT use in the care for elderly people living at home, ethical debate appears not to be a priority. The little discussion there relies heavily on thick concepts such as autonomy and obtrusiveness which seem to complicate the debate rather than clarify it, because they contain many underlying ambiguous concepts and assumptions. Most encountered ethical objections originate from the view that people are, or should be, independent and self-determinant. It is questionable whether the view is correct and helpful in the debate on AT use in the care for (frail) elderly people. Other ethical approaches that view people as social and reciprocal might be more applicable and shed a different light on the ethical aspects of AT use.

  9. 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.

  10. 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

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

    PubMed

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

    2017-01-01

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

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

    PubMed

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

    2017-01-03

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

  13. Disability and quality of life in community-dwelling elderly cancer survivors: Case-control study in the Korean population.

    PubMed

    Lee, Myung Kyung

    2016-10-01

    Advanced age is a significant risk factor for cancer and functional disabilities increase with age. The purpose of this case-control study of Korean individuals was to determine the effect of cancer and cancer treatment on functional disability and quality of life (QOL). Thus, we compared community-dwelling elderly cancer patients (ECPs) with individuals from the general elderly population (GEP) who never had diagnoses of cancer. We selected 1776 ECP who were at least 65 years-old from the 2008 Korean Community Health Survey data and used propensity score matching to randomly select 1766 individuals from the GEP who closely resembled the ECPs. Functional disability was measured using the Instrumental Activities of Daily Living (IADL) scale, and QOL was measured by the EuroQol Group EQ-5D. ECPs were more dependent in preparation of food, doing laundry, and shopping (IADL scale), and in mobility and usual activities (EQ-5D). Although ECP had more problems with pain, discomfort, anxiety, and depression, they were more independent in self-care and handling of financial responsibilities. ECPs had multiple physical and psychological symptoms that adversely affected functional disability and QOL, but higher functional ability, such as self-care and handling of financial responsibilities. Promotion of self-care by ECPs is pivotal for effective management in community practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. [Methodology and social, demographic, cognitive, and frailty profiles of community-dwelling elderly from seven Brazilian cities: the FIBRA Study].

    PubMed

    Neri, Anita Liberalesso; Yassuda, Mônica Sanches; Araújo, Ludgleydson Fernandes de; Eulálio, Maria do Carmo; Cabral, Benedita Edina; Siqueira, Maria Eliane Catunda de; Santos, Geraldine Alves dos; Moura, José Guilherme de Arruda

    2013-04-01

    A study was designed to identify conditions of frailty in relation to social, demographic, health, cognitive, functional, and psychosocial variables in community-dwelling elderly. The article presents the methodology and preliminary data. A total of 3,478 elderly (65 years and older) were selected from probabilistic samples of seven Brazilian cities chosen by convenience and participated in a data collection session in a community setting. The following characteristics predominated: women (67.7%), married (48%) or widowed (36.4%), living with a son or daughter and family (52.6%), head of family (64.5%), and 1-4 years of schooling (49%); 28.8% were illiterate and 24.8% presented a cognitive deficit; 9.1% were frail, 51.8% pre-frail, and 39.1% non-frail. There were more frail individuals among women, those 80 years or older, the widowed, the illiterate, those who had never attended school, and those with cognitive deficit. In general, the social and demographic data corroborate Brazilian epidemiological studies, while those on frailty, cognitive status, and schooling corroborate the international literature.

  15. 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.

  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. [The spreading of big geriatric centers in the community dwelling elderly: the challenge for the primary health care].

    PubMed

    Wojszel, Beata; Bień, Barbara

    2002-01-01

    As the giants of geriatrics are considered: immobility, instability, incontinence, intellectual impairment, depression, visual and auditory impairment. They have multiple causation, chronic course, no simple cure and make the elderly person dependent on others for care. The paper presents the results of the study on the prevalence of the giants of geriatrics in community dwelling elderly people 75 yers old +. The study design: cross-sectional questionnaire study, survey. Population studied lived in two chosen areas (the urban and the rural one) with the high percentages of the demographic senility. The interviewers were doctors and nurses serving the studied areas. 463 randomly selected elderly people (233 from the rural and 230 from the urban area) took part in the study. The serious locomotive disability (III/IV group according to J. Piotrowski) was observed in 17.1% of the probands (20.4% in the urban and 13.7% in the rural area; the worse locomotive ability was observed in women and in the older age groups.). Falls were reported by 45.1% of the group (more frequently by women and in the rural area--58.3% vs. 31.9% in the city). Visual impairment reported 21.1% of probands in the urban area and above 50% in rural one and auditory impairment respectively 30.8% and 53.9% of them (in both cases positive correlation with the age was noticed). Incontinence of urine was found in 31.7% of cases in the city and in 46% of them in the rural area (more frequently in women) and incontinence of faeces in 6% (without urban/rural differences). The pathologic result of the Geriatric Depression Scale was observed in 49.2% of the elderly (more frequently in women) and of the Cognitive Impairment Test by Katzman in 20.5% (more frequently in women and in the older age groups). Only 18.4% of the studied group of the elderly maintained the community nurse visited their home during the last 12 months (27.8% in the city and 9% in the rural area) and more frequently--34.3%--general

  18. Quality of diet and level of physical performance related to inflammatory markers in community-dwelling frail, elderly people.

    PubMed

    Kim, Do-Yeon; Kim, Chang-O; Lim, Hyunjung

    2017-06-01

    The aim of this study was to assess whether diet quality and functional status were associated with serum levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-α in frail, elderly, community-dwelling individuals. Seventy-eight frail, elderly individuals (age ≥65 y, usual gait speed <0.6 m/s and Mini Nutritional Assessment <24) participated in this cross-sectional study from the National Home Healthcare Services in Gangbuk-gu, Seoul, South Korea. Diet quality was assessed using mean adequacy ratio (MAR) of the diet, which was calculated by averaging the sum of the nutrient adequacy ratios (NAR) for the intakes of energy, protein, and 11 micronutrients. Grip strength was measured as an indicator of muscle strength, and short physical performance battery (SPPB) was measured as an indicator of physical performance. The levels of the inflammatory markers IL-6 and TNF-α were obtained from serum samples. MAR and NAR scores for phosphorus; vitamins A, B1, and B6; and niacin were negatively associated with IL-6 (β = -0.006, -0.004, -0.004, -0.007, -0.004, and -0.005, respectively; P < 0.05). SPPB score, as well as NAR scores for vitamin B6, niacin, and vitamin C, were negatively associated with TNF-α (β = -0.098, -0.006, -0.006, and -0.004, respectively; P < 0.05). MAR of the diet was inversely associated with IL-6 concentration in frail elderly individuals, and higher SPPB score was associated with lower levels of TNF-α. Results from the present study suggest that improving diet quality and physical performance might lower levels of inflammation in this frail, elderly population. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Social Participation and the Prevention of Decline in Effectance among Community-Dwelling Elderly: A Population-Based Cohort Study

    PubMed Central

    Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

    2015-01-01

    Background We examined the association between a decline in effectance and social participation (SP) from the perspective of the number and the type of SP in a prospective cohort study. Methods Included in this analysis were community-dwelling elderly aged ≥65 without dependency on the basic activities of daily living and reporting a perfect baseline effectance score (n = 4,588; mean age 72.8±5.7). SP was categorized into 5 types: neighborhood associations, hobby groups, local event groups, senior citizen clubs, and volunteer groups. Effectance was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Using logistic regression analysis, odds ratio (OR) and a 95% confidence interval (CI) for a decline in effectance were calculated. Age, family, BMI, pensions, medical history, medications, alcohol, smoking, cognitive function, depression, social support, ADL, and IADL were used as covariates. Results During the 3-year follow-up, 17.8% of eligible participants reported a decline in effectance. After adjustment for covariates, participation in various groups was associated with the preservation of effectance for both genders. Regarding the type of SP, among females, participation in neighborhood associations (OR: 0.62, 95%CI: 0.48–0.81), hobby groups (0.58, 0.43–0.77), local event groups (0.63, 0.47–0.86), and volunteer groups (0.53, 0.35–0.82) was inversely associated with a decline in effectance. Among males, the beneficial effect was more likely limited to hobby groups (0.59, 0.43–0.81) and volunteer groups (0.57, 0.39–0.83). Conclusions Our results suggest that participation in a variety of social groups is effective for maintenance of older people’s effectance, while the beneficial effect of each type of SP on effectance is stronger for females than for males. Recommending community-dwelling elderly to participate in social groups appropriate for their gender may be effective for successful aging. PMID:26406326

  20. Prevalence of Mental Disorders and Suicidal Thoughts Among Community-Dwelling Elderly Adults 3 Years After the Niigata-Chuetsu Earthquake

    PubMed Central

    Suzuki, Yuriko; Tsutsumi, Atsuro; Fukasawa, Maiko; Honma, Hiroko; Someya, Toshiyuki; Kim, Yoshiharu

    2011-01-01

    Background Japan is located in an area prone to natural disasters, and major earthquakes have occurred recently in rural areas where the proportion of elderly adults is high. Although elderly persons are vulnerable members of communities at a time of disaster, the prevalence of mental disorders among this population has yet to be reported in Japan. This study aimed to determine the prevalence of mental disorders and suicidal thoughts among community-dwelling elderly persons 3 years after an earthquake and to identify risk factors associated with their quality of life (QOL). Methods Face-to-face interviews were conducted with 496 community-dwelling persons aged 65 years or older in areas of Japan where 2 major earthquakes had occurred during a 3-year period. The main outcome was diagnosis of a mental disorder or suicidality. Results During the 3-year period after the earthquake, 1.6% of men and 5.5% of women had received a diagnosis of major depression. There were no cases of posttraumatic stress disorder. Women were more likely than men to report suicidality (7.8% vs 3.8%, P = 0.075). Conclusions The prevalence of mental disorders was lower than that reported in previous studies. Despite the low prevalence of mental disorders, the percentage of community-dwelling elderly persons with subclinical mental health symptoms was high. The results indicate that appropriate public health and medical interventions are warranted after a natural disaster. PMID:21325733

  1. Computer-adaptive balance testing improves discrimination between community-dwelling elderly fallers and nonfallers.

    PubMed

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

    2014-07-01

    To build an item response theory-based computer adaptive test (CAT) for balance from 3 traditional, fixed-form balance measures: Berg Balance Scale (BBS), Performance-Oriented Mobility Assessment (POMA), and dynamic gait index (DGI); and to examine whether the CAT's psychometric performance exceeded that of individual measures. Secondary analysis combining 2 existing datasets. Community based. Community-dwelling older adults (N=187) who were aged ≥65 years (mean age, 75.2±6.8y, 69% women). Not applicable. The BBS, POMA, and DGI items were compiled into an initial 38-item bank. The Rasch partial credit model was used for final item bank calibration. CAT simulations were conducted to identify the ideal CAT. CAT score accuracy, reliability, floor and ceiling effects, and validity were examined. Floor and ceiling effects and validity of the CAT and individual measures were compared. A 23-item bank met model expectations. A 10-item CAT was selected, showing a very strong association with full item bank scores (r=.97) and good overall reliability (.78). Reliability was better in low- to midbalance ranges as a result of better item targeting to balance ability when compared with the highest balance ranges. No floor effect was noted. The CAT ceiling effect (11.2%) was significantly lower than the POMA (40.1%) and DGI (40.3%) ceiling effects (P<.001 per comparison). The CAT outperformed individual measures, being the only test to discriminate between fallers and nonfallers (P=.007), and being the strongest predictor of self-reported function. The balance CAT showed excellent accuracy, good overall reliability, and excellent validity compared with individual measures, being the only measure to discriminate between fallers and nonfallers. Prospective examination, particularly in low-functioning older adults and clinical populations with balance deficits, is recommended. Development of an improved CAT based on an expanded item bank containing higher difficulty items is also

  2. 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.

  3. Prevalence and Predictors of Depression in Community-Dwelling Elderly in Rural Haryana, India

    PubMed Central

    Pilania, Manju; Bairwa, Mohan; Khurana, Hitesh; Kumar, Neelam

    2017-01-01

    Background: Depression in the elderly has been emerged as a serious public health challenge in the developing countries. Elderly population with depression is on rise in India, but is not adequately addressed. This study was planned to ascertain the prevalence of depression among elderly in a rural population of Haryana and assess its socio-demographic correlates. Methods: This study was a community based, cross sectional study, which was conducted in Community Health Centre (CHC), Chiri of Rohtak district (Haryana, India). Of total 124 Anganwadi centres in study area, 10 were randomly selected. A total 500 elderly persons aged 60 years and above were randomly screened for depression. Long form of Geriatric Depression Scale (GDS- 30) was used with cut off score at 22. The Pearson’s Chi-squared test, student’s t test, and multiple logistic regression were used to assess the association of depression in the elderly with its risk factors. Result: In our study, the prevalence of depression in the elderly was 14.4% (95% CI: 11.6- 17.8). Mean age of study population was 68.5 ± 7.7 years. Depression in the elderly had significant association with female gender [OR=2.7 (95% CI 1.4- 5.0)], not being consulted for major decisions [OR=2.7 (95% CI 1.5- 4.7)], presence of any chronic morbidity [OR=2.4 (95% CI 1.3- 4.5)], spending day without doing any activity, work or hobby [OR=3.8 (2.1- 7.1)], and death of any close relative in the last 1 year [OR=2 (1.1- 3.7)] after adjustment of various factors. Conclusion: Our study revealed that the prevalence of depression in the elderly was 14.4% in a rural community of north India. PMID:28331248

  4. Prevalence and Predictors of Depression in Community-Dwelling Elderly in Rural Haryana, India.

    PubMed

    Pilania, Manju; Bairwa, Mohan; Khurana, Hitesh; Kumar, Neelam

    2017-01-01

    Depression in the elderly has been emerged as a serious public health challenge in the developing countries. Elderly population with depression is on rise in India, but is not adequately addressed. This study was planned to ascertain the prevalence of depression among elderly in a rural population of Haryana and assess its socio-demographic correlates. This study was a community based, cross sectional study, which was conducted in Community Health Centre (CHC), Chiri of Rohtak district (Haryana, India). Of total 124 Anganwadi centres in study area, 10 were randomly selected. A total 500 elderly persons aged 60 years and above were randomly screened for depression. Long form of Geriatric Depression Scale (GDS- 30) was used with cut off score at 22. The Pearson's Chi-squared test, student's t test, and multiple logistic regression were used to assess the association of depression in the elderly with its risk factors. In our study, the prevalence of depression in the elderly was 14.4% (95% CI: 11.6- 17.8). Mean age of study population was 68.5 ± 7.7 years. Depression in the elderly had significant association with female gender [OR=2.7 (95% CI 1.4- 5.0)], not being consulted for major decisions [OR=2.7 (95% CI 1.5- 4.7)], presence of any chronic morbidity [OR=2.4 (95% CI 1.3- 4.5)], spending day without doing any activity, work or hobby [OR=3.8 (2.1- 7.1)], and death of any close relative in the last 1 year [OR=2 (1.1- 3.7)] after adjustment of various factors. Our study revealed that the prevalence of depression in the elderly was 14.4% in a rural community of north India.

  5. Alternative medicine in a sample of 655 community-dwelling elderly.

    PubMed

    Dello Buono, M; Urciuoli, O; Marietta, P; Padoani, W; De Leo, D

    2001-03-01

    Use and satisfaction with herbal/homeopathic remedies, acupuncture and relaxation techniques were examined in an Italian elderly population. Data were collected as part of a survey on an elderly population, conducted in 1996--1997 in the urban centre of Padua, Italy. A total of 1362 elderly received a letter inviting them to participate and to accept the visit of an interviewer at home. Of these, 212 were unable to do so for insurmountable reasons and 666 gave consent to take part in the study with a response rate of 65%. Eleven participants were excluded from the study because cognitively impaired. Among the 655 respondents, overall use of at least one alternative medicine was 29.5%. Herbs/phytotherapeutics (47%) and acupuncture (34%) were the most frequently cited therapies. The use of alternative medical practices seems rather widespread among the elderly population in Padua, especially among females with depressive symptoms, pain and discomfort, but not suffering from chronic somatic disease. A percentage of 3.7% of the sample used exclusively alternative medicines; those subjects seemed to be younger, less likely to be physically ill and to report functional disorders and chronic somatic disease. Alternative medicines seem to have a complementary role for the elderly with self-perceived psychological symptomatology or disorders, particularly of depressive nature. They may constitute an attempt at self-treatment, probably concealing the difficulties encountered by the elderly subjects in seeking specialist advice for these problems.

  6. Lifestyle and Genetic Predictors of Stiffness Index in Community-dwelling Elderly Korean Men and Women.

    PubMed

    Park, Kyung-Ae; Park, Yeon-Hwan; Suh, Min-Hee; Choi-Kwon, Smi

    2015-09-01

    Differing lifestyle, nutritional, and genetic factors may lead to a differing stiffness index (SI) determined by quantitative ultrasound in elderly men and women. The purpose of this study was to determine SI and the gender-specific factors associated with low SI in a Korean elderly cohort. This was a cross-sectional descriptive study identifying the gender-specific factors related to SI in 252 men and women aged 65 years and greater from local senior centers in Seoul, Korea between January and February 2009. The mean SI of elderly men was significantly higher than that of the women's. A multiple regression analysis reveals that age, nutritional status, and physical activity were predictive factors of lower SI in men, whereas age, alcohol consumption, educational level, and genetic polymorphism were predictive factors for elderly women. Low SI was common in both elderly men and women. We found gender differences in factors linked to low SI. In multiple regression analysis, nutritional status and physical activity were more important factors in men, whereas alcohol consumption, educational level, and genetic polymorphism were significant factors predicting low SI in women. Gender-specific modifiable risk factors associated with low SI should be considered when developing osteoporosis prevention programs for the elderly. Copyright © 2015. Published by Elsevier B.V.

  7. Influence of blood pressure profile on frailty phenotype in community-dwelling elders in Brazil - FIBRA study.

    PubMed

    Fattori, A; Santimaria, M R; Alves, R M A; Guariento, M E; Neri, A L

    2013-01-01

    Frailty is a clinical condition associated with pathological aging and biological vulnerability. In the spectrum of events related to frailty, aging of the cardiocirculatory system and abnormalities in arterial blood pressure (BP) partly explain the changes in tissue perfusion and, potentially, the decrease in physiological reserves. This study investigated the relationship between BP levels, systemic arterial hypertension (SAH) and the frailty phenotype by analyzing frailty criteria in a cross-sectional model into the FIBRA network, a populational sample of community-dwelling elders in Southeastern Brazil. Study participants with ≥65 years were selected by probabilistic sampling of residents in the urban area of the municipality of Campinas (n=900). Considering frailty as a whole and the difference between genders, there was a greater proportion of frail or pre-frail individuals among women than men. Analysis of individual frailty criteria showed that weight loss and fatigue were more common among women (18.3% vs. 12.5%, p=0.034 and 22.5% vs. 11.9%, p<0.001, respectively). Comparison of individuals with or without SAH failed to reveal any differences related to frailty criteria. Nevertheless, averages of diastolic blood pressure (DBP) and mean arterial blood pressure values were lower among elderly individuals with reduced grip strength, physical activity and the frailty classification as a whole (OR 0.986, IC 0.975-0.997) (for every 1 mmHg reduction in MBP values, the likelihood of being frail increased 1.4%). Our findings corroborate the relationship between BP values and frailty in the elderly and contribute to an understanding of the pathophysiological mechanisms of the syndrome.

  8. Obstacle-negotiating gait and related physical measurement indicators for the community-dwelling elderly in Japan.

    PubMed

    Sun, Wei; Watanabe, Misuzu; Hirota, Chika; Tanimoto, Yoshimi; Kono, Rei; Takasaki, Kyosuke; Kono, Koichi

    2010-01-01

    The aim of this study is to assess obstacle-negotiating gait (ONG) and explore its related physical factors. Subjects comprised 571 community-dwelling persons (195 men and 376 women) age>or=65 years and without cognitive impairment. ONG, timed up and go (TUG), and stair-climbing were measured and their relations were assessed. Walking ability (usual walking speed=UWS and daily walking steps=DWS), balance deficiency, and musculoskeletal function (handgrip strength and bone health) were examined objectively to explore ONG related physical factors. Logistic regression and general linear model analysis were performed with adjustment for age and body mass index (BMI). Time of ONG was 7.72s in men and 8.93s in women. Logistic regression analysis showed that the fast tertiles of ONG corresponding to the fast levels of TUG and stair-climbing had the highest odds ratio values. General linear model analysis showed that ONG was significantly associated with UWS and balance deficiency (no) in men, and with UWS, handgrip strength, DWS and balance deficiency (no) in women. Overall, ONG was considerably associated with falls screening tools and its determinants were also the main causes of falls. Training in ONG could be an attractive strategy for the prevention of falls among the elderly. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

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

    PubMed Central

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

    2015-01-01

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

  10. Self-neglect in an elderly community-dwelling U.S. Chinese population: findings from the Population Study of Chinese Elderly in Chicago study.

    PubMed

    Dong, XinQi

    2014-12-01

    This study aimed to examine the prevalence of self-neglect and its specific behaviors in an elderly community-dwelling U.S. Chinese population through a population-based cohort study (PINE Study) in the greater Chicago area. Community-dwelling population of older Chinese adults were interviewed from 2011 to 2013 (n = 3,159). The personal and home environment of participants was rated based on prevalence of hoarding behavior, personal hygiene, repairs needed on the home, sanitary condition of the home, and adequacy of utilities. Prevalence estimates were presented according to self-reported quality of life (QOL). It was found that the prevalence of self-neglect was 18.2% for mild self-neglect and 10.9% for moderate to severe self-neglect. Unsanitary conditions (17.0%) was the most prevalent, followed by need for home repair (16.3%), hoarding behavior (14.9%), poor personal hygiene (11.3%), and inadequate utilities (4.2%). The prevalence of elder self-neglect of all severities and of all types was higher in older adults with fair or poor QOL than in those with good or very good QOL. Poorer QOL was significantly associated with greater risk of self-neglect of all severities (mild self-neglect: odds ratio (OR) = 1.93, 95% confidence interval (CI) = 1.26-2.96, P < .001; moderate to severe self-neglect: OR = 3.58, 95% CI = 1.79-7.13, P < .001) and specific personal and environmental hazards. The study's authors conclude that elder self-neglect is prevalent, especially in elderly adults with poorer QOL. Future research is needed to examine risk and protective factors associated with elder self-neglect. © 2014, Copyright the Author Journal compilation © 2014, The American Geriatrics Society.

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

    PubMed Central

    Matsubayashi, Yoshito; Asakawa, Yasuyoshi; Yamaguchi, Haruyasu

    2016-01-01

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

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

    PubMed

    Matsubayashi, Yoshito; Asakawa, Yasuyoshi; Yamaguchi, Haruyasu

    2016-01-01

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

  13. Spatiotemporal gait parameters and recurrent falls in community-dwelling elderly women: a prospective study

    PubMed Central

    Moreira, Bruno S.; Sampaio, Rosana F.; Kirkwood, Renata N.

    2015-01-01

    BACKGROUND: Falling is a common but devastating and costly problem of aging. There is no consensus in the literature on whether the spatial and temporal gait parameters could identify elderly people at risk of recurrent falls. OBJECTIVE: To determine whether spatiotemporal gait parameters could predict recurrent falls in elderly women. METHOD: One hundred and forty-eight elderly women (65-85 years) participated in this study. Seven spatiotemporal gait parameters were collected with the GAITRite(r) system. Falls were recorded prospectively during 12 months through biweekly phone contacts. Elderly women who reported two or more falls throughout the follow-up period were considered as recurrent fallers. Principal component analysis (PCA) and discriminant analysis followed by biplot graph interpretation were applied to the gait parameters. RESULTS: After 12 months, 23 elderly women fell twice or more and comprised the recurrent fallers group and 110 with one or no falls comprised the non-recurrent fallers group. PCA resulted in three components that explained 88.3% of data variance. Discriminant analysis showed that none of the components could significantly discriminate the groups. However, visual inspection of the biplot showed a trend towards group separation in relation to gait velocity and stance time. PC1 represented gait rhythm and showed that recurrent fallers tend to walk with lower velocity and cadence and increased stance time in relation to non-recurrent fallers. CONCLUSIONS: The analyzed spatiotemporal gait parameters failed to predict recurrent falls in this sample. The PCA-biplot technique highlighted important trends or red flags that should be considered when evaluating recurrent falls in elderly females. PMID:25714603

  14. Epidemiological and clinical aspects of urinary tract infection in community-dwelling elderly women.

    PubMed

    Marques, Luiz Paulo José; Flores, Juliana Timóteo; Barros Junior, Onofre de Oliveira; Rodrigues, Giovana Breda; Mourão, Carla de Medeiros; Moreira, Rosa Maria Portella

    2012-01-01

    Urinary tract infections (UTIs) in elderly patients can be a complex problem in terms of approach to diagnosis, treatment, and prevention, because the patients often present nonspecific symptoms. The epidemiological and clinical characteristics of UTI in elderly women were studied, in order to make early diagnosis and prevent serious clinical complications secondary to UTI. This was a prospective population-based study, with elderly women, during their first medical office visit. Medical records were obtained by clinical history and physical examination in order to detect signs and symptoms of UTI and the presence of co-morbidities. Clean-catch midstream urine specimens for urinary dipstick test, sediment, and culture were collected; cervical samples for conventional Pap smears were also collected. UTI was found in 16.55% of elderly women. The most frequent urinary symptom was foul smelling urine, in 60.6%. E. coli was responsible for 98 (76.56%) cases of significant bacteriuria; 34 (34.69%) were resistant to trimethoprim-sulfamethoxazole, and 21 (21.42%) to fluoroquinolones. Asymptomatic bacteriuria (AB) was not treated. The presence of predisposing factors demonstrated that the history of previous UTI (p < 0.001), vaginitis (p < 0.001), and diabetes (p = 0.042) increased the risk for UTI. This study confirmed the high prevalence of UTI among elderly women and its unusual clinical presentation. Diabetes, history of previous UTI, and vaginitis were shown to be predisposing factors for UTI; it is not necessary to treat AB in elderly women, even among diabetics. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

  15. Spatiotemporal gait parameters and recurrent falls in community-dwelling elderly women: a prospective study.

    PubMed

    Moreira, Bruno S; Sampaio, Rosana F; Kirkwood, Renata N

    2015-01-01

    Falling is a common but devastating and costly problem of aging. There is no consensus in the literature on whether the spatial and temporal gait parameters could identify elderly people at risk of recurrent falls. To determine whether spatiotemporal gait parameters could predict recurrent falls in elderly women. One hundred and forty-eight elderly women (65-85 years) participated in this study. Seven spatiotemporal gait parameters were collected with the GAITRite(r) system. Falls were recorded prospectively during 12 months through biweekly phone contacts. Elderly women who reported two or more falls throughout the follow-up period were considered as recurrent fallers. Principal component analysis (PCA) and discriminant analysis followed by biplot graph interpretation were applied to the gait parameters. After 12 months, 23 elderly women fell twice or more and comprised the recurrent fallers group and 110 with one or no falls comprised the non-recurrent fallers group. PCA resulted in three components that explained 88.3% of data variance. Discriminant analysis showed that none of the components could significantly discriminate the groups. However, visual inspection of the biplot showed a trend towards group separation in relation to gait velocity and stance time. PC1 represented gait rhythm and showed that recurrent fallers tend to walk with lower velocity and cadence and increased stance time in relation to non-recurrent fallers. The analyzed spatiotemporal gait parameters failed to predict recurrent falls in this sample. The PCA-biplot technique highlighted important trends or red flags that should be considered when evaluating recurrent falls in elderly females.

  16. Relationship of dietary intake and lifestyle factors to health-related quality of life in the community-dwelling elderly.

    PubMed

    Mori, Keiko; Kawano, Yukari; Tada, Yuki; Hida, Azumi; Nagasawa, Nobue; Inoue, Kumiko; Kamioka, Hiroharu; Inoue, Koichi; Ozeki, Tomoko

    2010-01-01

    Quality of life (QOL) encompasses a broad notion of health and is increasingly used to evaluate the effectiveness of health care services. The purpose of this cross-sectional study was to assess health-related quality of life (HR-QOL) in the community-dwelling elderly (mean age, 72.7±0.3 y; female 46.4%, n=179) in Japan and to explore diminished factors. We assessed HR-QOL by the 36-Item Short-Form Health Survey (SF-36), maximum walking speed, step counts, Tokyo Metropolitan Institute of Gerontology (TMIG) index, dietary intake and blood biochemistry. Two summary scores of the SF-36 were calculated (physical component score: PCS, mental component score: MCS). We divided participants into two groups based on the standard values of PCS and MCS classified by age (high and low group), which was further stratified into a high PCS and high MCS (BH) group and a low PCS and low MCS (BL) group. Mean maximum walking speed and daily step counts were 207.7±2.8 cm/s and 7,008±289. Eighty-one percent of the participants had full scores in the TMIG index. Daily intake of energy and protein were 2,081±33 kcal and 74.5±0.9 g. The maximum walking speed, TMIG index, alcohol consumption and chewing ability were significantly higher in the BH group than those in the BL group, but not dietary intake. Stepwise logistic regression analysis indicated that maintaining maximum walking speed might be associated with sustaining HR-QOL in the healthy elderly.

  17. Impact of patient education on influenza vaccine uptake among community-dwelling elderly: a randomized controlled trial.

    PubMed

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

    2017-10-01

    This randomized controlled trial aimed to test the effectiveness of brief face-to-face patient education in increasing influenza vaccination rate among elderly in the community. Recruitment and intervention were conducted at two general outpatient clinics in Hong Kong. 529 eligible patients were randomly assigned to intervention or control group with 1:1 allocation ratio. Patients in the intervention group received 3-min one-on-one verbal education by medical students and a pamphlet regarding influenza vaccination. Neither verbal health education nor pamphlet was given to the control group. Intention-to-treat analysis showed significantly higher vaccination rate in the intervention group compared with the control group (33.6 versus 25.0%) and the adjusted relative risk was 1.34 (95% CI 1.04-1.72; P = 0.021). Hence, brief face-to-face patient education was effective in increasing influenza vaccine uptake rate of community-dwelling elderly patients. Participants who were undecided whether to receive vaccination seemed to demonstrate larger beneficial effect (RR = 7.84; 95% CI 1.06-57.76) compared with patients who were certain of either receiving (RR = 1.16; 95% CI 0.90-1.48) or not receiving (RR = 2.18; 95% CI 0.68-6.99) the vaccine. The study also revealed that patients' intention for vaccination may not translate into action, reasons for which should be explored in future research. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  18. Risk factors of functional disability among community-dwelling elderly people by household in Japan: a prospective cohort study.

    PubMed

    Saito, Emiko; Ueki, Shouzoh; Yasuda, Nobufumi; Yamazaki, Sachiko; Yasumura, Seiji

    2014-08-26

    Although the number of elderly people needing care is increasing rapidly in the home setting in Japan, family size and ability to provide such support are declining. The purpose of this study was to identify the risk factors of functional disability by household composition among community-dwelling elderly people. A total of 1347 elderly people aged 70 years and over participated in a baseline geriatric health examination for this prospective cohort study. In the health examination, we conducted an interview survey using a questionnaire in July 2004 and July 2005. Questionnaire items covered the following: age, sex, household, medical history, instrumental activities of daily living, intellectual activity, social role, Motor Fitness Scale, falls experienced during the past year, Dietary Variety Score, frequency of going outdoors, cognitive impairment, and depressive status. We defined the occurrence of functional disability as certification for long-term care needs of the subjects. The certification process started with a home visit for an initial assessment to evaluate nursing care needs using a questionnaire on current physical and mental status. The onset of functional disability was followed from July 2004 to March 2011. Cox proportional hazard regression analysis was used to estimate the risk factors related to the onset of functional disability, adjusted for age and sex. Of the 1084 participants, 433 were male (39.9%), and the average age was 77.8 (standard deviation, 5.4). Up to March 2011, functional disabilities occurred in 226 participants (20.9%). Elderly people living only with their children demonstrated a significantly higher risk for functional disability than the three-generation household group (hazard ratio, 1.61; 95% confidence interval, 1.08-2.40). The risk factors for functional disability varied according to household group. In Japan, the number of vulnerable households with elderly people in need of care has increased steadily over the years

  19. Risk factors of functional disability among community-dwelling elderly people by household in Japan: a prospective cohort study

    PubMed Central

    2014-01-01

    Background Although the number of elderly people needing care is increasing rapidly in the home setting in Japan, family size and ability to provide such support are declining. The purpose of this study was to identify the risk factors of functional disability by household composition among community-dwelling elderly people. Methods A total of 1347 elderly people aged 70 years and over participated in a baseline geriatric health examination for this prospective cohort study. In the health examination, we conducted an interview survey using a questionnaire in July 2004 and July 2005. Questionnaire items covered the following: age, sex, household, medical history, instrumental activities of daily living, intellectual activity, social role, Motor Fitness Scale, falls experienced during the past year, Dietary Variety Score, frequency of going outdoors, cognitive impairment, and depressive status. We defined the occurrence of functional disability as certification for long-term care needs of the subjects. The certification process started with a home visit for an initial assessment to evaluate nursing care needs using a questionnaire on current physical and mental status. The onset of functional disability was followed from July 2004 to March 2011. Cox proportional hazard regression analysis was used to estimate the risk factors related to the onset of functional disability, adjusted for age and sex. Results Of the 1084 participants, 433 were male (39.9%), and the average age was 77.8 (standard deviation, 5.4). Up to March 2011, functional disabilities occurred in 226 participants (20.9%). Elderly people living only with their children demonstrated a significantly higher risk for functional disability than the three-generation household group (hazard ratio, 1.61; 95% confidence interval, 1.08–2.40). The risk factors for functional disability varied according to household group. Conclusions In Japan, the number of vulnerable households with elderly people in need of

  20. The prevalence and related factors of restless leg syndrome in the community dwelling elderly; in Kayseri, Turkey: A cross-sectional study.

    PubMed

    Safak, Elif Deniz; Gocer, Semsinur; Mucuk, Salime; Ozturk, Ahmet; Akin, Sibel; Arguvanli, Sibel; Mazicioglu, Mumtaz M

    2016-01-01

    The aim of this study is to determine the prevalence and related factors of restless leg syndrome (RLS) in the community-dwelling elderly living in Kayseri. This is a cross-sectional population based study in 960 community-dwelling elderly living in an urban area. We sampled 1/100 of elderly people aged 60 years and older. The diagnosis of RLS was made according to the criteria of the International RLS Study Group. The demographic data were collected by face-to-face interviews. Additionally, the Mini-Mental State Examination, Geriatric Depression Scale and anthropometric measurements were used. Logistic regression analyses were performed to define risk factors for RLS. We excluded elderly people with cognitive impairment (295). One hundred and five (15.8%) of the remaining 665 elderly subjects met the criteria to diagnose RLS. There was female predominance (3/1). Gender, length of education, employment status, smoking, hypertension, diabetes mellitus, depressive mood, high body mass index, and high waist circumferences, sleep quality, sleep duration, and difficulty in falling asleep in the first 30min were all detected as risk factors for RLS. However in logistic regression analysis, being a housewife, sleeping less than 6h a day and having diabetes was found as significantly related risk factors for RLS. This is the first epidemiologic study of RLS conducted in the Turkish community-dwelling elderly in an urban area. RLS is a common but underestimated disease in the elderly. Although RLS is prevalent we found very few risk factors for RLS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Nutritional Status in Community-Dwelling Elderly in France in Urban and Rural Areas

    PubMed Central

    Torres, Marion J.; Dorigny, Béatrice; Kuhn, Mirjam; Berr, Claudine; Barberger-Gateau, Pascale; Letenneur, Luc

    2014-01-01

    Malnutrition is a frequent condition in elderly people, especially in nursing homes and geriatric wards. Its frequency is less well known among elderly living at home. The objective of this study was to describe the nutritional status evaluated by the Mini Nutritional Assessment (MNA) of elderly community-dwellers living in rural and urban areas in France and to investigate its associated factors. Methods Subjects aged 65 years and over from the Approche Multidisciplinaire Intégrée (AMI) cohort (692 subjects living in a rural area) and the Three-City (3C) cohort (8,691 subjects living in three large urban zones) were included. A proxy version of the MNA was reconstructed using available data from the AMI cohort. Sensitivity and specificity were used to evaluate the agreement between the proxy version and the standard version in AMI. The proxy MNA was computed in both cohorts to evaluate the frequency of poor nutritional status. Factors associated with this state were investigated in each cohort separately. Results In the rural sample, 38.0% were females and the mean age was 75.5 years. In the urban sample, 60.3% were females and the mean age was 74.1 years. Among subjects in living in the rural sample, 7.4% were in poor nutritional status while the proportion was 18.5% in the urban sample. Female gender, older age, being widowed, a low educational level, low income, low body mass index, being demented, having a depressive symptomatology, a loss of autonomy and an intake of more than 3 drugs appeared to be independently associated with poor nutritional status. Conclusion Poor nutritional status was commonly observed among elderly people living at home in both rural and urban areas. The associated factors should be further considered for targeting particularly vulnerable individuals. PMID:25133755

  2. Nutritional status in community-dwelling elderly in France in urban and rural areas.

    PubMed

    Torres, Marion J; Dorigny, Béatrice; Kuhn, Mirjam; Berr, Claudine; Barberger-Gateau, Pascale; Letenneur, Luc

    2014-01-01

    Malnutrition is a frequent condition in elderly people, especially in nursing homes and geriatric wards. Its frequency is less well known among elderly living at home. The objective of this study was to describe the nutritional status evaluated by the Mini Nutritional Assessment (MNA) of elderly community-dwellers living in rural and urban areas in France and to investigate its associated factors. Subjects aged 65 years and over from the Approche Multidisciplinaire Intégrée (AMI) cohort (692 subjects living in a rural area) and the Three-City (3C) cohort (8,691 subjects living in three large urban zones) were included. A proxy version of the MNA was reconstructed using available data from the AMI cohort. Sensitivity and specificity were used to evaluate the agreement between the proxy version and the standard version in AMI. The proxy MNA was computed in both cohorts to evaluate the frequency of poor nutritional status. Factors associated with this state were investigated in each cohort separately. In the rural sample, 38.0% were females and the mean age was 75.5 years. In the urban sample, 60.3% were females and the mean age was 74.1 years. Among subjects in living in the rural sample, 7.4% were in poor nutritional status while the proportion was 18.5% in the urban sample. Female gender, older age, being widowed, a low educational level, low income, low body mass index, being demented, having a depressive symptomatology, a loss of autonomy and an intake of more than 3 drugs appeared to be independently associated with poor nutritional status. Poor nutritional status was commonly observed among elderly people living at home in both rural and urban areas. The associated factors should be further considered for targeting particularly vulnerable individuals.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2016-06-01

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

  5. Cognitive impairment associated with locomotive syndrome in community-dwelling elderly women in Japan.

    PubMed

    Nakamura, Misa; Tazaki, Fumie; Nomura, Kazuki; Takano, Taeko; Hashimoto, Masashi; Hashizume, Hiroshi; Kamei, Ichiro

    2017-01-01

    In our worldwide aging society, elderly people should maintain cognitive and physical function to help avoid health problems. Dementia is a major brain disease among elderly people, and is caused by cognitive impairment. The locomotive syndrome (LS) refers to a condition in which people require healthcare services because of problems associated with locomotion. The purpose of this study was to determine the association between cognitive impairment and LS. Study participants were 142 healthy elderly female volunteers living in a rural area in Japan. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). A score of ≤26 points on the MMSE was used to indicate categorically defined poor cognitive performance (cognitive impairment). The LS was defined by a score ≥16 points, and non-LS as <16 points, on the 25-question Geriatric Locomotive Function Scale (GLFS-25). Twenty-one participants (14.8%) had an MMSE score ≤26, and 19.0% were found to have LS. Compared with the MMSE >26 group, the ≤26 group was significantly older, had a higher percentage of body fat, and a higher GLFS-25 score. Those with LS were significantly older, had a higher body mass index, a higher percentage of body fat, and a lower MMSE score. Participants in the LS group had higher odds of cognitive impairment than those without LS [odds ratio (OR) =3.08] by logistic regression analysis adjusted for age. Furthermore, participants with GLFS-25 scores ≥6 had higher odds of cognitive impairment than those with a GLFS-25 score <6 by logistic regression analysis adjusted for both age (OR =4.44), and age and percent body fat (OR =4.12). These findings suggest that a strong relationship exists between the early stage of decreased motor function and cognitive impairment.

  6. Sagittal plane spinal mobility is associated with dynamic balance ability of community-dwelling elderly people

    PubMed Central

    Takeuchi, Yahiko

    2017-01-01

    [Purpose] The purpose of this study was to clarify the correlation between the range of spinal mobility on the sagittal plane and the dynamic balance ability of elderly people living in communities. [Subjects and Methods] The persons studied were 31 healthy elderly people living in the community (16 females and 15 males). The range of mobility of the participants’ spines in the sagittal plane was measured by using a spinal mouse®. Balance ability was evaluated by using Functional reach (FR), Timed up and go (TUG), and Maximum walking speed (MWS). [Results] A significant positive correlation between the flexion range of the lumbar vertebrae and the FR distance was identified, and a significant negative correlation between the extension range of the thoracic vertebrae and the time required for TUG was also identified. In addition, a significant positive correlation between the extension range of the entire spine and MWS, was identified. [Conclusion] The result of this study have clarified that mobility of the spine in the sagittal plane is associated with dynamic balance ability, which is related to falling. PMID:28210054

  7. Repatriation is associated with isthmus cingulate cortex reduction in community-dwelling elderly.

    PubMed

    Calati, Raffaella; Maller, Jerome J; Meslin, Chantal; Lopez-Castroman, Jorge; Ritchie, Karen; Courtet, Philippe; Artero, Sylvaine

    2016-12-15

    The impact of stressful life events (SLEs) on brain anatomy is poorly understood, particularly its long-term neural consequences. We tested the hypothesis that a serious SLE (repatriation of French citizens living in Algeria in 1962) is associated with changes in brain regions previously implicated in psychopathology (hippocampus, amygdala, corpus callosum, prefrontal cortex, anterior, posterior and isthmus cingulate cortex (ICC)) in a large elderly population. Structural magnetic resonance imaging was used to acquire anatomical scans from 82 subjects repatriated from Algeria and 339 subjects without this experience or any other trauma. We derived quantitative regional estimates of subcortical volume using FreeSurfer Software. The General Linear Model was used to test the association between repatriation and changes in brain volume adjusted for confounders (gender, age, education, total brain volume, traumatic brain injury, Mini Mental State Examination score at baseline, current and lifetime major depression and recent SLEs). Repatriation to France was associated with reduced volume in a number of areas; however, only left and right ICC survived to false discovery rate correction. In the elderly a previous (approximately 40 years before) serious SLE could be associated with long-term volume reduction in the ICC, independently of psychopathology.

  8. Cognitive Decline, Body Mass Index, and Waist Circumference in Community-Dwelling Elderly Participants.

    PubMed

    Rodríguez-Fernández, Jorge Mario; Danies, Emily; Martínez-Ortega, José; Chen, William C

    2017-03-01

    The aim of this study was to explore the association of body mass index (BMI), waist circumference (WC), and BMI and WC changes over time with cognitive decline in a nationally representative sample. A total of 5239 participants (≥65 years) were followed for 3 years as part of the National Health and Aging Trends Study. Cox proportional hazard regression was applied to model the risk of cognitive decline. BMI, after adjusting for WC and main confounders, was associated with reduced risk of cognitive decline (hazard ratio [HR] 0.97 for each unit BMI increase, 0.95-0.99). After stratifying by gender and age, this effect remained significant among females and young elders ≤80 years. A BMI decrease and WC increase >10% over the study period were associated with increased risk of cognitive decline (HR 1.98, 1.16-3.38; HR 1.30, 1.04-1.62, respectively). In the elderly individuals, lean mass, as measured by BMI adjusted for WC, was associated with reduced risk of cognitive decline. Loss of lean mass and gain of fat mass, as measured by WC adjusted for BMI, were associated with elevated risk of cognitive decline.

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

    PubMed Central

    Dong, XinQi

    2014-01-01

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

  10. Lower sex hormone levels are associated with more chronic musculoskeletal pain in community-dwelling elderly women.

    PubMed

    de Kruijf, Marjolein; Stolk, Lisette; Zillikens, M Carola; de Rijke, Yolanda B; Bierma-Zeinstra, Sita M A; Hofman, Albert; Huygen, Frank J P M; Uitterlinden, Andre G; van Meurs, Joyce B J

    2016-07-01

    Chronic pain is more prevalent in women than in men, with increasing differences between sexes in advanced age. This could be caused by differences in sex hormone levels. We therefore studied the relationship between sex hormones and the prevalence and incidence of chronic pain. The association between sex hormone levels and chronic pain was examined in 9717 participants aged 45 years and older from the Rotterdam Study, a population-based study. Chronic pain was defined as pain in the lower back, hands, knees and/or hips for at least 3 months. Sex hormone levels included estrogen, testosterone, androstenedione, and 17-hydroxyprogesterone. Relationships between hormones and prevalent and new onset chronic pain were analyzed using linear and logistic regression, stratified by gender. Women with androstenedione or estradiol levels in the lowest tertile had more chronic pain (odds ratio, 1.20; 95% CI, 1.03-1.39 and odds ratio, 1.27; 95% CI, 1.10-1.48, respectively). Mean estradiol levels were lower among men with chronic pain (mean difference -3.88 pmol/L; P = 0.005). Lowest tertile 17-hydroxyprogesterone in women was associated with 38% more new onset pain. All these associations were independent from age, body mass index, health and lifestyle factors, and osteoarthritis. Lower sex hormone levels are associated with chronic musculoskeletal pain, independent from lifestyle and health-related factors, in community-dwelling elderly women. These results suggest that sex hormones play a role in chronic pain and should be taken into account when a patient presents with chronic pain. Therefore, sex hormones may be a potential treatment target for these patients.

  11. Sharp Turning and Corner Turning: Comparison of Energy Expenditure, Gait Parameters, and Level of Fatigue among Community-Dwelling Elderly

    PubMed Central

    Sulaiman, Affeenddie; Razi, Shahir

    2014-01-01

    This study compares energy expenditure (EE), gait parameters (GP), and level of fatigue (LOF) between 5-minute walking with sharp turning (ST) and corner turning (CT). Data were obtained from 29 community-dwelling elderly (mean age, 62.7 ± 3.54 years). For 5 minutes, in ST task, participants walked on a 3-meter pathway with 2 cones placed at each end (180° turning), while in CT task, participants walked on a 6-meter pathway with 4 cones placed at 4 corners (90° turning). The physiological cost index, pedometer, and 10-point Modified Borg Dyspnoea Scale were used to measure EE (beats/min), GP (no of steps), and LOF, respectively. Data were analyzed by using independent t-tests. EE during ST (0.62 ± 0.21 beats/min) was significantly higher than CT (0.48 ± 0.17 beats/min) (P < 0.05). GP (434 ± 92.93 steps) and LOF (1.40 ± 1.11) in ST were found to be lower compared to GP (463 ± 92.18 steps) and LOF (1.54 ± 1.34) in CT (All, P > 0.05). Higher EE in ST could be due to the difficulty in changing to a 180° direction, which may involve agility and different turning strategies (step-turn or pivot-turn) to adjust the posture carefully. In CT, participants could choose a step-turn strategy to change to a 90° direction, which was less challenging to postural control. PMID:24977154

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2017-01-01

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

  14. After adjusting for bias in meta-analysis seasonal influenza vaccine remains effective in community-dwelling elderly.

    PubMed

    Darvishian, Maryam; Gefenaite, Giedre; Turner, Rebecca M; Pechlivanoglou, Petros; Van der Hoek, Wim; Van den Heuvel, Edwin R; Hak, Eelko

    2014-07-01

    To compare the performance of the bias-adjusted meta-analysis to the conventional meta-analysis assessing seasonal influenza vaccine effectiveness among community-dwelling elderly aged 60 years and older. Systematic literature search revealed 14 cohort studies that met inclusion and exclusion criteria. Laboratory-confirmed influenza, influenza-like illness, hospitalization from influenza and/or pneumonia, and all-cause mortality were study outcomes. Potential biases were identified using bias checklists. The magnitude and uncertainty of biases were assessed by expert opinion. Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using random effects model. After incorporating biases, overall effect estimates regressed slightly toward no effect, with the largest relative difference between conventional and bias-adjusted ORs for laboratory-confirmed influenza (OR, 0.18; 95% CI: 0.01, 3.00 vs. OR, 0.23; 95% CI: 0.03, 2.04). In most of the studies, CIs widened reflecting uncertainties about the biases. The between-study heterogeneity reduced considerably with the largest reduction for all-cause mortality (I(2) = 4%, P = 0.39 vs. I(2) = 91%, P < 0.01). This case study showed that after addressing potential biases influenza vaccine was still estimated effective in preventing hospitalization from influenza and/or pneumonia and all-cause mortality. Increasing the number of assessors and incorporating empirical evidence might improve the new bias-adjustment method. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2017-02-01

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

  16. Strength training reduces circulating interleukin-6 but not brain-derived neurotrophic factor in community-dwelling elderly individuals.

    PubMed

    Forti, Louis Nuvagah; Njemini, Rose; Beyer, Ingo; Eelbode, Elke; Meeusen, Romain; Mets, Tony; Bautmans, Ivan

    2014-01-01

    Ageing is associated with a chronic low-grade inflammatory profile (CLIP). Physical exercise could circumvent the deleterious effects of CLIP by influencing circulating inflammatory mediators and neurotrophic growth factors. This study aimed at assessing whether 12 weeks of progressive strength training (PST) influences circulating brain-derived neurotrophic factor (BDNF), interleukin (IL)-6 and IL-10 in elderly individuals. Forty community-dwelling persons aged 62-72 years participated. Twenty participants were assigned to 12-week PST (70-80 % of maximal strength, three times per week). Matched control individuals (n = 20) maintained daily activity levels. Serum was collected for BDNF, IL-6 and IL-10 assay from all participants before and after 12 weeks (for PST subjects 24-48 h after the last training). In PST, muscle strength was significantly improved (+49 % for leg extension, p = 0.039), and basal IL-6 levels significantly reduced (p = 0.001), which remained unchanged in control (p = 0.117). No significant change in BDNF was observed in PST subjects (p = 0.147) or control (p = 0.563). IL-10 was below the detection limit in most subjects. Gender and health status did not influence the results. Our results show that after 12-week PST, muscle performance improved significantly, and basal levels of IL-6 were significantly decreased in older subjects. However, serum BDNF was not altered. The lack of an observable change in BDNF might be due to a short-lived BDNF response, occurring acutely following exercise, which might have been washed out when sampling. Furthermore, blood levels of BDNF may not reflect parallel increases that occur locally in the brain and muscle. These hypotheses need confirmation by further studies.

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

    PubMed

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

    2013-04-01

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

  18. COMPUTER-ADAPTIVE BALANCE TESTING IMPROVES DISCRIMINATION BETWEEN COMMUNITY-DWELLING ELDERLY FALLERS AND NON-FALLERS

    PubMed Central

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

    2014-01-01

    Objective To build an item response theory based computer-adaptive balance test (CAT) from three traditional, fixed-form balance measures: Berg Balance Scale (BBS), Performance-Oriented Mobility Assessment (POMA), and Dynamic Gait Index (DGI); and examine whether CAT psychometric performance exceeded that of individual measures. Design Secondary analysis combining two existing datasets. Setting Community-based. Participants 187 community-dwelling older adults, 65 years or older, mean age 75.2±6.8 years, 69% female. Interventions Not applicable. Main Outcome Measure(s) BBS, POMA, and DGI items were compiled into an initial 38-item bank. Rasch Partial Credit Model was used for final item bank calibration. CAT simulations were conducted to identify the ideal CAT. CAT score accuracy, reliability, floor and ceiling effects, and validity were examined. Floor and ceiling effects and validity of CAT and individual measures were compared. Results A 23-item bank met model expectations. A 10-item CAT was selected, showing very strong association with full item bank scores (r=0.97), and good overall reliability (0.78). Reliability was better in low- to mid-balance ranges due to better item targeting to balance ability, compared with highest balance ranges. No floor effect was noted. CAT ceiling effect (11.2%) was significantly lower than POMA (40.1%) and DGI (40.3%) ceiling effects (p<0.0001 per comparison). The CAT outperformed individual measures, being the only test to discriminate between fallers and non-fallers (p=0.0068), and strongest predictor of self-reported function. Conclusions The balance CAT showed excellent accuracy, good overall reliability, and excellent validity compared with individual measures, being the only measure to discriminate between fallers and non-fallers. Prospective examination, particularly in low- functioning elderly and clinical populations with balance deficits, is recommended. Development of an improved CAT based on an expanded item bank

  19. Risk factors and prevalence of periodontitis in community-dwelling elders in Mexico.

    PubMed

    Borges-Yáñez, S Aída; Irigoyen-Camacho, María Esther; Maupomé, Gerardo

    2006-03-01

    The objective of this study was to determine whether an association existed between chronic systemic diseases/conditions, risk factors common in old age, and the extent and severity of chronic periodontal disease. Sociodemographic and lifestyle characteristics were examined by contrasting rural, urban-marginal, and urban social environments in Central Mexico. Data were analysed with Analysis of Variance, chi2 tests, and multivariable logistic regression. A total of 473 adults 60 years old and over were interviewed; 315 were also examined and underwent laboratory assays (participation rate, 66%); women, 62%; mean age 73+/-8 years; 23% edentulous. The distribution of periodontitis by sociodemographic variables showed differences across locales (73% low-urban, 57% middle-urban, 29% rural). The regression model indicated that periodontitis was more frequently associated with low-urban locale, higher systolic blood pressure, higher body mass index, and worse calculus readings, with an interaction whereby being obese and having a high calculus index was associated with a high probability of having periodontitis. Overall periodontal conditions were fair. While we identified oral, systemic, and social variables that modulated the experience of periodontitis, it would appear that urban, low social class elders appeared to have worse periodontal conditions.

  20. Japanese elderly persons walk faster than non-Asian elderly persons: a meta-regression analysis

    PubMed Central

    Ando, Masataka; Kamide, Naoto

    2015-01-01

    [Purpose] The purpose of this study was to clarify ethnic differences in walking speed by comparing walking speed in both Japanese and non-Asian elderly individuals and to investigate the necessity of consideration of ethnic differences in walking speed. [Subjects and Methods] Articles that reported comfortable walking speeds for community-dwelling elderly individuals were identified from electronic databases. Articles that involved community-dwelling individuals who were 60 years old or older and well functioning were included in the study. Articles that involved Asians were excluded. Weighted means for 5-m walking times were calculated as walking speeds from the Japanese and non-Asian sample data. The effects of age, gender, and ethnicity on 5-m walking times were then investigated using meta-regression analysis. [Results] Twenty studies (34 groups) were included for Japanese, and 16 studies (28 groups) were included for non-Asians. The weighted mean 5-m walking time was estimated to be 4.15 sec (95% confidence interval [CI]: 3.87–4.44) for Japanese and 4.24 sec (95% CI: 4.09–4.40) for non-Asians. Furthermore, using meta-regression analysis adjusted for age and gender, the 5-m walking time was 0.40 sec faster (95% CI: 0.03–0.77) for Japanese than for non-Asian elderly individuals. [Conclusion] Walking speed appeared faster for Japanese community-dwelling elderly individuals than for non-Asian elderly individuals. PMID:26696722

  1. Depression, antidepressants, and falls among community-dwelling elderly people: the MOBILIZE Boston study.

    PubMed

    Quach, Lien; Yang, Frances M; Berry, Sarah D; Newton, Elizabeth; Jones, Richard N; Burr, Jeffrey A; Lipsitz, Lewis A

    2013-12-01

    The mechanisms linking falls and depression are still unknown. The aim of the study is to examine the association between depression and antidepressants, with indoor and outdoor falls, and to investigate how antidepressants mediate this relationship. The study included 763 men and women aged 70 and older with baseline measures for depression and antidepressant use are captured with prospective data on falls from the "Maintenance of Balance, Independent Living, Intellect and Zest in the Elderly" (MOBILIZE) Boston study, which is a population-based longitudinal study (from 2005 to 2009). Overall, the rate of falls was 26 falls/100 person-years. Seventeen percent of participants had clinically significant depressive symptoms (CSDS), and 12% used antidepressants. CSDS increased the risk of indoor and outdoor falls (incidence rate ratio [IRR] = 1.6, 95% confidence interval [CI] = 1.2-2.3, p < .01; IRR = 1.6, 95% CI = 1.2-2.2, p < .01). Antidepressant use increased the risk of outdoor falls by 70% and partially mediated the association between CSDS and outdoor falls (IRR = 1.7, 95% CI = 1.2-2.5, p < .05). There was no relationship between antidepressant use and indoor falls. Similar results were observed when depression was considered as a continuous variable. Depression increased the risk of indoor and outdoor falls. Antidepressant use among older adults with CSDS increased the risk of outdoor, but not indoor falls. Clinicians should carefully consider the role of antidepressants among older adults with CSDS and their potential increase for the risk of outdoor falls.

  2. Evaluation of chewing ability and its relationship with activities of daily living, depression, cognitive status and food intake in the community-dwelling elderly.

    PubMed

    Kimura, Yumi; Ogawa, Hiroshi; Yoshihara, Akihiro; Yamaga, Takayuki; Takiguchi, Tomoya; Wada, Taizo; Sakamoto, Ryota; Ishimoto, Yasuko; Fukutomi, Eriko; Chen, Wenling; Fujisawa, Michiko; Okumiya, Kiyohito; Otsuka, Kuniaki; Miyazaki, Hideo; Matsubayashi, Kozo

    2013-07-01

    The aim of this study was to assess chewing ability using color-changeable chewing gum and to show the association between chewing ability and geriatric functions, as well as dietary status in the community-dwelling elderly. The study population consisted of 269 community-dwelling elderly aged ≥ 75 living in Tosa, Japan. Assessment of chewing ability was carried out by a dentist using color-changeable chewing gum. Activities of daily living (ADL), depression and subjective quality of life (QOL) were assessed by questionnaire. Cognitive status was assessed by; Mini-Mental State Examination (MMSE), Hasegawa Dementia Scale-Revised (HDS-R) and Frontal Assessment Battery (FAB) during the check-up. Food diversity was assessed using the 11-item Food Diversity Score Kyoto (FDSK-11). Number of teeth was significantly related to chewing ability (P<0.001). The participants with low chewing ability had significantly lower ADL scores in the items of self-maintenance (P=0.029) and intellectual activity (P=0.021). There was a significant association between low chewing ability and depression (P<0.001). Lower cognitive functions were significantly related to low chewing ability; MMSE (P=0.022), HDSR (P=0.017) and FAB (P=0.002). The participants with low chewing ability had lower food variety (P<0.001), and less frequent intake of beans, vegetables, seaweed and nuts, than the participants with high chewing ability. Low chewing ability evaluated by color-changeable gum was associated with lower ADL, lower cognitive functioning, depression and food insufficiency in the community-dwelling elderly. More attention should be paid to assessing chewing ability of elderly persons in community settings. © 2012 Japan Geriatrics Society.

  3. Characteristics of polymedicated (≥ 4) elderly: a survey in a community-dwelling population aged 60 years and over.

    PubMed

    Husson, N; Watfa, G; Laurain, M-C; Perret-Guillaume, C; Niemier, J-Y; Miget, P; Benetos, A

    2014-01-01

    Polypharmacy is an important concern for patient safety and has been associated with increased adverse drug reactions, hospitalization and mortality in the elderly. In light of the above, the present study aimed to assess the major characteristics associated with polypharmacy (≥ 4 drugs) in a larger population of apparently healthy older subjects over 60 years. Cross-sectional study. The preventive medical center (CMP) in Nancy. 2,545 volunteers (1,175 women, 1,370 men) aged 60 years and older (66 ± 4.8 years) were included from the Senior health examination study. All subjects underwent clinical, biological examinations. Sociodemographic data, practice of regular physical activity and drug intake data were collected. A self-administered questionnaire of health status, psychological status and questions regarding falls were collected. The prevalence of polypharmacy in this study was 29.9%. The number of drugs in polymedicated people was 5.67 ± 1.82 versus 1.32 ± 1.11 in non polymedicated people; p≤0.01. Multivariate analyses identified 6 independent variables associated with polypharmacy: age over 65 years (OR = 1.58 95% CI: [1.05 - 2.38]; p = 0.03), poor self-perceived health status (2.79 [1.80 - 4.31]; p ≤ 0,01), history of falls (1.66 [1.02 - 2.71]; p = 0.04), lack of a physical activity (1.50 [1.001 - 2.26]; p = 0.049), metabolic syndrome (3.17 [1.95 - 5.15]; p ≤ 0,01), low or medium education level (2.20 [1.24 - 4.30]; p = 0.02). Among community-dwelling people aged 60 years and over, in addition to the presence of several diseases and advanced age, the psychological and socio-educative factors may influence drug intake and polypharmacy in the elderly. Physicians should be take into account these considerations before issuing any prescriptions and review all medications used at every visit to avoid unnecessary addictions or dangerous drug-drug interactions.

  4. [Risk factors influencing probability and severity of elder abuse in community-dwelling older adults: applying zero-inflated negative binomial modeling of abuse count data].

    PubMed

    Jang, Mi Heui; Park, Chang Gi

    2012-12-01

    This study was conducted to identify risk factors that influence the probability and severity of elder abuse in community-dwelling older adults. This study was a cross-sectional descriptive study. Self-report questionnaires were used to collect data from community-dwelling Koreans, 65 and older (N=416). Logistic regression, negative binomial regression and zero-inflated negative binomial regression model for abuse count data were utilized to determine risk factors for elder abuse. The rate of older adults who experienced any one category of abuse was 32.5%. By zero-inflated negative binomial regression analysis, the experience of verbal-psychological abuse was associated with marital status and family support, while the experience of physical abuse was associated with self-esteem, perceived economic stress and family support. Family support was found to be a salient risk factor of probability of abuse in both verbal-psychological and physical abuse. Self-esteem was found to be a salient risk factor of probability and severity of abuse in physical abuse alone. The findings suggest that tailored prevention and intervention considering both types of elder abuse and target populations might be beneficial for preventative efficiency of elder abuse.

  5. Reducing the fear of falling among community-dwelling elderly adults through cognitive-behavioural strategies and intense Tai Chi exercise: a randomized controlled trial.

    PubMed

    Huang, Tzu-Ting; Yang, Lin-Hui; Liu, Chia-Yih

    2011-05-01

    To examine the effectiveness of cognitive-behavioural strategies with/without intense Tai Chi exercise in reducing fear of falling among community-dwelling elderly adults. Background.  Fear of falling is a major health problem among community-dwelling older persons. The prevalence of this fear ranges from 29% to 77%, indicating the importance of developing effective strategies to reduce fear of falling among elderly adults. Data were collected from January to December 2007. A randomized controlled trial with three groups (control, cognitive-behavioural and cognitive-behavioural with Tai Chi). Participants were assessed at baseline for demographic data, falls-related history, and fear of falling. Data on these variables plus falls, mobility, social support behaviour and satisfaction, and quality of life were also collected at 2 and 5 months after interventions. Participants in the three groups differed significantly in both measures of fear of falling (F = 20·89, P < 0·001; F = 6·09, P < 0·001) and mobility (F = 30·33, P < 0·001), social support behaviour and satisfaction (F = 3·32, P < 0·05 and F = 6·35, P < 0·001, respectively), and quality of life (F = 16·66, P< 0·001). In addition, participants who received the cognitive-behavioural intervention with Tai Chi had significantly lower fear of falling scores (P < 0·001) and higher mobility (P < 0·001), social support satisfaction (P < 0·01) and quality of life (P < 0·001) than the cognitive-behavioural alone and control groups at 5 months. The three groups did not differ significantly in falls. The results of this trial suggest that the cognitive-behavioural intervention with Tai Chi exercise helped community-dwelling elderly adults to enhance their mobility, to manage their fear of falling and to increase their quality of life. © 2011 Blackwell Publishing Ltd.

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

    PubMed

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

    2016-01-01

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

  7. Association Between Social Participation and 3-Year Change in Instrumental Activities of Daily Living in Community-Dwelling Elderly Adults.

    PubMed

    Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

    2017-01-01

    To investigate whether social participation (SP) in older adults is associated with ability to perform instrumental activities of daily living (IADLs). Prospective cohort study. Two local municipalities of Nara, Japan. Individuals aged 65 to 96 (n = 2,774 male, n = 3,586 female) free of IADL disability at baseline. SP and IADLs were assessed using self-administered questionnaires. SP was categorized into five types and assessed using the number and type of social activities. IADLs were evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression analysis stratified according to sex was used to examine change in IADLs according to SP, with nonparticipation as a reference. During the 3-year follow-up, 13.6% of men and 9.0% of women reported IADL decline. After adjusting for age, family structure, body mass index, pension, occupation, medical treatment, self-rated health, drinking, smoking, depression, cognitive function, and activities of daily living, participation in various social activities was inversely associated with change in IADLs in women but not men. Participation in the following types of social activities had significant inverse associations with IADL disability: hobby clubs (odds ratio (OR) = 0.68, 95% confidence interval (CI) = 0.49-0.94) for men and local events (OR = 0.68, 95% CI = 0.48-0.95), hobby clubs (OR = 0.53, 95% CI = 0.36-0.79), senior citizen clubs (OR = 0.74, 95% CI = 0.56-0.97), and volunteer groups (OR = 0.56, 95% CI = 0.32-0.99) for women. Participation in a variety of different types of social activities was associated with change in IADLs over the 3 years of this study in women, and participation in hobby clubs was associated with change in IADLs in men and women. Recommending that community-dwelling elderly adults participate in social activities appropriate for their sex may promote successful aging. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics

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

    PubMed

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

    2013-07-01

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

  9. [Abdominal obesity mediates the association between a low physical activity and a decline in gait speed in community-dwelling elderly people: A cross-sectional study].

    PubMed

    Sugimoto, Taiki; Tsutsumimoto, Kota; Nakakubo, Sho; Murata, Shunsuke; Doi, Takehiko; Ono, Rei

    2016-01-01

    A low physical activity leads to obesity and a decline in the physical function. The aim of this cross-sectional study was to examine whether the association between a low physical activity and low physical function was mediated by obesity. A total of 73 community-dwelling elderly people participated in this study. The analysis included 56 participants without knee and hip osteoarthritis, low cognitive function (the Mini Mental State Examination score <24) and rheumatoid arthritis (mean age±SD: 73.3±4.1, female: 50%). The daily step count was collected as a measure of physical activity by a single axial accelerometer. The physical function was measured by the gait speed. Obesity was measured by the body mass index and waist circumference. To assess whether the association between the physical activity and physical function was mediated by obesity, linear regression models were fitted according to Baron and Kenny procedures for a mediation analysis. A p value <0.05 was considered to be statistically significant. The body mass index did not act as a mediator in the association between the physical activity and gait speed, whereas the waist circumference acted as a full mediator in the association between the physical activity and gait speed. An increased waist circumference mediates the association between a low physical activity and a low physical function in community-dwelling elderly people.

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

    PubMed

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

    2017-01-01

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

  11. Cross-sectional study of the characteristics of reported elder self-neglect in a community-dwelling population: findings from a population-based cohort.

    PubMed

    Dong, Xin-Qi; Simon, Melissa; Evans, Denis

    2010-01-01

    Elder self-neglect is an important public health issue. However, little is known about the characteristics of self-neglect and its association with social factors among community-dwelling populations. (1) To examine the sociodemographic, health-related and psychosocial characteristics of reported elder self-neglect; (2) to examine the association of social network and social engagement with reported self-neglect. Population-based study conducted from 1993 to 2005 of community-dwelling subjects (n = 9,056) participating in the Chicago Health and Aging Project (CHAP). Subsets of the CHAP subjects (n = 1,812) were identified for suspected self-neglect by the social services agency, which also assessed the severity. This reported group was compared with the unreported group in the CHAP across the sociodemographic, health-related and psychosocial variables. Logistical regressions were used to assess the association of social factors and self-neglect. Older age, women, African-Americans, and those with lower education or lower income were more likely to be reported for self-neglect. Those reported for self-neglect were more likely to have lower levels of cognitive and physical function, nutritional status, psychosocial function and a higher number of medical comorbidities. After adjusting for confounders, lower levels of social network and social engagement were significantly associated with an increased risk of reported self-neglect. Among the reported cases of self-neglect, the study found increased trends of older age, women, African-American, lower income, lower cognitive and physical function, lower social engagement and a higher number of chronic medical conditions with self-neglect severity. Reported self-neglect elders have multiple sociodemographic, health- related and psychosocial characteristics that are different than elders not reported. Lower levels of social network and social engagement were associated with increased risk of self-neglect. 2009 S. Karger

  12. Cross-Sectional Study of the Characteristics of Reported Elder Self-Neglect in a Community-Dwelling Population: Findings from a Population-Based Cohort

    PubMed Central

    Dong, Xin-Qi; Simon, Melissa; Evans, Denis

    2010-01-01

    Background Elder self-neglect is an important public health issue. However, little is known about the characteristics of self-neglect and its association with social factors among community-dwelling populations. Objectives: (1) To examine the sociodemographic, health-related and psychosocial characteristics of reported elder self-neglect; (2) to examine the association of social network and social engagement with reported self-neglect. Methods Population-based study conducted from 1993 to 2005 of community-dwelling subjects (n = 9,056) participating in the Chicago Health and Aging Project (CHAP). Subsets of the CHAP subjects (n = 1,812) were identified for suspected self-neglect by the social services agency, which also assessed the severity. This reported group was compared with the unreported group in the CHAP across the sociodemographic, health-related and psychosocial variables. Logistical regressions were used to assess the association of social factors and self-neglect. Results Older age, women, African-Americans, and those with lower education or lower income were more likely to be reported for self-neglect. Those reported for self-neglect were more likely to have lower levels of cognitive and physical function, nutritional status, psychosocial function and a higher number of medical comorbidities. After adjusting for confounders, lower levels of social network and social engagement were significantly associated with an increased risk of reported self-neglect. Among the reported cases of self-neglect, the study found increased trends of older age, women, African-American, lower income, lower cognitive and physical function, lower social engagement and a higher number of chronic medical conditions with self-neglect severity. Conclusion Reported self-neglect elders have multiple sociodemographic, health-related and psychosocial characteristics that are different than elders not reported. Lower levels of social network and social engagement were associated with

  13. Temporal trends in self-reported functional limitations and physical disability among the community-dwelling elderly population: the Framingham heart study.

    PubMed

    Murabito, Joanne M; Pencina, Michael J; Zhu, Lei; Kelly-Hayes, Margaret; Shrader, Peter; D'Agostino, Ralph B

    2008-07-01

    We sought to determine change in the prevalence of functional limitations and physical disability among the community-dwelling elderly population across 3 decades. We studied original participants of the Framingham Heart Study, aged 79 to 88 years, at examination 15 (1977-1979; 177 women, 103 men), examination 20 (1988-1990; 159 women, 98 men) and examination 25 (1997-1999; 174 women, 119 men). Self-reported functional limitation was defined using the Nagi scale, and physical disability was defined using the Rosow-Breslau and Katz scales. Functional limitations declined across examinations from 74.6% to 60.5% to 37.9% (P < .001) among women and from 54.2% to 37.8% to 27.8% (P<.001) among men. Physical disability declined from 74.5% to 48.5% to 34.6% (P < .001) among women and 42.3% to 33.3% to 22.8% (P = .009) among men. Among women, improvements in functional limitations (P = .05) were greater from examination 20 to 25, whereas for physical disability (P=.02), improvements were greater from examination 15 to 20. Improvements in function were constant across the 3 examinations in men. Among community-dwelling elders, the prevalence of functional limitations and physical disability declined significantly in both women and men from the 1970s to the 1990s. This may in part be due to improvements in technological devices used to maintain independence. Further work is needed to identify the underlining causes of the decline so preventative measures can be established that promote independence for the elderly population.

  14. 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.

  15. 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

  16. A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling: results of a 3-year prospective study.

    PubMed

    Pluijm, S M F; Smit, J H; Tromp, E A M; Stel, V S; Deeg, D J H; Bouter, L M; Lips, P

    2006-01-01

    The aim of the prospective study reported here was to develop a risk profile that can be used to identify community-dwelling elderly at a high risk of recurrent falling. The study was designed as a 3-year prospective cohort study. A total of 1365 community-dwelling persons, aged 65 years and older, of the population-based Longitudinal Aging Study Amsterdam participated in the study. During an interview in 1995/1996, physical, cognitive, emotional and social aspects of functioning were assessed. A follow-up on the number of falls and fractures was conducted during a 3-year period using fall calendars that participants filled out weekly. Recurrent fallers were identified as those who fell at least twice within a 6-month period during the 3-year follow-up. The incidence of recurrent falls at the 3-year follow-up point was 24.9% in women and 24.4% in men. Of the respondents, 5.5% reported a total of 87 fractures that resulted from a fall, including 20 hip fractures, 21 wrist fractures and seven humerus fractures. Recurrent fallers were more prone to have a fall-related fracture than those who were not defined as recurrent fallers (11.9% vs. 3.4%; OR: 3.8; 95% CI: 2.3-6.1). Backward logistic regression analysis identified the following predictors in the risk profile for recurrent falling: two or more previous falls, dizziness, functional limitations, weak grip strength, low body weight, fear of falling, the presence of dogs/cats in the household, a high educational level, drinking 18 or more alcoholic consumptions per week and two interaction terms (high education x 18 or more alcohol consumptions per week and two or more previous falls x fear of falling) (AUC=0.71). At a cut-off point of 5 on the total risk score (range 0-30), the model predicted recurrent falling with a sensitivity of 59% and a specificity of 71%. At a cut-off point of 10, the sensitivity and specificity were 31% and 92%, respectively. A risk profile including nine predictors that can easily be

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

    PubMed Central

    Kyougoku, Makoto

    2016-01-01

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

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

    PubMed

    Sano, Nobuyuki; Kyougoku, Makoto

    2016-01-01

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

  19. Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals.

    PubMed

    Johansson, Jonas; Nordström, Anna; Gustafson, Yngve; Westling, Göran; Nordström, Peter

    2017-05-22

    fall-related injuries constitute major health risks in older individuals, and these risks are projected to increase in parallel with increasing human longevity. Impaired postural stability is a potential risk factor related to falls, although the evidence is inconclusive, partly due to the lack of prospective studies. This study aimed to investigate how objective measures of postural sway predict incident falls. this prospectively observational study included 1,877 community-dwelling individuals aged 70 years who participated in the Healthy Ageing Initiative between June 2012 and December 2015. postural sway was measured during eyes-open (EO) and eyes-closed (EC) trials using the Wii Balance Board. Functional mobility, muscle strength, objective physical activity and cognitive performance were also measured. Participants reported incident falls 6 and 12 months after the examination. during follow-up, 255 (14%) prospective fallers were identified. Division of centre of pressure (COP) sway lengths into quintiles revealed a nonlinear distribution of falls for EO trial data, but not EC trial data. After adjustment for multiple confounders, fall risk was increased by 75% for participants with COP sway lengths ≥400 mm during the EO trial (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.09-2.79), and approximately doubled for sway lengths ≥920 mm during the EC trial (OR 1.90, 95% CI 1.12-3.22). objective measures of postural sway independently predict incident falls in older community-dwelling men and women. Further studies are needed to evaluate whether postural sway length is of interest for the prediction of incident falls in clinical settings.

  20. Glomerular filtration rate after a 12-wk resistance exercise program with post-exercise protein ingestion in community dwelling elderly.

    PubMed

    Ramel, Alfons; Arnarson, Atli; Geirsdottir, Olof G; Jonsson, Palmi V; Thorsdottir, Inga

    2013-05-01

    Increased protein intake and resistance exercise can be beneficial for maintenance of lean body mass (LBM) in older adults. However, these factors could also negatively affect renal function. We investigated changes in renal function after a 12-wk resistance exercise program combined with protein supplementation in community dwelling older adults. Patients (N = 237, 73.7 ± 5.7 y, 58.2% female) participated in a 12-wk resistance exercise program (3 times/wk) designed to increase strength and muscle mass of major muscle groups. Participants were randomly assigned to one of three dietary supplements consumed directly after training: whey protein drink (20 g whey protein, 20 g carbohydrates), milk protein drink (20 g milk protein, 20 g carbohydrates), or carbohydrate drink (40 g carbohydrates). Renal function was estimated as glomerular filtration rate (GFR, Cockcroft-Gault formula), and dietary intake was measured as 3-d-weighed food record at baseline and endpoint. During the intervention, energy intake did not increase. Carbohydrate intake increased in the carbohydrate group and protein intake increased in the milk group, both approximately in accordance with the supplementation. In the whey group, protein intake did not increase, but carbohydrate intake did. GFR increased after the intervention (+4.4 mL/min/1.73 m2; P < 0.001), and the changes were similar in men and women or in the age quartiles. Changes in GFR at endpoint were not associated with LBM, dietary supplements, or total protein intake. A 12-wk resistance exercise program combined with protein supplementation in community dwelling older adults does not negatively affect GFR. The supplementation had only minor effects on total dietary intake. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. 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.

  2. 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

  3. The CareWell-primary care program: design of a cluster controlled trial and process evaluation of a complex intervention targeting community-dwelling frail elderly.

    PubMed

    Ruikes, Franca G H; Meys, Antoinette R M; van de Wetering, Gijs; Akkermans, Reinier P; van Gaal, Betsie G I; Zuidema, Sytse U; Schers, Henk J; van Achterberg, Theo; Koopmans, Raymond T C M

    2012-12-05

    With increasing age and longevity, the rising number of frail elders with complex and numerous health-related needs demands a coordinated health care delivery system integrating cure, care and welfare. Studies on the effectiveness of such comprehensive chronic care models targeting frail elders show inconclusive results. The CareWell-primary care program is a complex intervention targeting community-dwelling frail elderly people, that aims to prevent functional decline, improve quality of life, and reduce or postpone hospital and nursing home admissions of community dwelling frail elderly. The CareWell-primary care study includes a (cost-) effectiveness study and a comprehensive process evaluation. In a one-year pragmatic, cluster controlled trial, six general practices are non-randomly recruited to adopt the CareWell-primary care program and six control practices will deliver 'care as usual'. Each practice includes a random sample of fifty frail elders aged 70 years or above in the cost-effectiveness study. A sample of patients and informal caregivers and all health care professionals participating in the CareWell-primary care program are included in the process evaluation. In the cost-effectiveness study, the primary outcome is the level of functional abilities as measured with the Katz-15 index. Hierarchical mixed-effects regression models/multilevel modeling approach will be used, since the study participants are nested within the general practices. Furthermore, incremental cost-effectiveness ratios will be calculated as costs per QALY gained and as costs weighed against functional abilities. In the process evaluation, mixed methods will be used to provide insight in the implementation degree of the program, patients' and professionals' approval of the program, and the barriers and facilitators to implementation. The CareWell-primary care study will provide new insights into the (cost-) effectiveness, feasibility, and barriers and facilitators for

  4. Physical fitness exercise versus cognitive behavior therapy on reducing the depressive symptoms among community-dwelling elderly adults: A randomized controlled trial.

    PubMed

    Huang, Tzu-Ting; Liu, Chiu-Bi; Tsai, Yu-Hsia; Chin, Yen-Fan; Wong, Ching-Hsiang

    2015-10-01

    Depression is a major health problem for community-dwelling elderly adults. Since limited resources are available to decrease the high prevalence of depressive symptoms among the elderly adults, improved support for them can be provided if we can determine which intervention is superior in ridding depressive symptoms. To compare the effectiveness of the physical fitness exercise program and the cognitive behavior therapy program on primary (depressive symptoms) and secondary outcomes (6-min walk distance, quality of life, and social support) for community-dwelling elderly adults with depressive symptoms. A prospective randomized control trial was conducted in three communities in northern Taiwan. The elderly adults in the three communities were invited to participate by mail, phone calls, and posters. There were a total of 57 participants who had depressive symptoms and all without impaired cognition that participated in this trial. None of the participants withdrew during the 9 months of follow-up for this study. Fifty-seven participants were randomly assigned to one of the three groups: the physical fitness exercise program group, the cognitive behavior therapy (CBT) group, or the control group. The primary (Geriatric Depression Scale-15, GDS-15), and secondary outcomes (6-min walk distance, SF-36, and Inventory of Socially Supportive Behaviors scales, ISSB) were collected immediately (T2), at 3 months (T3), and at 6 months after the interventions (T4). After the interventions, the CBT group participants demonstrated significantly lower symptoms of depression (p=0.009) at T2 and perceived more social support from those around them (p<0.001, <0.001 and =0.004, respectively) at three time-point comparisons than the control group. Moreover, after intervention, participants in the physical fitness exercise program group had decreased GDS-15 scores at three time-point comparisons (p=0.003, 0.012 and 0.037, respectively), had a substantially greater 6-min walk distance

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

    PubMed

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

    2014-05-01

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

  6. A modified seated side tapping test in which the arms are crossed also reflects gait function in community-dwelling elderly.

    PubMed

    Fuchioka, Satoshi; Iwata, Akira; Higuchi, Yumi; Miyake, Mari; Kanda, Seiji; Nishiyama, Toshimasa

    2017-09-01

    [Purpose] Seated side tapping test (SST) performance is associated with mobility impairment in the elderly. Although this test was developed to assess trunk function, interpretation of its results may be confounded by the upper-limb movements in its protocol. Here, this study aimed to validate the association between trunk function and gait function by means of the Arms Crossed SST (AC-SST), a modified version of the SST in which the arms are crossed over the chest, to exclude the effects of the upper limbs. [Subjects and Methods] A total of 116 community-dwelling elderly people were enrolled in the study (mean age: 75.1 ± 5.5 yrs). Measurement categories were gait function (gait speed and TUG), lower extremity strength (knee extension and flexion strength), trunk muscle endurance (trunk extension and flexion endurance), and trunk function (SST and AC-SST). [Results] AC-SST performance significantly correlated with gait function items, as did SST performance. Moreover, AC-SST was one of the significant predictor variables of gait function selected in stepwise multiple regressions. [Conclusion] Gait function associated with performance on the AC-SST, a test of trunk function in which the effects of upper limb function were excluded, reinforcing the importance of trunk function to elderly mobility.

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

    PubMed Central

    2013-01-01

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

  8. Automated detection of amnestic mild cognitive impairment in community-dwelling elderly adults: a combined spatial atrophy and white matter alteration approach.

    PubMed

    Cui, Yue; Wen, Wei; Lipnicki, Darren M; Beg, Mirza Faisal; Jin, Jesse S; Luo, Suhuai; Zhu, Wanlin; Kochan, Nicole A; Reppermund, Simone; Zhuang, Lin; Raamana, Pradeep Reddy; Liu, Tao; Trollor, Julian N; Wang, Lei; Brodaty, Henry; Sachdev, Perminder S

    2012-01-16

    Amnestic mild cognitive impairment (aMCI) is a syndrome widely considered to be prodromal Alzheimer's disease. Accurate diagnosis of aMCI would enable earlier treatment, and could thus help minimize the prevalence of Alzheimer's disease. The aim of the present study was to evaluate a magnetic resonance imaging-based automated classification schema for identifying aMCI. This was carried out in a sample of community-dwelling adults aged 70-90 years old: 79 with a clinical diagnosis of aMCI and 204 who were cognitively normal. Our schema was novel in using measures of both spatial atrophy, derived from T1-weighted images, and white matter alterations, assessed with diffusion tensor imaging (DTI) tract-based spatial statistics (TBSS). Subcortical volumetric features were extracted using a FreeSurfer-initialized Large Deformation Diffeomorphic Metric Mapping (FS+LDDMM) segmentation approach, and fractional anisotropy (FA) values obtained for white matter regions of interest. Features were ranked by their ability to discriminate between aMCI and normal cognition, and a support vector machine (SVM) selected an optimal feature subset that was used to train SVM classifiers. As evaluated via 10-fold cross-validation, the classification performance characteristics achieved by our schema were: accuracy, 71.09%; sensitivity, 51.96%; specificity, 78.40%; and area under the curve, 0.7003. Additionally, we identified numerous socio-demographic, lifestyle, health and other factors potentially implicated in the misclassification of individuals by our schema and those previously used by others. Given its high level of performance, our classification schema could facilitate the early detection of aMCI in community-dwelling elderly adults.

  9. Quality of life (QOL) of the community-dwelling elderly and associated factors: a population-based study in urban areas of China.

    PubMed

    Sun, Wei; Aodeng, Surita; Tanimoto, Yoshimi; Watanabe, Misuzu; Han, Jinsong; Wang, Bowen; Yu, Lianzheng; Kono, Koichi

    2015-01-01

    China has the most elderly people. Maintaining and improving the QOL of the elderly has emerged as a particularly important issue. This population-based study aimed to examine the QOL of the urban elderly and to clarify the associated factors. A cross-sectional study was performed in Liaoning Province. The elderly people without senile dementia composed our study population and were interviewed from March to November, 2012 with questionnaires pertaining to QOL (SF-36), cognitive ability, demographic characteristics, health status, behavioral factors, and social-psychological factors. 4067 effective responses were received (effective response rate: 86.0%). After further cognitive screening, 3714 participants were included as the subjects. The mean scores of physical component summary (PCS) and mental component summary (MCS) were 53.7±21.5 (mean±SD) and 58.9±18.9, respectively. With adjustment for age and sex, general linear model analysis showed that, in standardized estimate (β) sequence, PCS was significantly associated with chronic disease, taking a walk, visual ability, sleeping quality, marital status, alcohol consumption, hearing ability, smoking, neighborhood relationships, filial piety, ethnicity, and regular diet, and MCS was associated with chronic disease, sleeping quality, taking a walk, visual ability, marital status, ethnicity, filial piety, regular diet, alcohol consumption, smoking, and hearing ability. The community-dwelling elderly in urban areas had a low level of QOL. To improve QOL, the maintenance of health conditions was crucial. Efforts to encourage the elderly to perform feasible exercise and develop good lifestyles should be focused on. Also, children's filial duty to their parents should be enhanced. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. The prevalence of elder self-neglect in a community-dwelling population: hoarding, hygiene, and environmental hazards.

    PubMed

    Dong, XinQi; Simon, Melissa A; Mosqueda, Laura; Evans, Denis A

    2012-04-01

    To examine the prevalence of self-neglect and its specific behaviors in a community-dwelling population of older adults. A population-based cohort study conducted between 2007 and 2010 rated participant's personal and home environment, particularly with regard to hoarding, personal hygiene, house in need of repair, unsanitary conditions, and inadequate utility. Prevalence estimates were presented across health-related variables of health status, physical function, and cognitive function. There were 4,627 older adults (1,645 men and 2,982 women). Prevalence of self-neglect in older adults increased with lower health status in both men (4.7% in very good/excellent health, 7.9% in good health, and 14.9% in fair/poor health) and women (4.5% in very good/excellent health, 7.9% in good health, and 10.6% in fair/poor health). For those with ≥3 Katz impairments, the prevalence of self-neglect in older adults was 12.8% in men and 13.8% in women. For those with MMSE (Mini-Mental State Examination) ≤20, the prevalence of self-neglect in older adults was 18.8% in men and 13.6% in women. Self-neglect was clearly prevalent among older adults, especially among those with lower health status and physical and cognitive function.

  11. Development and Evaluation of an Online Fall-Risk Questionnaire for Nonfrail Community-Dwelling Elderly Persons: A Pilot Study

    PubMed Central

    Obrist, Seraina; Rogan, Slavko; Hilfiker, Roger

    2016-01-01

    Introduction. Falls are frequent in older adults and may have serious consequences but awareness of fall-risk is often low. A questionnaire might raise awareness of fall-risk; therefore we set out to construct and test such a questionnaire. Methods. Fall-risk factors and their odds ratios were extracted from meta-analyses and a questionnaire was devised to cover these risk factors. A formula to estimate the probability of future falls was set up using the extracted odds ratios. The understandability of the questionnaire and discrimination and calibration of the prediction formula were tested in a cohort study with a six-month follow-up. Community-dwelling persons over 60 years were recruited by an e-mail snowball-sampling method. Results and Discussion. We included 134 persons. Response rates for the monthly fall-related follow-up varied between the months and ranged from low 38% to high 90%. The proportion of present risk factors was low. Twenty-five participants reported falls. Discrimination was moderate (AUC: 0.67, 95% CI 0.54 to 0.81). The understandability, with the exception of five questions, was good. The wording of the questions needs to be improved and measures to increase the monthly response rates are needed before test-retest reliability and final predictive value can be assessed. PMID:27247571

  12. 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.

  13. [Relationships between volunteerism and social-physical health and QOL with community-dwelling elderly participating in a long-term care prevention programme].

    PubMed

    Shimanuki, Hideki; Honda, Haruhiko; Ito, Tsunehisa; Kasai, Toshiyuki; Takato, Jinro; Sakamoto, Yuzuru; Inuzuka, Go; Ito, Yuzuki; Arayama, Naoko; Ueki, Shouzoh; Haga, Hiroshi

    2007-11-01

    The aim of this study was to clarify the influence of volunteerism as part of a long-term care prevention program on social and physical health indicators and QOL, as compared with non-participation among elderly people. The baseline survey was conducted in 2003 among elderly people (age, 70-84 years) living in a rural community in Miyagi Prefecture. We recruited elderly volunteer leaders for long-term care prevention from among the 1,503 elderly people participating in the baseline survey. Of these, 77 individuals were registered as volunteer leaders. One year later, we conducted a follow-up survey to clarify the influence of volunteerism. Finally, we analyzed data for 69 volunteer leaders and 1,207 non-leaders, focusing on influences of volunteerism on social and physical health and QOL using a logistic regression model. State of volunteer activity was treated as a dependent variable, and social and physical health indicators and QOL indices as independent variables. Non-participating individuals had significant declines in Intellectual Activity (OR: 4.51, 95% CI: 1.60-12.74), Social Role (OR: 2.85, 95%CI: 1.11-7.21), Self-efficacy for ADL (OR: 4.58, 95%CI: 1.11-18.88), Satisfaction with Economic State (OR: 2.83, 95%CI: 1.11-7.21), and Contact with Neighbors (OR: 3.62, 95%CI: 1.29-10.16), as compared with volunteers. These results suggest that volunteerism prevents lowering of higher-level functional capacity and social networking among community-dwelling elderly individuals.

  14. Association of depression and psychotropic medication on cardiac-related outcomes in a nationwide community-dwelling elderly population in Taiwan

    PubMed Central

    Hsu, Wen-Yu; Tsai, Hui-Ju; Yu, Shu-Han; Hsu, Chih-Cheng; Tsai, Yu-Ting; Tzeng, Han-Yun; Lin, I-Ching; Liu, Kiang; Lee, Marion M.; Chiu, Nan-Ying; Hsiung, Chao A.

    2016-01-01

    Abstract The objective of this study was to examine the association of depression, psychotropic medications, and mental illness with cardiovascular disease in a nationwide community-dwelling elderly population in Taiwan. A total of 5664 participants who enrolled in the Healthy Aging Longitudinal Study in Taiwan (HALST) were included in the study. Multiple logistic regression was applied to investigate the association of depression, psychotropic medication use, and mental illness, separately, with cardiovascular disease. The results suggested that cardiovascular disease was significantly associated with various definitions of depression, including: the Center for Epidemiologic Studies-Depression scale (CES-D) ≥ 16, self-reported, and physician-diagnosed for depression (adjusted odds ratio [AOR] = 1.51; 95% confidence interval (CI): 1.14–2.00 for CES-D; AOR = 3.29; 95% CI: 1.99–5.42 for self-reported; and AOR = 2.45; 95% CI: 1.51–3.97 for physician-diagnosed). Additionally, significant associations of cardiovascular disease with the use of antipsychotics (AOR = 2.04; 95% CI: 1.25–3.34), benzodiazepines (BZDs) (AOR = 1.84; 95% CI: 1.52–2.21), and Z-drugs (AOR = 1.41; 95% CI: 1.03–1.93), respectively, were also observed, but not the use of antidepressants. In addition, a significant association of cardiovascular disease with mental illness was found in this study (AOR = 2.33; 95% CI: 1.68–3.24). In line with previous reports, these findings provided supportive evidence that depression and/or mental illness were significantly associated with cardiovascular disease in a community-dwelling elderly population in Taiwan. Moreover, significant associations of cardiovascular disease with the use of antipsychotics, BZDs, and Z-drugs, individually, were found. Further investigation would be of importance to clarify the causal relationship of depression and/or psychotropic medications with cardiovascular disease, especially among

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

    PubMed Central

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

    2012-01-01

    Background/Aims Neighborhood socioeconomic status (SES) can affect cognitive function. We assessed cognitive function and cognitive impairment among community-dwelling elderly in a multi-ethnic urban low-SES Asian neighborhood and compared them with a higher-SES neighborhood. Methods The study population involved all residents aged ≥60 years in two housing estates comprising owner-occupied housing (higher SES) and rental flats (low SES) in Singapore in 2012. Cognitive impairment was defined as <24 on the Mini Mental State Examination. Demographic/clinical details were collected via questionnaire. Multilevel linear regression was used to evaluate factors associated with cognitive function, while multilevel logistic regression determined predictors of cognitive impairment. Results Participation was 61.4% (558/909). Cognitive impairment was found in 26.2% (104/397) of residents in the low-SES community and in 16.1% (26/161) of residents in the higher-SES community. After adjusting for other sociodemographic variables, living in a low-SES community was independently associated with poorer cognitive function (β = −1.41, SD = 0.58, p < 0.01) and cognitive impairment (adjusted odds ratio 5.13, 95% CI 1.98–13.34). Among cognitively impaired elderly in the low-SES community, 96.2% (100/104) were newly detected. Conclusion Living in a low-SES community is independently associated with cognitive impairment in an urban Asian society. PMID:23277785

  16. Mini-Mental State Examination sentence writing among community-dwelling elderly adults in Brazil: text fluency and grammar complexity.

    PubMed

    Neri, Anita Liberalesso; Ongaratto, Lia Lopes; Yassuda, Mônica Sanches

    2012-11-01

    In normal aging, the decrease in the syntactic complexity of written production is usually associated with cognitive deficits. This study was aimed to analyze the quality of older adults' textual production indicated by verbal fluency (number of words) and grammatical complexity (number of ideas) in relation to gender, age, schooling, and cognitive status. From a probabilistic sample of community-dwelling people aged 65 years and above (n = 900), 577 were selected on basis of their responses to the Mini-Mental State Examination (MMSE) sentence writing, which were submitted to content analysis; 323 were excluded as they left the item blank or performed illegible or not meaningful responses. Education adjusted cut-off scores for the MMSE were used to classify the participants as cognitively impaired or unimpaired. Total and subdomain MMSE scores were computed. 40.56% of participants whose answers to the MMSE sentence were excluded from the analyses had cognitive impairment compared to 13.86% among those whose answers were included. The excluded participants were older and less educated. Women and those older than 80 years had the lowest scores in the MMSE. There was no statistically significant relationship between gender, age, schooling, and textual performance. There was a modest but significant correlation between number of words written and the scores in the Language subdomain. Results suggest the strong influence of schooling and age over MMSE sentence performance. Failing to write a sentence may suggest cognitive impairment, yet, instructions for the MMSE sentence, i.e. to produce a simple sentence, may limit its clinical interpretation.

  17. A randomized trial comparing Tai Chi with and without cognitive-behavioral intervention (CBI) to reduce fear of falling in community-dwelling elderly people.

    PubMed

    Liu, Yat Wa Justina; Tsui, Chi Man

    2014-01-01

    The aim of this randomized trial was to compare the effects of Tai Chi with and without CBI on a primary outcome of reducing the fear of falling, and on secondary outcomes including encouraging better social engagement, improving self-perceived personal wellbeing, and achieving better mobility among elderly people with fear of falling. One hundred and twenty-two community-dwelling elderly people aged ≥ 65 were randomly assigned to either a Tai Chi or a Tai Chi plus CBI group. Participants' level of fear of falling, physical mobility, self-perceived personal wellbeing and social participation were compared before and after completing the 8-week intervention and then at a 2-month follow-up. The findings showed that Tai Chi both with and without CBI had a similar effect on reducing elderly people's fear of falling, but only Tai Chi plus CBI had a positive effect on participants' self-perceived personal wellbeing. Tai Chi both with and without CBI had no effect on participants' self-perceived social participation and mobility. Apart from a slight improvement in participants' self-perceived personal wellbeing, other outcome effects were similar for Tai Chi with and without CBI. This finding raises a question about the additive effects of combined intervention over Tai Chi alone in reducing elderly people's fear of falling. In view of the higher demand for resources and manpower to implement a combined intervention, further study is still required to confirm the potential additional benefits of this combined intervention prior to recommending it to community services. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

    PubMed

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

    2011-03-01

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

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

    PubMed Central

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

    2015-01-01

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

  20. Association between Elder Mistreatment and Suicidal Ideation among Community-Dwelling Chinese Older Adults in the USA.

    PubMed

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

    2015-01-01

    Elder mistreatment and suicidal ideation are important public health concerns among aging populations. However, very few studies have been conducted to explore the association between elder mistreatment and suicidal ideation. To examine the association between elder mistreatment and suicidal ideation among Chinese older adults in the USA. Guided by a community-based participatory research approach, in this study we conducted in-person interviews with Chinese older adults aged 60 years and older in the Greater Chicago area from 2011 to 2013. Elder mistreatment was assessed by a 10-item instrument derived from the Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST) and the Vulnerability to Abuse Screening Scale (VASS). Suicidal ideation was assessed by the ninth item of the Patient Health Questionnaire-9 (PHQ-9) and the Geriatric Mental State Examination-Version A (GMS-A). Overall, 3,159 Chinese older adults participated in this study, and their mean age was 72.8 years. After controlling for age, gender, education, income, medical comorbidities, depressive symptoms, and social support, elder mistreatment was significantly associated with 2-week suicidal ideation (OR 2.46, 95% CI 1.52-4.01) and 12-month suicidal ideation (OR 2.46, 95% CI 1.62-3.73). With respect to gender differences, the study found that the association remained significant for older women but not for older men after adjusting for all confounding factors. As the largest epidemiological study conducted among Chinese older adults in the USA, this study suggests that elder mistreatment is significantly associated with 2-week and 12-month suicidal ideation in older women but not in older men. Longitudinal studies should be conducted to explore the mechanisms through which elder mistreatment links with suicidal ideation. © 2015 S. Karger AG, Basel.

  1. Interest of the androgen deficiency in aging males (ADAM) questionnaire for the identification of hypogonadism in elderly community-dwelling male volunteers.

    PubMed

    Tancredi, Annalisa; Reginster, Jean-Yves; Schleich, Florence; Pire, Georges; Maassen, Philippe; Luyckx, Francoise; Legros, Jean-Jacques

    2004-09-01

    To date, serum free testosterone measurement is considered to be the gold standard for the diagnosis of hypogonadism in elderly males but it is not available to all subjects suspected of a decrease in testicular function. Therefore, we evaluated whether the Androgen Deficiency in Aging Males (ADAM) questionnaire, in its original or in a modified 'quantitative' version (qADAM), could be used as a surrogate to biochemical determinations for the identification of hypogonadism in elderly males. 5028 men, aged 50-70 years, spontaneously consulting for the assessment of their gonadal function were studied. ADAM and qADAM, allocating a value of 1 point for any positive answer to each of the 10 questions of the ADAM test, were assessed for their ability to discriminate between males with free testosterone levels below or above 70 ng/l. The sensitivity and specificity of the ADAM score were 81% and 21.6% respectively. The use of ADAM resulted in an appropriate classification of our population in normal or hypogonadal subjects in 44.5% of the cases. The area under the receiver operating characteristics (ROC) curve for the qADAM (0.529) revealed a highly marginal interest of this quantitative approach compared with the original scoring system. The ADAM test has a high sensitivity to identify aging males with low free testosterone levels. However, due to its lack of specificity, this test cannot be used as a surrogate to serum free testosterone testing for the identification of androgen deficiency in elderly, community-dwelling males.

  2. Effectiveness of seasonal influenza vaccine in community-dwelling elderly people: a meta-analysis of test-negative design case-control studies.

    PubMed

    Darvishian, Maryam; Bijlsma, Maarten J; Hak, Eelko; van den Heuvel, Edwin R

    2014-12-01

    The application of test-negative design case-control studies to assess the effectiveness of influenza vaccine has increased substantially in the past few years. The validity of these studies is predicated on the assumption that confounding bias by risk factors is limited by design. We aimed to assess the effectiveness of influenza vaccine in a high-risk group of elderly people. We searched the Cochrane library, Medline, and Embase up to July 13, 2014, for test-negative design case-control studies that assessed the effectiveness of seasonal influenza vaccine against laboratory confirmed influenza in community-dwelling people aged 60 years or older. We used generalised linear mixed models, adapted for test-negative design case-control studies, to estimate vaccine effectiveness according to vaccine match and epidemic conditions. 35 test-negative design case-control studies with 53 datasets met inclusion criteria. Seasonal influenza vaccine was not significantly effective during local virus activity, irrespective of vaccine match or mismatch to the circulating viruses. Vaccination was significantly effective against laboratory confirmed influenza during sporadic activity (odds ratio [OR] 0·69, 95% CI 0·48-0·99) only when the vaccine matched. Additionally, vaccination was significantly effective during regional (match: OR 0·42, 95% CI 0·30-0·60; mismatch: OR 0·57, 95% CI 0·41-0·79) and widespread (match: 0·54, 0·46-0·62; mismatch: OR 0·72, 95% CI 0·60-0·85) outbreaks. Our findings show that in elderly people, irrespective of vaccine match, seasonal influenza vaccination is effective against laboratory confirmed influenza during epidemic seasons. Efforts should be renewed worldwide to further increase uptake of the influenza vaccine in the elderly population. None. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Associations of Blood Cadmium Levels With Depression and Lower Handgrip Strength in a Community-Dwelling Elderly Population: A Repeated-Measures Panel Study.

    PubMed

    Kim, Kyoung-Nam; Lee, Mee-Ri; Choi, Yoon-Hyeong; Lee, Bo-Eun; Hong, Yun-Chul

    2016-11-01

    Although biologically plausible, few studies have linked cadmium exposure to depression or muscle strength. Herein, we hypothesized that blood cadmium concentrations are associated with depression and lower handgrip strength in a community-dwelling elderly population. Data from 983 elderly participants who completed up to 3 surveys between 2012 and 2015 were analyzed. At every survey, we assessed depressive status using the Korean version of the Geriatric Depression Scale-Short Form (SGDS-K) and measured handgrip strength and blood cadmium levels (mean, 1.24 μg/L). We evaluated the associations of cadmium with depression using generalized linear mixed models, and handgrip strength using linear mixed models. All models were adjusted for sociodemographic factors, lifestyle factors including active and passive smoking, weight, height, and comorbidity status. Interquartile-range increase (0.645 μg/L) in blood cadmium levels was associated with depression defined as SGDS-K score ≥8 (odds ratio = 1.27, 95% confidence interval: 1.06, 1.52) and lower handgrip strength (right hand: β = -0.40, 95% confidence interval: -0.75, -0.09; left hand: β = -0.36, 95% confidence interval: -0.69, -0.04). The association between cadmium levels and handgrip strength was robust after further adjustment for depressive status, although it attenuated in size by 14.7%-18.0%. After adjusting for potential confounders, blood cadmium concentrations were associated with depression and lower handgrip strength in an elderly population. The participants' depressive status partially mediated the association between cadmium levels and handgrip strength. © 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.

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

    PubMed

    Park, Junhyuck; Yim, JongEun

    2016-01-01

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

  5. 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.

  6. 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.

  7. 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

  8. Comparative cost-benefit analysis of tele-homecare for community-dwelling elderly in Japan: Non-Government versus Government Supported Funding Models.

    PubMed

    Akiyama, Miki; Abraham, Chon

    2017-08-01

    Tele-homecare is gaining prominence as a viable care alternative, as evidenced by the increase in financial support from international governments to fund initiatives in their respective countries. The primary reason for the funding is to support efforts to reduce lags and increase capacity in access to care as well as to promote preventive measures that can avert costly emergent issues from arising. These efforts are especially important to super-aged and aging societies such as in Japan, many European countries, and the United States (US). However, to date and to our knowledge, a direct comparison of non-government vs. government-supported funding models for tele-homecare is particularly lacking in Japan. The aim of this study is to compare these operational models (i.e., non-government vs. government-supported funding) from a cost-benefit perspective. This simulation study applies to a Japanese hypothetical cohort with implications for other super-aged and aging societies abroad. We performed a cost-benefit analysis (CBA) on two operational models for enabling tele-homecare for elderly community-dwelling cohorts based on a decision tree model, which we created with parameters from published literature. The two models examined are (a) Model 1-non-government-supported funding that includes monthly fixed charges paid by users for a portion of the operating costs, and (b) Model 2-government-supported funding that includes startup and installation costs only (i.e., no operating costs) and no monthly user charges. We performed base case cost-benefit analysis and probabilistic cost-benefit analysis with a Monte Carlo simulation. We calculated net benefit and benefit-to-cost ratios (BCRs) from the societal perspective with a five-year time horizon applying a 3% discount rate for both cost and benefit values. The cost of tele-homecare included (a) the startup system expense, averaged over a five-year depreciation period, and (b) operation expenses (i.e., labor and non

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

    PubMed

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

    2014-04-01

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

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

    PubMed

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

    2012-01-01

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

  11. The Association between Total Protein and Vegetable Protein Intake and Low Muscle Mass among the Community-Dwelling Elderly Population in Northern Taiwan.

    PubMed

    Huang, Ru-Yi; Yang, Kuen-Cheh; Chang, Hao-Hsiang; Lee, Long-Teng; Lu, Chia-Wen; Huang, Kuo-Chin

    2016-06-17

    Sarcopenia, highly linked with fall, frailty, and disease burden, is an emerging problem in aging society. Higher protein intake has been suggested to maintain nitrogen balance. Our objective was to investigate whether pre-sarcopenia status was associated with lower protein intake. A total of 327 community-dwelling elderly people were recruited for a cross-sectional study. We adopted the multivariate nutrient density model to identify associations between low muscle mass and dietary protein intake. The general linear regression models were applied to estimate skeletal muscle mass index across the quartiles of total protein and vegetable protein density. Participants with diets in the lowest quartile of total protein density (<13.2%) were at a higher risk for low muscle mass (odds ratio (OR) 3.03, 95% confidence interval (CI) 1.37-6.72) than those with diets in the highest quartile (≥17.2%). Similarly, participants with diets in the lowest quartile of vegetable protein density (<5.8%) were at a higher risk for low muscle mass (OR 2.34, 95% CI 1.14-4.83) than those with diets in the highest quartile (≥9.4%). Furthermore, the estimated skeletal muscle mass index increased significantly across the quartiles of total protein density (p = 0.023) and vegetable protein density (p = 0.025). Increasing daily intakes of total protein and vegetable protein densities appears to confer protection against pre-sarcopenia status.

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

    PubMed

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

    2015-01-01

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

  13. 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.

  14. 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.

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

    PubMed

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

    2016-12-01

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

  16. [Factors associated to the use of psychotropic drugs by community-dwelling elderly in São Paulo city].

    PubMed

    Noia, Aparecida Santos; Secoli, Silvia Regina; Duarte, Yeda Aparecida de Oliveira; Lebrão, Maria Lúcia; Lieber, Nicolina Silvana Romano

    2012-10-01

    The objectives of study were to identify the prevalence and factors associated to the use of psychotropic drugs among elderly people in São Paulo city. It is a cross-sectional study. Data were used from the SABE survey (for Health, Well-being and Ageing). The sample was constituted of 1.115 elderly people, aging 65 and over, which were interviewed by standard method. In the data analysis, it was used univariate and multiple logistic regression, stepwise forward and level of significance of 5%. The prevalence of the use of psychotropic drugs of 12,2% and the factors associated were female gender (OR=3,04 IC95%= 1,76-5,23) and polypharmacy (OR=4,91 IC95%=2,74-8,79). The use of psychotropics drugs by the elderly must have their benefits and risks very well established. Elder women, especially those who were submitted to a polipharmacy, deserve special attention to adjust dosage and duration of the treatment, with the purpose of minimizing the adverse outcomes.

  17. 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.

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

    PubMed

    Takai, Itsushi

    2013-01-01

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

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

    PubMed

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

    2011-08-01

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

  20. Difficulties with physical function associated with obesity, sarcopenia, and sarcopenic-obesity in community-dwelling elderly women: the EPIDOS (EPIDemiologie de l'OSteoporose) Study.

    PubMed

    Rolland, Yves; Lauwers-Cances, Valérie; Cristini, Christelle; Abellan van Kan, Gabor; Janssen, Ian; Morley, John E; Vellas, Bruno

    2009-06-01

    In elders, decreased muscle mass (sarcopenia) and increased fat mass (obesity) may contribute to difficulties with physical function. The objective was to examine the association of obesity, sarcopenia, and their combination (sarcopenic-obesity) with self-reported difficulties performing physical function in a cohort of community-dwelling elderly women. We assessed muscle and fat mass by dual-energy X-ray absorptiometry and self-reported difficulties with physical function in 1308 healthy women aged > or =75 y. Sarcopenia was defined as an appendicular skeletal muscle mass < or =2 SD below the mean in a young female reference group. Obesity was defined as a percentage body fat above the 60th percentile. Thirty-six sarcopenic-obese, 90 purely sarcopenic, 435 purely obese, and 747 women with a healthy body composition were studied. Anthropometric measures, health status, lifestyle habits, and self-reported difficulties with 6 different physical functions were obtained. Compared with women with a healthy body composition and after adjustment for confounders, purely sarcopenic women had no increased odds of having difficulties for all of the physical functions assessed, purely obese women had a 44-79% higher odds of having difficulties with most of the physical functions assessed (P < 0.05), and sarcopenic-obese women had a 2.60 higher odds of having difficulty climbing stairs and a 2.35 higher odds of having difficulty going down stairs (all P < 0.05). Sarcopenia is not associated with physical difficulties in the absence of obesity. However, in the presence of obesity, sarcopenia tends to add difficulty for some physical functions.

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

    PubMed

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

    2016-10-01

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

  2. Muscle function-dependent sarcopenia and cut-off values of possible predictors in community-dwelling Turkish elderly: calf circumference, midarm muscle circumference and walking speed.

    PubMed

    Akın, S; Mucuk, S; Öztürk, A; Mazıcıoğlu, M; Göçer, Ş; Arguvanlı, S; Şafak, E D

    2015-10-01

    The aim of this study was to determine the prevalence of muscle strength-based sarcopenia and to determine possible predictors. This is a cross-sectional population-based study in the community-dwelling Turkish elderly. Anthropometric measurements, namely body height, weight, triceps skin fold (TSF), mid upper arm circumference (MUAC), waist circumference (WC) and calf circumference (CC), were noted. The midarm muscle circumference (MAMC) was calculated by using MUAC and TSF measurement. Sarcopenia was assessed, adjusted for body mass index (BMI) and gender, according to muscle strength. Physical performance was determined by 4 m walking speed (WS; m/s). The receiver operating curve analysis was performed to determine cut-offs of CC, MAMC and 4 m WS. A total of 879 elderly subjects, 50.1% of whom were female, were recruited. The mean handgrip strength (HGS) and s.d. was 24.2 (8.8) kg [17.9 (4.8) female, 30.6 (7.1) male]. The muscle function-dependent sarcopenia was 63.4% (female 73.5%, male 53.2%). The muscle mass-dependent sarcopenia for CC (<31 cm) and MAMC(<21.1 cm in males, <19.9 cm in females) was 6.7% and 7.3%, respectively. The prevalence of low 4 m WS (≤ 0.8 m/s) was 81.8% (91.3% in females and 72.3% in males, respectively). We compared MAMC, CC and 4 m WS and found that AUC for 4 m WS was the best predictor of sarcopenia. An adequate muscle mass may not mean a reliable muscle function. Muscle function may describe sarcopenia better compared with muscle mass. The CC, MAMC and 4 m WS cut-offs may be used to assess sarcopenia in certain age groups.

  3. Higher prevalence of elevated LDL-C than non-HDL-C and low statin treatment rate in elderly community-dwelling Chinese with high cardiovascular risk.

    PubMed

    Kuang, YaShu; Li, Xiaolin; Chen, Xiaoli; Sun, Huimin; Tomlinson, Brian; Chan, Paul; Zheng, Liang; Pi, Jinjiang; Peng, Sheng; Wu, Hong; Ding, Xugang; Qian, Dingguang; Shen, Yixin; Yu, Zuoren; Fan, Lieying; Chen, Ming; Fan, Huimin; Liu, Zhongmin; Zhang, Yuzhen

    2016-09-30

    Lipid levels are increasing in all age groups in the Chinese population, but the use of statin treatment in the elderly is not well documented. We examined serum lipids, statin usage and achievement of lipid goals in 3950 subjects aged ≥65 years. Established CVD was present in 7.77% of participants and increased CVD risk was common. Elevated LDL-C according to CVD risk level was present in 46.70% of all subjects and was more frequent (p < 0.01) than elevated non-HDL-C at 32.58%. With increasing age, LDL-C was unchanged but triglycerides and non-HDL-C decreased and HDL-C increased. Individuals at moderate risk for CVD had higher TC, LDL-C, and non-HDL-C than low-risk subjects, but the values were lower in high- and very-high-risk individuals, probably because of the use of statin which was 28.57% in high-risk subjects with established CVD and 37.60% in very-high-risk individuals, but only 2.62% in those with estimated high-risk and 3.75% in those with high-risk from diabetes. More subjects in each risk group reached the non-HDL-C goal than the LDL-C goal because of the relatively low triglycerides and VLDL-C levels. These findings demonstrate a high prevalence of elevated LDL-C but low rate of statin treatment in elderly community-dwelling Chinese.

  4. The relationship of the Korean version of the WHO Five Well-Being Index with depressive symptoms and quality of life in the community-dwelling elderly.

    PubMed

    Moon, Yoo Sun; Kim, Hyun Ji; Kim, Do Hoon

    2014-06-01

    Depression in the geriatric population is becoming markedly more prevalent. Quality of life has been linked with the development of depression. A screening tool for assessing both geriatric depression and quality of life is needed. The purpose of this study was to assess the utility of the Korean version of the World Health Organization Five Well-Being Index (WHO-5) in evaluating geriatric depression and quality of life as compared to the widely used Short Geriatric Depression Scale of Korean version (SGDS-K). Two hundred and forty four elderly people (>60-years-of-age) living in the Yanggu and Inje areas of Gangwon Province, Korea, were interviewed and responded to scales including WHO-5, SGDS-K, Mini Mental Status Examination in the Korean version of the CERAD assessment packet (MMSE-KC), and Geriatric Quality of Life-Dementia (GQOL-D). A total WHO-5 score<13 indicated low well-being. The SGDS-K score showed a reverse correlation with the WHO-5, MMSE-KC, and GQOL-D scores. The WHO-5 score reversely correlated with the SGDS-K score and positively correlated with GQOL-D, but showed no significant correlation with MMSE-KC score. Subjects ranked as having poor well-being (WHO-5 score<13) had a significantly lower GQOL-D score and a significantly higher SGDS-K score. In multiple regression analysis, WHO-5 was significantly associated with GQOL-D and SGDS-K. The Korean version of WHO-5 is useful in evaluating both depressive symptoms and quality of life of community-dwelling elderly. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  5. Higher prevalence of elevated LDL-C than non-HDL-C and low statin treatment rate in elderly community-dwelling Chinese with high cardiovascular risk

    PubMed Central

    Kuang, YaShu; Li, Xiaolin; Chen, Xiaoli; Sun, Huimin; Tomlinson, Brian; Chan, Paul; Zheng, Liang; Pi, Jinjiang; Peng, Sheng; Wu, Hong; Ding, Xugang; Qian, Dingguang; Shen, Yixin; Yu, Zuoren; Fan, Lieying; Chen, Ming; Fan, Huimin; Liu, Zhongmin; Zhang, Yuzhen

    2016-01-01

    Lipid levels are increasing in all age groups in the Chinese population, but the use of statin treatment in the elderly is not well documented. We examined serum lipids, statin usage and achievement of lipid goals in 3950 subjects aged ≥65 years. Established CVD was present in 7.77% of participants and increased CVD risk was common. Elevated LDL-C according to CVD risk level was present in 46.70% of all subjects and was more frequent (p < 0.01) than elevated non-HDL-C at 32.58%. With increasing age, LDL-C was unchanged but triglycerides and non-HDL-C decreased and HDL-C increased. Individuals at moderate risk for CVD had higher TC, LDL-C, and non-HDL-C than low-risk subjects, but the values were lower in high- and very-high-risk individuals, probably because of the use of statin which was 28.57% in high-risk subjects with established CVD and 37.60% in very-high-risk individuals, but only 2.62% in those with estimated high-risk and 3.75% in those with high-risk from diabetes. More subjects in each risk group reached the non-HDL-C goal than the LDL-C goal because of the relatively low triglycerides and VLDL-C levels. These findings demonstrate a high prevalence of elevated LDL-C but low rate of statin treatment in elderly community-dwelling Chinese. PMID:27686151

  6. [Phenotype of frailty: the influence of each item in determining frailty in community-dwelling elderly - The Fibra Study].

    PubMed

    Silva, Silvia Lanziotti Azevedo da; Neri, Anita Liberalesso; Ferrioli, Eduardo; Lourenço, Roberto Alves; Dias, Rosângela Corrêa

    2016-11-01

    The phenotype of frailty is used to assess frailty among the elderly by examining the following items: weight loss; exhaustion; low level of physical activity; weakness; and slow gait speed. The aim of the study was to evaluate the contribution of each item to determine the frailty syndrome among elderly Brazilians. The analysis was done using Multinomial Logistic Regression. The total sample of 5532 randomly selected elderly people in many cities in Brazil between December 2008 and September 2009 was assessed using the phenotype of frailty. The most frequent items were level of physical activity, followed by muscular weakness and slow gait speed. Items that were more likely to develop frailty, when positive, were slow gait speed (OR = 10.50, 95%CI 8.55 - 12.90, p <0.001) and muscular weakness (OR = 7.31, 95%CI 6,02 - 8,86, p <0.001). The final model with five items explained 99.6% of frailty in the sample. These results suggested that the level of physical activity, weakness and slow gait speed were the items that most influence the determination of frailty, however the application of all items of the phenotype of frailty is the best way to assess frailty.

  7. Randomized clinical trial on arresting dental root caries through silver diammine fluoride applications in community-dwelling elders.

    PubMed

    Li, R; Lo, E C M; Liu, B Y; Wong, M C M; Chu, C H

    2016-08-01

    To investigate the effectiveness of silver diammine fluoride (SDF) solution application in arresting dental root caries and to assess the color of arrested caries lesions. This study was conducted in elderly centers in Hong Kong. A total of 83 elders with 157 root surfaces with active caries lesion were randomly allocated into 3 groups: Gp1 (placebo control)-annual application of soda water; Gp2-annual application of SDF solution; Gp3-annual application of SDF solution immediately followed by potassium iodide (KI) solution. Color of the arrested root caries lesion was assessed with reference to PANTONE color plates and classified into one of the followings: yellow (7401U); light brown (1245U); dark brown (4635U); and black (Black U). Status of root surfaces was assessed every 6 months by the same independent examiner. After 30 months, 100 (64%) of the included root caries lesions were reviewed. The arrest rates of root caries were 45%, 90%, and 93% in Gp1 (control), Gp2 (SDF) and Gp3 (SDF/KI), respectively (χ(2) test, p<0.001). Pairwise comparisons showed elders in the control group had a lower proportion of the active root caries changed to arrested (p<0.001) and the proportions of root caries being arrested in the SDF and SDF/KI groups were not significantly different (p>0.05). The distributions of arrested caries lesions by color were not significantly different between the SDF and SDF/KI groups (χ(2) test, p>0.05). Application of SDF solution, with or without application of KI afterwards, is effective in arresting root caries among elders in a water fluoridated area. In the long term, blackening of arrested root caries is not reduced by immediate application of KI after the application of SDF. In a water fluoridated area, annual application of SDF solution or SDF/KI solution can arrest dental root caries in elders. In the long term, application of KI does not reduce the blackening of arrested caries lesions caused by SDF. Copyright © 2016 The Authors

  8. Health status profiles in community-dwelling elderly using self-reported health indicators: a latent class analysis.

    PubMed

    Ng, Charis W L; Luo, Nan; Heng, Bee Hoon

    2014-12-01

    Latent class analysis (LCA), a statistical method for identifying latent classes within a population using multiple indicators, has been used to study the heterogeneity of health among the elderly. We aim to identify health status profiles of older adults using LCA and examine the socio-demographic characteristics associated with each profile. A community health survey of residents ≥60 years was conducted in Marine Parade, Singapore. We performed LCA on seven health indicators (number of chronic conditions, activities of daily living (ADL) dependency, pain, depression, cognition, social isolation, and frequency of socialising) to identify distinct classes of health status profiles. Multivariable logistic regression was conducted to examine the socio-demographic characteristics associated with each profile. Of the 2,444 elderly interviewed, we identified two health status profiles: "Health at risk" (n = 465, 19.0 %), and "Relatively healthy" (n = 1,979, 81.0 %). The "Health at risk" profile was characterised by high probabilities of 3+ chronic conditions (λ = 0.63), at least one basic/instrumental ADL dependency (λ = 0.56), moderate/extreme pain (λ = 0.55), cognitive impairment (λ = 0.29), depressive symptoms (λ = 0.29), social isolation (λ = 0.27), and infrequent socialisation (λ = 0.61). Individuals who were older (65-74, 75-84, and 85+ years), females, of non-Chinese ethnicity (Indian, Malay, and Others), had primary and lower education, and were unemployed/not employed were more likely to be "Health at risk". Using LCA, we identified two distinct health status profiles which accounted for the heterogeneity of the elderly population. Selected socio-demographic characteristics were associated with different profiles and provide implications for the structuring of future public health interventions targeting the older population.

  9. Urban and rural variations in the characteristics associated with elder mistreatment in a community-dwelling Chinese population.

    PubMed

    Dong, Xinqi; Simon, Melissa Andrea

    2013-01-01

    This study compares the urban and rural differences in characteristics associated with elder mistreatment (EM) in a Chinese population. A cross-sectional study of 269 urban and 135 rural participants aged 60 years or greater was performed. Among those with EM, rural participants were more likely to be women, have lower levels of education and income, have lower levels of health status and quality of life, have worse change in recent health, and have lower levels of psychosocial well-being. Both higher levels of depressive symptoms and lower levels of social support were associated with increased risk of EM.

  10. Occlusal support including that from artificial teeth as an indicator for health promotion among community-dwelling elderly in Japan.

    PubMed

    Kimura, Motoshi; Watanabe, Misuzu; Tanimoto, Yoshimi; Kusabiraki, Toshiyuki; Komiyama, Maki; Hayashida, Itsushi; Kono, Koichi

    2013-07-01

    The Eichner index (EI) is used to evaluate occlusal support. However, this index is based on existing natural tooth contact. This study aimed to establish whether a modified EI that included artificial teeth reflected individual oral condition of elderly people, and to clarify the relationship between this index and: (i) mental condition; (ii) physical condition; and (iii) physical function. We recruited 286 people (145 men, 141 women) aged 65-79 years. They were divided into three groups by modified EI, and then underwent assessment of oral condition. After establishing that the index was clearly related to oral condition, we investigated psychological factors (satisfaction with life, self-rated health and anxiety regarding falling), indicators of walking and balance (Timed Up & Go test [TUG] and one-leg standing balance), physical condition (higher-level functional capacity [HLFC]: instrumental activities of daily living [IADL], intellectual activity and social role; continuous walking over 15 min; and frequency of outings), and health history in the previous year (history of hospital admissions and falls). Modified EI was a good indicator of occlusal condition. The index was significantly correlated in men with satisfaction with life, TUG test, one-leg standing balance, overall HLFC and HLFC-IADL, and in women with TUG test, one-leg standing balance and HLFC-Intellectual activity. The evaluation of occlusal support including that from artificial teeth is beneficial in the elderly as an indicator of health and oral function, in particular firm bite. © 2012 Japan Geriatrics Society.

  11. Structural brain changes after traditional and robot-assisted multi-domain cognitive training in community-dwelling healthy elderly.

    PubMed

    Kim, Geon Ha; Jeon, Seun; Im, Kiho; Kwon, Hunki; Lee, Byung Hwa; Kim, Ga Young; Jeong, Hana; Han, Noh Eul; Seo, Sang Won; Cho, Hanna; Noh, Young; Park, Sang Eon; Kim, Hojeong; Hwang, Jung Won; Yoon, Cindy W; Kim, Hee Jin; Ye, Byoung Seok; Chin, Ju Hee; Kim, Jung-Hyun; Suh, Mee Kyung; Lee, Jong Min; Kim, Sung Tae; Choi, Mun-Taek; Kim, Mun Sang; Heilman, Kenneth M; Jeong, Jee Hyang; Na, Duk L

    2015-01-01

    The purpose of this study was to investigate if multi-domain cognitive training, especially robot-assisted training, alters cortical thickness in the brains of elderly participants. A controlled trial was conducted with 85 volunteers without cognitive impairment who were 60 years old or older. Participants were first randomized into two groups. One group consisted of 48 participants who would receive cognitive training and 37 who would not receive training. The cognitive training group was randomly divided into two groups, 24 who received traditional cognitive training and 24 who received robot-assisted cognitive training. The training for both groups consisted of daily 90-min-session, five days a week for a total of 12 weeks. The primary outcome was the changes in cortical thickness. When compared to the control group, both groups who underwent cognitive training demonstrated attenuation of age related cortical thinning in the frontotemporal association cortices. When the robot and the traditional interventions were directly compared, the robot group showed less cortical thinning in the anterior cingulate cortices. Our results suggest that cognitive training can mitigate age-associated structural brain changes in the elderly. ClnicalTrials.gov NCT01596205.

  12. Working memory performance is related to intrinsic resting state functional connectivity changes in community-dwelling elderly cohort.

    PubMed

    Charroud, Céline; Le Bars, Emmanuelle; Deverdun, Jérémy; Steffener, Jason; Molino, François; Abdennour, Meriem; Portet, Florence; Bonafe, Alain; Stern, Yaakov; Ritchie, Karen; Akbaraly, Tasnime N; Menjot de Champfleur, Nicolas

    2016-07-01

    Characterization of normal age-related changes in resting state brain networks associated with working memory performance is a major prerequisite for studying neurodegenerative diseases. The aim of this study was to investigate the relationship between performing a working memory task (under MRI) and resting-state brain networks in a large cohort of healthy elderly subjects (n=337). Functional connectivity and interactions between networks were assessed within the default mode (DMN), salience (SN), and right and left central executive (CEN) networks in two groups of subjects classed by their performance (low and high). The low performance group showed lower functional connectivity in both the DMN and SN, and higher functional connectivity in the right and left CEN compared to the high performance group. Overall the functional connectivity within the DMN and the CEN were correlated. The lower functional connectivity within the DMN and SN in the low performance group is suggestive of altered attentional and memory processes and/or altered motivation. The higher functional connectivity within the CEN could be related to compensatory mechanisms, without which the subjects would have even lower performances. The correlation between the DMN and CEN suggests a modulation between the lower functional connectivity within the DMN and the higher functional connectivity within the CEN when performance is reduced. Finally, this study suggests that performance modifications in healthy elderly subjects are associated with reorganization of functional connectivity within the DMN, SN, and CEN.

  13. Structural Brain Changes after Traditional and Robot-Assisted Multi-Domain Cognitive Training in Community-Dwelling Healthy Elderly

    PubMed Central

    Kim, Geon Ha; Jeon, Seun; Im, Kiho; Kwon, Hunki; Lee, Byung Hwa; Kim, Ga Young; Jeong, Hana; Han, Noh Eul; Seo, Sang Won; Cho, Hanna; Noh, Young; Park, Sang Eon; Kim, Hojeong; Hwang, Jung Won; Yoon, Cindy W.; Kim, Hee Jin; Ye, Byoung Seok; Chin, Ju Hee; Kim, Jung-Hyun; Suh, Mee Kyung; Lee, Jong Min; Kim, Sung Tae; Choi, Mun-Taek; Kim, Mun Sang; Heilman, Kenneth M; Jeong, Jee Hyang; Na, Duk L.

    2015-01-01

    The purpose of this study was to investigate if multi-domain cognitive training, especially robot-assisted training, alters cortical thickness in the brains of elderly participants. A controlled trial was conducted with 85 volunteers without cognitive impairment who were 60 years old or older. Participants were first randomized into two groups. One group consisted of 48 participants who would receive cognitive training and 37 who would not receive training. The cognitive training group was randomly divided into two groups, 24 who received traditional cognitive training and 24 who received robot-assisted cognitive training. The training for both groups consisted of daily 90-min-session, five days a week for a total of 12 weeks. The primary outcome was the changes in cortical thickness. When compared to the control group, both groups who underwent cognitive training demonstrated attenuation of age related cortical thinning in the frontotemporal association cortices. When the robot and the traditional interventions were directly compared, the robot group showed less cortical thinning in the anterior cingulate cortices. Our results suggest that cognitive training can mitigate age-associated structural brain changes in the elderly. Trial Registration ClnicalTrials.gov NCT01596205 PMID:25898367

  14. The Association Between Fall History and Physical Performance Tests in the Community-Dwelling Elderly: A Cross-Sectional Analysis.

    PubMed

    Kim, Jin Chul; Chon, Jinmann; Kim, Hee Sang; Lee, Jong Ha; Yoo, Seung Don; Kim, Dong Hwan; Lee, Seung Ah; Han, Yoo Jin; Lee, Hyun Seok; Lee, Bae Youl; Soh, Yun Soo; Won, Chang Won

    2017-04-01

    To evaluate the association between baseline characteristics, three physical performance tests and fall history in a sample of the elderly from Korean population. A total of 307 participants (mean age, 76.70±4.85 years) were categorized into one of two groups, i.e., fallers and non-fallers. Fifty-two participants who had reported falling unexpectedly at least once in the previous 12 months were assigned to the fallers group. Physical performance tests included Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), Timed Up and Go test. The differences between the two study groups were compared and we analyzed the correlations between fall histories and physical performance tests. SPPB demonstrated a significant association with fall history. Although the BBS total scores did not show statistical significance, two dynamic balance test items of BBS (B12 and B13) showed a significant association among fallers. This study suggests that SPPB and two dynamic balance test items of the BBS can be used in screening for risk of falls in an ambulatory elderly population.

  15. Edentulism associates with worse cognitive performance in community-dwelling elders in rural Ecuador: results of the Atahualpa project.

    PubMed

    Del Brutto, Oscar H; Gardener, Hannah; Del Brutto, Victor J; Maestre, Gladys E; Zambrano, Mauricio; Montenegro, Jipson E; Wright, Clinton B

    2014-12-01

    Studies in industrialized nations suggest that severe edentulism correlates with cognitive impairment, but there is little information on this association in underserved populations. We conducted a community-based study to assess whether edentulism associates with cognitive impairment in elders living in rural Ecuador. Atahualpa residents aged ≥60 years were identified during a door-to-door census and evaluated using the Montreal Cognitive Assessment (MoCA). Persons were classified into two groups according to whether they have severe edentulism (<10 remaining teeth) or not. In addition, a questionnaire allowed self-rating of oral health. A total of 274 persons (mean age 69.6 ± 7.7 years; 59% women) were included. Persons with <10 remaining teeth (n = 116) have significantly lower MoCA scores than those with ≥10 teeth (n =158), after adjusting for demographics, cardiovascular risk factors, depression and dementia (β = -1.06, p = 0.03). Self-rated poor oral health was more prevalent among persons with <10 teeth (p < 0.0001), but did not correlate with MoCA scores (good vs. poor, β = -0.89, p = 0.89). Severe edentulism is associated with poor cognitive performance in elders living in rural Ecuador. Public health campaigns directed to improve oral health may facilitate early recognition of persons with cognitive impairment in underserved populations.

  16. Consumption of star fruit juice on pro-inflammatory markers and walking distance in the community dwelling elderly.

    PubMed

    Leelarungrayub, Jirakrit; Laskin, James J; Bloomer, Richard J; Pinkaew, Decha

    2016-01-01

    This study aimed to evaluate the effect of star fruit juice supplementation on tumor necrosis factor-alpha (TNF-α), interleukin-23 (IL-23) and interleukin-2 (IL-2), nitric oxide (NO), and 6 min walking distance (6MWD) in a group of elderly individuals. Twenty-nine individuals (20 males, 9 females) with a mean age of 72.4±8.3 years completed this study. A two-week control period was followed by four weeks of 100g fresh star fruit juice consumption twice per day after meals. Plasma TNF-α, IL-23, IL-2, NO and the 6MWD were evaluated twice during the control period (weeks 0 and 2) and once after the star fruit juice consumption (week 6). The results showed that all parameters in the blood did not change significantly during the control period. After 4 weeks of star fruit juice consumption, a significant reduction in NO, TNF-α and IL-23 was found; however, there was no change in IL-2. Moreover, the 6MWD increased significantly at week 6, when compared to that at week 0 and 2. Furthermore, the results also showed a significantly positive and negative correlation of NO and TNF-α to the 6MWD, but no correlation of IL-23 and IL-2. This preliminary study concluded that consumption of star fruit juice at 100g twice daily for one month can significantly depress the pro-inflammation cytokines: TNF-α, IL-23, and NO, while increasing walking distance. Low TNF-α and high NO also present a significant correlation to walking capacity in elderly individuals. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Low fat-free mass as a marker of mortality in community-dwelling healthy elderly subjects.

    PubMed

    Genton, Laurence; Graf, Christophe E; Karsegard, Véronique L; Kyle, Ursula G; Pichard, Claude

    2013-01-01

    low fat-free mass has been related to high mortality in patients. This study evaluated the relationship between body composition of healthy elderly subjects and mortality. in 1999, 203 older subjects underwent measurements of body composition by bioelectrical impedance analysis, Charlson co-morbidity index and estimation of energy expenditure through physical activity by a validated questionnaire. These measurements were repeated in 2002, 2005 and 2008 in all consenting subjects. Mortality data between 1999 and 2010 were retrieved from the local death registers. The relationship between mortality and the last indexes of fat and fat-free masses was analysed by multiple Cox regression models. women's and men's data at last follow-up were: age 81.1 ± 5.9 and 80.9 ± 5.8 years, body mass index 25.3 ± 4.6 and 26.1 ± 3.4 kg/m(2), fat-free mass index 16.4 ± 1.8 and 19.3 ± 1.9 kg/m(2) and fat mass index 9.0 ± 3.2 and 6.8 ± 2.0 kg/m(2). Fifty-eight subjects died between 1999 and 2010. The fat-free mass index (hazard ratio 0.77; 95% confidence interval 0.63-0.95) but not the fat mass index, predicted mortality in addition to sex and Charlson index. The multiple Cox regression model explained 31% of the variance of mortality. a low fat-free mass index is an independent risk factor of mortality in elderly subjects, healthy at the time of body composition measurement.

  18. Dental status and satisfaction with oral function in a sample of community-dwelling elderly people in Japan.

    PubMed

    Ikebe, Kazunori; Nokubi, Takashi; Ettinger, Ronald L; Namba, Hidekazu; Tanioka, Nozomu; Iwase, Katsuya; Ono, Takahiro

    2002-01-01

    The purpose of this study was to determine the influence of dental status on oral function and satisfaction among a group of independently living elderly persons in an urban area of Japan. The study sample consisted of participants of the Senior Citizens' College from 1995 to 1999. Their dental status and oral satisfaction were measured by a questionnaire. The number of usable questionnaires was 3967, or 80.8% of the total sample. The mean age of the subjects was 66.5+/-4.3 years, and 52.2% were male. Twenty-nine percent of them had a natural dentition, and 7.0% were edentulous in both jaws. The prevalence of edentulism in the study sample was significantly lower (p < 0.01) than that for the national survey. Overall, 66.4% of the subjects were satisfied with their ability to chew, 56.2% with the appearance of their teeth, 63.1% with their ability to speak clearly, and 76.5% with their ability to taste food. For complete-denture wearers, the greatest dissatisfaction was with speech (28.5%); however, for the RPD wearers, it was with chewing ability (21.7%). Sixty-one percent of complete-denture wearers reported that they were satisfied with their chewing ability, but only 11% of them could eat all three of the evaluated foods without difficulty. The multiple stepwise logistic regression analyses showed that both dental status and self-assessed general health had a significant association with dissatisfaction with all four oral functions and self-assessed impairment of chewing ability. There were significant associations between the elderly subjects' dental status and oral function.

  19. Discrepancies between self-reported years of education and estimated reading level among elderly community-dwelling African-Americans: Analysis of the MOAANS data.

    PubMed

    O'Bryant, Sid E; Lucas, John A; Willis, Floyd B; Smith, Glenn E; Graff-Radford, Neill R; Ivnik, Robert J

    2007-03-01

    The influence of education on cognition has received a great deal of attention in the literature. Although there is general consensus regarding the importance of education on cognitive functioning, the extent to which self-reported level of education corresponds to true educational attainment remains unclear, especially in ethnic minority populations where equal access to education has not always been available. Several investigators have suggested that reading skill may serve as a quantitative estimate of true education experience. Among African-Americans, however, research has shown that self-reported educational level consistently over predicts estimated reading level. The current study analyzed the discrepancy between self-reported years of education completed and estimated reading level in a sample of community-dwelling, elderly African-Americans participating in Mayo's Older African Americans Normative Studies (MOAANS) (Lucas, J.A., Ivnik, R.J., Willis, F.B., Ferman, T.J., Smith, G.E., Parfitt, F.C., Petersen, R.C., & Graff-Radford, N.R. (2005). Mayo's Older African Americans Normative Studies: Normative data for commonly used clinical neuropsychological measures. The Clinical Neuropsychologist, 19, 162-183). In this sample, 29% of the participants read at a level that was 3 or more years below what would be expected based on self-report of education attained. This study also sought to evaluate the extent to which this discrepancy fluctuated as a function of demographic variables such as location of schooling (urban, suburban, rural; North vs. South), parental education and literacy, and percentage of segregation in schooling. Implications of these results are discussed, as are areas for further inquiry.

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

    PubMed

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

    2010-01-01

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

  1. Urban and Rural Variations in the Characteristics Associated with Elder Mistreatment in a Community-Dwelling Chinese Population

    PubMed Central

    DONG, XINQI; SIMON, MELISSA ANDREA

    2012-01-01

    This study compared the urban and rural differences in the sociodemographic, socioeconomic, health-related, and psychosocial factors associated with elder mistreatment (EM) in a Chinese population. Cross-sectional study of 269 urban and 135 rural participants aged 60 years or greater was performed. For urban participants, those with EM were more likely to be younger, have lower levels of education and income, and have lower levels of psychosocial well-being. For rural participants, those with EM were more likely to be older, have lower levels of education, have higher numbers of medical conditions and lower levels of health status, and have lower levels of psychosocial well-being. Among those with EM, rural participants were more likely to be women, have lower levels of education and income, have lower levels of health status and quality of life, have worse change in recent health, and have lower levels of psychosocial well-being. Both higher levels of depressive symptoms and lower levels of social support were associated with increased risk of EM. Future intervention studies are needed to examine the effect of improving psychosocial well-being on the risk of EM among Chinese populations. PMID:23473295

  2. 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

  3. 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

  4. Prediction of Hospitalization due to Adverse Drug Reactions in Elderly Community-Dwelling Patients (The PADR-EC Score)

    PubMed Central

    Parameswaran Nair, Nibu; Chalmers, Leanne; Connolly, Michael; Bereznicki, Bonnie J.; Peterson, Gregory M.; Curtain, Colin; Castelino, Ronald L.; Bereznicki, Luke R.

    2016-01-01

    Background Adverse drug reactions (ADRs) are the major cause of medication-related hospital admissions in older patients living in the community. This study aimed to develop and validate a score to predict ADR-related hospitalization in people aged ≥65 years. Methods ADR-related hospitalization and its risk factors were determined using a prospective, cross-sectional study in patients aged ≥65 years admitted to two hospitals. A predictive model was developed in the derivation cohort (n = 768) and the model was applied in the validation cohort (n = 240). ADR-related hospital admission was determined through expert consensus from comprehensive reviews of medical records and patient interviews. The causality and preventability of the ADR were assessed based on the Naranjo algorithm and modified Schumock and Thornton criteria, respectively. Results In the derivation sample (mean [±SD] age, 80.1±7.7 years), 115 (15%) patients were admitted due to a definite or probable ADR; 92.2% of these admissions were deemed preventable. The number of antihypertensives was the strongest predictor of an ADR followed by presence of dementia, renal failure, drug changes in the preceding 3 months and use of anticholinergic medications; these variables were used to derive the ADR prediction score. The predictive ability of the score, assessed from calculation of the area under the receiver operator characteristic (ROC) curve, was 0.70 (95% confidence interval (CI) 0.65–0.75). In the validation sample (mean [±SD] age, 79.6±7.6 years), 30 (12.5%) patients’ admissions were related to definite or probable ADRs; 80% of these admissions were deemed preventable. The area under the ROC curve in this sample was 0.67 (95% CI 0.56–0.78). Conclusions This study proposes a practical and simple tool to identify elderly patients who are at an increased risk of preventable ADR-related hospital admission. Further refinement and testing of this tool is necessary to implement the score in

  5. Postural stability and occlusal status among Japanese elderly.

    PubMed

    Song-Yu, Xuan; Rodis, Omar M M; Ogata, Sagiri; Can-Hu, Jin; Nishimura, Michiko; Matsumura, Seishi

    2012-06-01

    There are still no data available on the relationship between postural stability and occlusal status among the elderly. To examine relationships between postural stability and occlusal status through a cohort study among elderly Japanese. Oral examination, occlusal status, postural stability and a questionnaire were conducted and given to 87 community-dwelling Japanese at enrolment. The average occlusal pressure of the female group was statistically higher than the male group while average occlusal pressure and postural stability length were lesser in the group with more remaining teeth. Postural stability area and number of remaining teeth showed statistically significant correlations. Postural stability length was lesser in the group with strong occlusal force. Furthermore, the number of decayed teeth was fewer in the good hygiene group. This study identified a close relationship between occlusal status and postural stability of Japanese older individuals. Occlusal hypofunction was observed more in those with occlusal problems, and a decrease in their occlusal functions resulted in postural instability. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

  6. Ankle brachial index values, leg symptoms, and functional performance among community-dwelling older men and women in the lifestyle interventions and independence for elders study

    USDA-ARS?s Scientific Manuscript database

    The prevalence and significance of low normal and abnormal ankle brachial index (ABI) values in a community dwelling population of sedentary, older individuals is unknown. We describe the prevalence of categories of definite peripheral artery disease (PAD), borderline ABI, low-normal ABI and no PAD...

  7. 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.

  8. 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

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

    PubMed

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

    2015-01-01

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

  10. Abdominal obesity is strongly associated with Cardiovascular Disease and its Risk Factors in Elderly and very Elderly Community-dwelling Chinese

    PubMed Central

    Fan, Huimin; Li, Xiaolin; Zheng, Liang; Chen, Xiaoli; lan, Qin; Wu, Hong; Ding, Xugang; Qian, Dingguang; Shen, Yixin; Yu, Zuoren; Fan, Lieying; Chen, Ming; Tomlinson, Brian; Chan, Paul; Zhang, Yuzhen; Liu, Zhongmin

    2016-01-01

    Obesity is usually considered to predispose to atherosclerotic cardiovascular disease (ASCVD) but milder degrees of obesity or overweight may be protective in some elderly populations. We examined the relationships between general and abdominal obesity indices with ASCVD and its risk factors in elderly (aged ≥65 years) Shanghai community residents Among the 3950 participants, 21.5% had ASCVD, 56.2% had body mass index (BMI) ≥24 kg/m2, 50.1% had high waist circumference (WC) and 77.1% had waist-to-height ratio (WHtR) ≥0.50. WHtR increased with age in both men and women whereas WC increased with age only in women and BMI decreased with age only in men. The optimal WHtR cut-off value to predict the risk of ASCVD determined by receiver operating characteristic analysis was WHtR ≥0.53 with a prevalence of 55.8%. Having abdominal obesity was significantly associated with prevalent ASCVD with WHtR ≥0.53 having a higher value for the odds ratio than high WC, whereas high BMI was not associated. All three indices predicted high glucose, triglycerides and hsCRP levels but only the WHtR ≥0.53 showed a significant association with physical activity. Abdominal obesity indices, but not BMI, predicted prevalent ASCVD and its risk factors in this elderly Chinese population. PMID:26882876

  11. Abdominal obesity is strongly associated with Cardiovascular Disease and its Risk Factors in Elderly and very Elderly Community-dwelling Chinese.

    PubMed

    Fan, Huimin; Li, Xiaolin; Zheng, Liang; Chen, Xiaoli; Lan, Qin; Wu, Hong; Ding, Xugang; Qian, Dingguang; Shen, Yixin; Yu, Zuoren; Fan, Lieying; Chen, Ming; Tomlinson, Brian; Chan, Paul; Zhang, Yuzhen; Liu, Zhongmin

    2016-02-17

    Obesity is usually considered to predispose to atherosclerotic cardiovascular disease (ASCVD) but milder degrees of obesity or overweight may be protective in some elderly populations. We examined the relationships between general and abdominal obesity indices with ASCVD and its risk factors in elderly (aged ≥ 65 years) Shanghai community residents Among the 3950 participants, 21.5% had ASCVD, 56.2% had body mass index (BMI) ≥ 24 kg/m2, 50.1% had high waist circumference (WC) and 77.1% had waist-to-height ratio (WHtR) ≥ 0.50. WHtR increased with age in both men and women whereas WC increased with age only in women and BMI decreased with age only in men. The optimal WHtR cut-off value to predict the risk of ASCVD determined by receiver operating characteristic analysis was WHtR ≥ 0.53 with a prevalence of 55.8%. Having abdominal obesity was significantly associated with prevalent ASCVD with WHtR ≥ 0.53 having a higher value for the odds ratio than high WC, whereas high BMI was not associated. All three indices predicted high glucose, triglycerides and hsCRP levels but only the WHtR ≥ 0.53 showed a significant association with physical activity. Abdominal obesity indices, but not BMI, predicted prevalent ASCVD and its risk factors in this elderly Chinese population.

  12. Contextual effect of neighborhood environment on homebound elderly in a Japanese community.

    PubMed

    Murayama, Hiroshi; Yoshie, Satoru; Sugawara, Ikuko; Wakui, Tomoko; Arami, Reiko

    2012-01-01

    Homebound status is associated with poorer health and disability; however, the impact of community factors on the decision to remain homebound is unclear. We applied multilevel analyses to examine the association between neighborhood environment and homebound status among Japanese community-dwelling elderly. A cross-sectional survey was conducted in February 2009 using a mailed questionnaire. A total of 4123 participants aged 20 years and over living in 72 small districts of Kashiwa, Japan, were randomly selected for the survey. Of the 1735 returned questionnaires, the 588 that were completed by individuals aged 65 years and over were used for analysis. Frequency of going outdoors was assessed and respondents going outdoors once a week or less were defined as homebound. Neighborhood environment was assessed using three subscales of the Neighborhood Environment Walkability Scale (NEWS-A) (land use mix-access, aesthetics and crime safety). Multilevel logistic regression analysis indicated that the lower score of land use mix-access at the district level was associated with the elderly being homebound after adjustment for individual demographic data, physical, psychological and social factors and district prevalence of population aged 65 years or more. This finding could contribute to devising a successful community-based strategy for homebound prevention of community-dwelling elderly individuals.

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

    PubMed

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

    2014-07-01

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

  14. The Epidemiology of Hip and Major Osteoporotic Fractures in a Dutch Population of Community-Dwelling Elderly: Implications for the Dutch FRAX® Algorithm

    PubMed Central

    Klop, Corinne; Welsing, Paco M. J.; Leufkens, Hubert G. M.; Elders, Petra J. M.; Overbeek, Jetty A.; van den Bergh, Joop P.; Bijlsma, Johannes W. J.; de Vries, Frank

    2015-01-01

    Background Incidence rates of non-hip major osteoporotic fractures (MOF) remain poorly characterized in the Netherlands. The Dutch FRAX® algorithm, which predicts 10-year probabilities of hip fracture and MOF (first of hip, humerus, forearm, clinical vertebral), therefore incorporates imputed MOF rates. Swedish incidence rate ratios for hip fracture to MOF (Malmo 1987–1996) were used to perform this imputation. However, equality of these ratios between countries is uncertain and recent evidence is scarce. Aims were to estimate incidence rates of hip fracture and MOF and to compare observed MOF rates to those predicted by the imputation method for the Netherlands. Methods Using hospitalisation and general practitioner records from the Dutch PHARMO Database Network (2002–2011) we calculated age-and-sex-specific and age-standardized incidence rates (IRs) of hip and other MOFs (humerus, forearm, clinical vertebral) and as used in FRAX®. Observed MOF rates were compared to those predicted among community-dwelling individuals ≥50 years by the standardized incidence ratio (SIR; 95% CI). Results Age-standardized IRs (per 10,000 person-years) of MOF among men and women ≥50 years were 25.9 and 77.0, respectively. These numbers were 9.3 and 24.0 for hip fracture. Among women 55–84 years, observed MOF rates were significantly higher than predicted (SIR ranged between 1.12–1.50, depending on age). In men, the imputation method performed reasonable. Conclusion Observed MOF incidence was higher than predicted for community-dwelling women over a wide age-range, while it agreed reasonable for men. As miscalibration may influence treatment decisions, there is a need for confirmation of results in another data source. Until then, the Dutch FRAX® output should be interpreted with caution. PMID:26633011

  15. A higher adherence to a Mediterranean-style diet is inversely associated with the development of frailty in community-dwelling elderly men and women.

    PubMed

    Talegawkar, Sameera A; Bandinelli, Stefania; Bandeen-Roche, Karen; Chen, Ping; Milaneschi, Yuri; Tanaka, Toshiko; Semba, Richard D; Guralnik, Jack M; Ferrucci, Luigi

    2012-12-01

    Adherence to a Mediterranean-style diet is associated with a lower risk for mortality, cognitive decline, and dementia. Whether adherence to a Mediterranean-style diet protects against age-related frailty is unclear. Therefore, our objective was to examine the association between a Mediterranean-style diet with the risk of frailty in community-dwelling older persons. We conducted longitudinal analyses using data from 690 community-living persons (≥65 y) who were randomly selected from a population registry in Tuscany, Italy. Participants of the Invecchiare in Chianti study of aging completed the baseline examination in 1998-2000 and were re-examined at least once over 6 y. Adherence to a Mediterranean-style diet (scored 0-9, modeled categorically as ≤3, 4-5, and ≥6) was computed from the European Prospective Investigation into Cancer and nutrition FFQ previously validated in this cohort. Frailty was defined as having at least 2 of the following criteria: poor muscle strength, feeling of exhaustion, low walking speed, and low physical activity. After a 6-y follow-up, higher adherence (score ≥6) to a Mediterranean-style diet was associated with lower odds of developing frailty [OR = 0.30 (95% CI: 0.14, 0.66)] compared with those with lower adherence (score ≤3). A higher adherence to a Mediterranean-style diet at baseline was also associated with a lower risk of low physical activity (OR = 0.62; 95% CI: 0.40, 0.96) and low walking speed [OR = 0.48 (95% CI: 0.27, 0.86)] but not with feelings of exhaustion and poor muscle strength. In community-dwelling older adults, higher adherence to a Mediterranean-style diet was inversely associated with the development of frailty.

  16. On the frequency and reproducibility of orthostatic blood pressure changes in healthy community-dwelling elderly during 60-degree head-up tilt.

    PubMed

    Patel, A; Maloney, A; Damato, A N

    1993-07-01

    The postural effects of 20 minutes of 60-degree head-up tilt on systolic, diastolic, and mean arterial blood pressures (BPs), heart rate, and rhythm were studied in 70 healthy, community-dwelling volunteer subjects of both sexes, divided into three age groups. Group A consisted of 30 subjects, with a mean age of 76 years (range 65 to 95 years); group B had 19 subjects, with a mean age of 54 years (range 45 to 64 years); and group C had 21 subjects, with a mean age of 33 years (range 24 to 44 years). To qualify, subjects had to have a systolic BP of 150 mm Hg or less and a diastolic BP of < 90 mm Hg, be taking no prescribed medications, have had no previous syncopal episodes, and have absence of any significant medical illness. Nine of 30 (30%) subjects in group A, 1 of 19 (5%) subjects in group B, and 2 of 21 (9.5%) subjects in group C exhibited asymptomatic postural drops in systolic blood pressure > 20 mm Hg (p < 0.05). The mean time for the systolic blood pressure drops in group A was 9.2 minutes. Results were reproducible upon retesting after 1 week.

  17. Effects of body mass index, abdominal obesity, and type 2 diabetes on mortality in community-dwelling elderly in Sao Paulo, Brazil: analysis of prospective data from the SABE study.

    PubMed

    Suemoto, Claudia K; Lebrao, Maria Lucia; Duarte, Yeda A; Danaei, Goodarz

    2015-04-01

    The majority of studies on the effects of adiposity on mortality in the elderly have been conducted in developed countries with mixed results. We investigated the association between adiposity and mortality in a cohort of community-dwelling elderly in Sao Paulo, Brazil. Body mass index (BMI), waist circumference, waist-to-hip ratio, and type 2 diabetes were evaluated in 1,882 participants (mean age 71.0 ± 8.3 years old, 61% female). Mortality was confirmed by national vital statistics records during a maximum of 10 years of follow-up. Proportional hazards models were used to estimate hazard ratios (HRs) for mortality after adjusting for sociodemographics and comorbidities. In a subsample of 897 participants, the effects of changes in measures of adiposity on mortality were investigated during a median follow-up of 4.6 years. Having type-2 diabetes at baseline was associated with increased mortality (HR = 1.44, 95% CI: 1.17-1.77), with a higher HR among men. When compared with normal weight participants (BMI = 20-<25kg/m(2)), overweight and obesity were not associated with mortality (overweight: HR = 0.84 [0.70, 1.02]; obesity: HR = 0.82 [0.64, 1.06]), whereas participants with low-normal weight (BMI = 18.5<20 kg/m(2)) had increased risk of death (HR = 1.51 [1.08-2.10]). Higher waist circumference and waist-to-hip ratio were not associated with increased mortality. Weight gain was protective against mortality in all BMI categories, except in obese participants, and weight loss increased the risk of death in all BMI categories by 42-63%. In community-dwelling elderly in Sao Paulo, overweight and obesity were not associated with a higher risk of death, and weight gain seemed to reduce mortality, except in the obese. © 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.

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

    PubMed

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

    2015-05-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  1. Elderly men have low levels of anti-Müllerian hormone and inhibin B, but with high interpersonal variation: a cross-sectional study of the sertoli cell hormones in 615 community-dwelling men.

    PubMed

    Chong, Yih Harng; Dennis, Nicola A; Connolly, Martin J; Teh, Ruth; Jones, Gregory T; van Rij, Andre M; Farrand, Stephanie; Campbell, A John; McLennan, Ian S; Mlennan, Ian S

    2013-01-01

    The Sertoli cells of the testes secrete anti-Müllerian hormone (Müllerian inhibiting Substance, AMH) and inhibin B (InhB). AMH triggers the degeneration of the uterine precursor in male embryos, whereas InhB is part of the gonadal-pituitary axis for the regulation of sperm production in adults. However, both hormones are also putative regulators of homeostasis, and age-related changes in these hormones may therefore be important to the health status of elderly men. The levels of AMH in elderly men are unknown, with limited information being available about age-related changes in InhB. We have therefore used ELISAs to measure Sertoli cell hormone levels in 3 cohorts of community-dwelling men in New Zealand. In total, 615 men were examined, 493 of which were aged 65 or older. Serum AMH and InhB levels inversely correlated with age in men older than 50 years (p<0.001) but not in the younger men. A minority of elderly men had undetectable levels of AMH and InhB. The variation in hormone levels between similarly aged men increased with the age of men. AMH and InhB partially correlated with each other as expected (r = 0.48, p<0.001). However, the ratio of the two Sertoli hormones varied significantly between men, with this variation increasing with age. Elderly men selected for the absence of cardiovascular disease had AMH levels similar to those of young men whereas their InhB levels did not differ from aged-matched controls. These data suggests that Sertoli cell number and function changes with age, but with the extent and nature of the changes varying between men.

  2. 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

  3. Prevalence and symptom profiling of oropharyngeal dysphagia in a community dwelling of an elderly population: a self-reporting questionnaire survey.

    PubMed

    Holland, G; Jayasekeran, V; Pendleton, N; Horan, M; Jones, M; Hamdy, S

    2011-09-01

    Symptomatic dysphagia is believed to be more common in the older population; however, the factors that predict age-related dysphagia are less well-understood. Here, we describe a questionnaire-based survey of swallowing dysfunction in a large, otherwise 'healthy' community dwelling older population in the UK in whom additional cognitive and depression related scores were evaluated. A postal survey using Sydney oropharyngeal dysphagia questionnaire was sent to 800 residences in the North of England that formed part of the University of Manchester Age and Cognitive Performance Longitudinal Study. This cohort was composed of older individuals (mean age 81 [range 69-98 years]) who are otherwise healthy with no history of previous neurological disease. The postal questionnaire is a validated self-report inventory measuring symptoms of oropharyngeal dysphagia covering a total of 17 domains of swallowing function. The maximal score obtainable is 1700, with a score of ≥200 arbitrarily considered to indicate swallowing difficulty. Cognitive performance and depression scores utilized the telephone interview cognitive screen and the Geriatric Depression Scale. All data were analyzed in SPSS. Of the 800 questionnaires sent out, 637 where returned. Three were later discarded as unusable after follow-up telephone interviews of incomplete forms, giving a completed response rate of 79%. Females made up 77% of the total respondents. Of the population, 11.4% reported symptoms indicative of significant dysphagia. Unsurprisingly, dysphagia severity was directly correlated with subject age (r= 0.11, P= 0.007). When cognitive factors were taken into account, there was no correlation between memory, recall, and mental performance and dysphagia; however, depression was strongly and independently associated (P= 0.002) with dysphagia symptoms. Dysphagia symptoms are prevalent in older people, affecting nearly one in nine people who are otherwise living independently in the community

  4. Prevalence of Sarcopenia in Community-Dwelling Chilean Elders According to an Adapted Version of the European Working Group on Sarcopenia in Older People (EWGSOP) Criteria.

    PubMed

    Lera, L; Albala, C; Sánchez, H; Angel, B; Hormazabal, M J; Márquez, C; Arroyo, P

    2017-01-01

    Sarcopenia is the progressive loss of mass and skeletal muscle strength and has serious consequences on older people's health. The Chilean older population has a high life-expectancy, but the prevalence of functional dependence is also high. To determine the prevalence of sarcopenia in Chilean older adults and its relationship with age, gender, and body mass index (BMI). Cross-sectional study. Community. 1,006 non-disabled, community-dwelling subjects aged 60 years or older living in Santiago. Anthropometric measurements, handgrip strength, physical performance tests, and dual-energy-x-ray-absorptiometry (DXA) scan were performed. Sarcopenia was defined using the algorithm of the European Working Group on Sarcopenia in Older People (EWGSOP). Muscle mass was measured with DXA scan; skeletal muscle mass index (SMI) and hand dynamometry were defined with cut-off points obtained for the Chilean population. For a 3m walking speed we used the cut-off point of the EWGSOP definition. Nutritional status and obesity were defined according to World Health Organization standards. Association between sarcopenia and age, gender, BMI and lean/fat mass ratio was estimated by logistic regression models. The prevalence of sarcopenia was 19.1% (95%CI: 16.8%-21.8%), similar in men and women. There was an increasing trend of sarcopenia by age group and a decreasing trend with nutritional status. After logistic regression, sarcopenia was positively associated with age (OR=1.10; 95%CI:1.06-1.15) and falls (OR=1.83; 95%CI:1.07-3.15) and negatively associated with overweight (OR=0.31; 95%CI:0.16-0.59), obesity (OR=0.02; 95%CI:0.004-0.11), lean mass/fat mass ratio (OR=0.69; 95%CI:0.48-0.9997), knee height (OR=0.78; 95%CI:0.68-0.89) and calf circumference (OR=0.87; 95%CI:0.77-0.97). The total prevalence of sarcopenia was 19.1% increasing with age reaching 39.6% in people of 80 or more years of age. A negative association of sarcopenia with overweight, obesity and lean/fat mass ratio was

  5. Age-related Changes in Energy Intake and Weight in Community-dwelling Middle-aged and Elderly Japanese.

    PubMed

    Otsuka, R; Kato, Y; Nishita, Y; Tange, C; Tomida, M; Nakamoto, M; Imai, T; Ando, F; Shimokata, H

    2016-04-01

    This study attempts to describe trends in energy intake and weight change over 12 years according to age at first participation in the study. Prospective cohort study. The National Institute for Longevity Sciences - Longitudinal Study of Aging (NILS-LSA), a community-based study. Participants included 922 men and 879 women who participated in the first study-wave (age 40-79 years) and also participated in at least one study-wave from the second to seventh study-wave. Each study-wave was conducted biennially. For individuals, the entire follow-up period was 12 years. Energy intake was calculated from 3-day dietary records with photographs. Weight and height were measured under a fasting state. To estimate linear changes in energy intake and weight over 12 years according to age at first study-wave, we used the mixed-effects model. Mean (SD) follow-up time and number of study-wave visits were 9.5 (3.7) years and 5.4 (1.8) times, respectively. The fixed effect of the interaction of age and time in energy intake and weight was statistically or marginally statistically significant both in men (p<0.01) and in women (p<0.06). In men, when energy intake was estimated according to age, the rate of decrease in energy intake increased from -6.8 to -33.8 kcal/year for ages 40-79 years. In women, the rate of decrease in energy intake slightly increased in older age groups (-9.1 to -16.7 kcal/year for ages 40-79 years). Weight increased in males in their 40s (0.07 kg/year from age 40) and started to decline by age 53. In women, weight started to decline around age 47 (-0.04 kg/year). Twelve-year longitudinal data showed energy intake declined both in men and women in their 40s, and the rate of decrease increased in older males. Weight started to decline in men in their mid-50s and women in their late 40s. Further studies that focus on energy intake and weight reduction are needed to prevent weight loss or underweight in an increasingly aging society.

  6. 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.

  7. Body Mass Index and Mortality according to Gender in a Community-Dwelling Elderly Population: The 3-Year Follow-up Findings from the Living Profiles of Older People Surveys in Korea.

    PubMed

    Yu, Seon Yeong; Kim, Byung Sung; Won, Chang Won; Choi, Hyunrim; Kim, Sunyoung; Kim, Hyung Woo; Kim, Min Joung

    2016-11-01

    Body mass index is widely regarded as an important predictor of mortality. The purpose of this study was to investigate the relationship between body mass index and mortality and to compare community-dwelling elderly people in South Korea according to sex. Data were collected from the 2008 and 2011 Living Profiles of Older People Surveys, which comprised 10,613 community-living South Korean men and women aged 65 years or older. The participants were stratified into five groups according to body mass index as defined by the World Health Organization guidelines. The sociodemographic characteristics of participants and mortality rates were compared across the body mass index groups. The highest survival rates were observed in men with a body mass index of 25.0-29.9 kg/m(2). A similar trend was observed in women, but it was not statistically significant. After adjusting for covariates, this association was also found in men across all BMI index groups, but not in women. This study supports previous findings that overweight or mild obesity is associated with the lowest mortality and suggests that the current categories of obesity require revision. Furthermore, the absence of statistically significant findings in the female cohort suggests that body mass index is not a suitable predictor of mortality in women and that an alternative is required.

  8. 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.

  9. Factors that prolong the 'postmortem interval until finding' (PMI-f) among community-dwelling elderly individuals in Japan: analysis of registration data.

    PubMed

    Ito, Tomoko; Tamiya, Nanako; Takahashi, Hideto; Yamazaki, Kentaro; Yamamoto, Hideki; Sakano, Shoji; Kashiwagi, Masayo; Miyaishi, Satoru

    2012-01-01

    To clarify the factors affecting 'postmortem interval until finding' (PMI-f) among elderly unexpected death cases. Cross-sectional study. All area of Yamagata prefecture in Japan. Entering subjects were 5675 elderly cases with age of ≥65 years selected from all 9002 cases of unexpected death from 2002 to 2007 in Yamagata prefecture between 2002 and 2007. Our final study subjects consisted of 3387 cases sampled with several criteria to assess the factors to prolong PMI-f. The outcome was the postmortem interval until finding (PMI-f) as the time from death until finding the body which we defined in this study. 'Living alone' showed the highest adjusted HR (3.73, 95% CI 3.37 to 4.13), also 'unnatural death' (1.50, 1.28 to 1.75), 'found at own home' (1.37, 1.22 to 1.55) and 'younger subjects' (0.99, 0.98 to 0.99). In the model including interactions with the household situation, we found 'male subjects living alone' and 'female subjects living with family' tended to be found later. PMI-f is an effective outcome for quantitative analyses of risk of bodies left. To prevent the elderly dead bodies left for long time, it is necessary to keep regular home-based contact with elderly individuals living alone.

  10. Quality of life and physical activity associated to lower prevalence of depression in community-dwelling elderly subjects from Sao Paulo.

    PubMed

    Barcelos-Ferreira, Ricardo; Nakano, Eduardo Yoshio; Steffens, David C; Bottino, Cassio M C

    2013-09-05

    Studies investigating major depression and associated factors in older people from developing countries are scarce. Cross-sectional study of a community-based sample of 1563 elderly subjects aged 60 years or older from Sao Paulo, Brazil. The frequency of major depression (MD) and the relationship with sociodemographic factors, cognitive and functional impairment (CFI), clinically significant depressive symptoms (CSDS) and clinical diseases were analyzed. A brief instrument for screening of depressive symptoms in elderly people, the Mini Mental State Examination, the Fuld Object Memory Evaluation, the Informant Questionnaire on Cognitive Decline in the Elderly, the Bayer Activities of Daily Living Scale, the Cambridge Mental Disorders of the Elderly Examination, and a sociodemographic and clinical questionnaire were applied to the subjects. Major depression was diagnosed in 60 patients (3.8%). A higher odds ratio of MD was associated with female gender, being widowed, previous depressive episode, hypertension, use of psychotropic medication, (CFI), and alcohol use. A lower odds ratio of depression diagnosis was associated with physical activity and going to cinema. The cross-sectional design of the study; our sample was restricted only to community residents, excluding persons in hospitals or nursing homes. Our study shows significant association between depression and potentially modifiable factors, reinforcing the benefit of probable preventive measures, to incentive healthy lifestyle, leisure activities and the practice of physical exercise, as well as the diagnosis and treatment of CSDS, especially in primary care. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. The Role of Life-Space, Social Activity, and Depression on the Subjective Memory Complaints of Community-Dwelling Filipino Elderly: A Structural Equation Model

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Lagdaan, Lovely France M.; Lagoy, Marie Lauren V.

    2015-01-01

    Subjective memory complaints are one of the major concerns of the elderly and remain a challenging area in gerontology. There are previous studies that identify different factors affecting subjective memory complaints. However, an extended model that correlates life-space on subjective memory complaints remains a blank spot. The objective of this…

  12. The Role of Life-Space, Social Activity, and Depression on the Subjective Memory Complaints of Community-Dwelling Filipino Elderly: A Structural Equation Model

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Lagdaan, Lovely France M.; Lagoy, Marie Lauren V.

    2015-01-01

    Subjective memory complaints are one of the major concerns of the elderly and remain a challenging area in gerontology. There are previous studies that identify different factors affecting subjective memory complaints. However, an extended model that correlates life-space on subjective memory complaints remains a blank spot. The objective of this…

  13. Physiotherapist-designed aquatic exercise programme for community-dwelling elders with osteoarthritis of the knee: a Hong Kong pilot study.

    PubMed

    Lau, Mary C K; Lam, Joseph K S; Siu, Eva; Fung, Carmen S W; Li, Kevin T Y; Lam, Margaret W F

    2014-02-01

    OBJECTIVES. To examine the effectiveness and feasibility of a community-based aquatic exercise programme for elders with osteoarthritis of the knee. DESIGN. Prospective intervention study, with a before-and-after design. SETTING. Community elders. PARTICIPANTS. Twenty elders aged 65 years or above (mean, 72 years) attending four Elderly Health Centres of the Department of Health who had suffered from osteoarthritis of the knee for at least 3 years and with mild-to-severe knee pain. INTERVENTION. A 10-week aquatic exercise programme designed and led by physiotherapists. MAIN OUTCOME MEASURES. Range of motion and power of extension of the knees, functional reach test, repeated sit-to-stand test, and the Chinese Arthritis Impact Measurement Scales 2. RESULTS. There was an improvement in the median range of knee flexion from 115° to 125° (P<0.01) and the median strength of the quadriceps from 9 kg to 21 kg (P<0.001). The median score of the functional reach test increased from 20 cm to 28 cm (P<0.001) and the repeated sit-to-stand test from 10 to 14 repetitions (P<0.001). Also, there was an improvement in the mobility level (P<0.01), walking and bending ability of the trunk (P<0.05), levels of pain (P<0.01) and mood (P<0.01), and the total score (P<0.01) in the Chinese Arthritis Impact Measurement Scales 2. CONCLUSIONS. Physiotherapist-designed aquatic exercise has definite benefits in terms of physical and psychosocial functioning, and should be promoted as one of the strategies to enhance long-term self-management of community elders with knee osteoarthritis.

  14. [Prevalence of frailty and associated factors in community-dwelling elderly in Belo Horizonte, Minas Gerais State, Brazil: data from the FIBRA study].

    PubMed

    Vieira, Renata Alvarenga; Guerra, Ricardo Oliveira; Giacomin, Karla Cristina; Vasconcelos, Karina Simone de Souza; Andrade, Amanda Cristina de Souza; Pereira, Leani Souza Máximo; Dias, João Marcos Domingues; Dias, Rosângela Corrêa

    2013-08-01

    The prevalence of frailty varies greatly and has received insufficient attention in developing countries. This study aimed to identify the prevalence of frailty and associated factors among the elderly in Belo Horizonte, Minas Gerais State, Brazil. Clinical, functional, and socio-demographic factors were analyzed. An ordinal regression model was used to verify conditions associated with frailty and to determine odds ratios ( α= 0.05). Prevalence rates were 46.3% for pre-frailty was 8.7% for weakness. Pre-frail and frail elderly, respectively, showed higher and increasing odds ratios for dependency in instrumental activities of daily living; restrictions in advanced activities of daily living; use of walking aids; comorbidities; falls; depressive symptoms; lower self-efficacy in preventing falls; hospitalization; and advanced age. The study identified a high percentage of frail states associated with higher odds of adverse health conditions, especially related to disability.

  15. Factors that prolong the ‘postmortem interval until finding’ (PMI-f) among community-dwelling elderly individuals in Japan: analysis of registration data

    PubMed Central

    Ito, Tomoko; Tamiya, Nanako; Takahashi, Hideto; Yamazaki, Kentaro; Yamamoto, Hideki; Sakano, Shoji; Kashiwagi, Masayo; Miyaishi, Satoru

    2012-01-01

    Objectives To clarify the factors affecting ‘postmortem interval until finding’ (PMI-f) among elderly unexpected death cases. Design Cross-sectional study. Setting All area of Yamagata prefecture in Japan. Participants Entering subjects were 5675 elderly cases with age of ≥65 years selected from all 9002 cases of unexpected death from 2002 to 2007 in Yamagata prefecture between 2002 and 2007. Our final study subjects consisted of 3387 cases sampled with several criteria to assess the factors to prolong PMI-f. Primary outcome measures The outcome was the postmortem interval until finding (PMI-f) as the time from death until finding the body which we defined in this study. Results ‘Living alone’ showed the highest adjusted HR (3.73, 95% CI 3.37 to 4.13), also ‘unnatural death’ (1.50, 1.28 to 1.75), ‘found at own home’ (1.37, 1.22 to 1.55) and ‘younger subjects’ (0.99, 0.98 to 0.99). In the model including interactions with the household situation, we found ‘male subjects living alone’ and ‘female subjects living with family’ tended to be found later. Conclusions PMI-f is an effective outcome for quantitative analyses of risk of bodies left. To prevent the elderly dead bodies left for long time, it is necessary to keep regular home-based contact with elderly individuals living alone. PMID:23024252

  16. Comparison of 2-year effects of once and twice weekly water exercise on activities of daily living ability of community dwelling frail elderly.

    PubMed

    Sato, Daisuke; Kaneda, Koichi; Wakabayashi, Hitoshi; Nomura, Takeo

    2009-01-01

    Previous research suggests that water exercise improves the activities of daily living (ADL) ability of the frail elderly, but the specific frequency and intensity of such programs is unclear. This study aims at comparing the effects of once- and twice-weekly water exercise on the ADL ability of frail elderly receiving nursing care for 2 years. The design is a prospective randomized longitudinal study. Participants were assigned to two different exercise groups (Group 1 and Group 2). Group 1 participated in a 60-min exercise session once a week, for 2 years, while Group 2 attended the session twice a week. Exercise sessions were divided into a 10-min warm-up on land and 50 min of exercise in water. The 50-min water exercise program consisted of 20 min walking, 10 min ADL exercise, 10 min stretching and strength exercises, and 10 min relaxation in water. ADL ability and lower muscle strength were measured before the beginning of exercise and 6 months, 1 year, and 2 years after the program had started. Significant group differences occurred for bathing transfer and stair climbing at the 2-year measurement. These results suggested that at least twice-weekly water exercise was necessary to maintain the ADL ability and KEX of the frail elderly during the 1-year water exercise period and for one additional year afterward.

  17. Effects of increased physical activity on body composition, physical functions, vascular functions, HR-QOL, and self-efficacy in community-dwelling elderly people.

    PubMed

    Morisawa, Tomoyuki; Tamaki, Akira; Nagai, Kotatsu; Tsukagoshi, Rui; Nozaki, Sonoko; Miyamoto, Toshiaki; Mori, Akiko; Kaya, Mitsumasa; Fujioka, Hiroyuki

    2017-01-01

    [Purpose] The objective of this study was to clarify the effects of increased number of steps on body composition, physical functions, vascular functions, health-related quality of life (HR-QOL) and self-efficacy in elderly people. [Subjects and Methods] The subjects were 47 elderly persons who resided in Port Island in the Chuo Ward of Kobe City in Hyogo Prefecture, Japan. After the calculation of the mean preintervention physical activity (PA), the subjects were instructed to increase their PA to a target baseline + 1,300 steps/day. Body composition, physical functions, vascular functions, HR-QOL, and self-efficacy were measured at baseline, after 3 and 6 months. These items were compared between a group that increased their PA and a group that did not. [Results] After 6 months, 26.1% of the subjects achieved the PA target. No significant improvements were observed in body composition, physical functions, vascular functions, or self-efficacy for either group after 3 and 6 months. However, the HR-QOL improved significantly after 6 months in the achievement group. [Conclusion] Although the intervention to increase PA did not produce significant improvements after 6 months in body composition, physical functions, vascular functions, or self-efficacy, the HR-QOL improved significantly during this relatively short period.

  18. Effects of increased physical activity on body composition, physical functions, vascular functions, HR-QOL, and self-efficacy in community-dwelling elderly people

    PubMed Central

    Morisawa, Tomoyuki; Tamaki, Akira; Nagai, Kotatsu; Tsukagoshi, Rui; Nozaki, Sonoko; Miyamoto, Toshiaki; Mori, Akiko; Kaya, Mitsumasa; Fujioka, Hiroyuki

    2017-01-01

    [Purpose] The objective of this study was to clarify the effects of increased number of steps on body composition, physical functions, vascular functions, health-related quality of life (HR-QOL) and self-efficacy in elderly people. [Subjects and Methods] The subjects were 47 elderly persons who resided in Port Island in the Chuo Ward of Kobe City in Hyogo Prefecture, Japan. After the calculation of the mean preintervention physical activity (PA), the subjects were instructed to increase their PA to a target baseline + 1,300 steps/day. Body composition, physical functions, vascular functions, HR-QOL, and self-efficacy were measured at baseline, after 3 and 6 months. These items were compared between a group that increased their PA and a group that did not. [Results] After 6 months, 26.1% of the subjects achieved the PA target. No significant improvements were observed in body composition, physical functions, vascular functions, or self-efficacy for either group after 3 and 6 months. However, the HR-QOL improved significantly after 6 months in the achievement group. [Conclusion] Although the intervention to increase PA did not produce significant improvements after 6 months in body composition, physical functions, vascular functions, or self-efficacy, the HR-QOL improved significantly during this relatively short period. PMID:28210063

  19. Elder Mistreatment and its Subtypes across Different Sociodemographic and Socioeconomic Groups among U.S. Chinese Community-Dwelling Older Adults

    PubMed Central

    Chen, Ruijia; Dong, Xin Qi

    2016-01-01

    Objectives To examine the risk of overall elder mistreatment (EM) and its subtypes in each sociodemographic and socioeconomic group based on different definitional criteria. Methods In person interviews were conducted with 3,159 Chinese older adults in the Greater Chicago Area from 2011 to 2013. Psychological mistreatment, physical mistreatment, sexual abuse, caregiver neglect, and financial exploitation were measured using definitional approaches from the least strict to the strictest criteria. Results Physical, psychological mistreatment, and financial exploitation were closely correlated with each other, but caregiver neglect was not correlated with any other types of mistreatment. The risk of EM and its subtypes across sociodemographic groups differed by types and definitions of mistreatment. Discussion Future longitudinal studies are needed to quantity the risk and protective factors associated with EM and its subtypes with consideration of definitional issues in Chinese aging populations. PMID:26973979

  20. Association of Tooth Loss With Development of Swallowing Problems in Community-Dwelling Independent Elderly Population: The Fujiwara-kyo Study.

    PubMed

    Okamoto, Nozomi; Morikawa, Masayuki; Yanagi, Motokazu; Amano, Nobuko; Tomioka, Kimiko; Hazaki, Kan; Harano, Akihiro; Kurumatani, Norio

    2015-12-01

    Tooth loss induces changes to the anatomy of the oral cavity. We hypothesized that tooth loss may disturb smooth swallowing in healthy elderly people. The purpose of this study was to investigate the effect of tooth loss on the development of swallowing problems in an independent elderly population. This was a 5-year prospective cohort study conducted in Nara, Japan. Included in this analysis were 1,988 community residents aged 65 years or older without swallowing problems at baseline. The participants were classified into quartile groups according to the number of remaining teeth at the baseline survey: 0-12, 13-22, 23-26, and 27-32 teeth. A decrease in the number of teeth during the survey was calculated by subtracting follow-up number from baseline number. Main outcome was the development of swallowing problems at follow-up. During follow-up, 312 individuals developed swallowing problems. After adjustment for confounding factors by multiple logistic regression analysis, the odds ratios for developing swallowing problems in participants with 13-22 or 0-12 teeth were 2.42 (95% confidence interval [CI], 1.61-3.63) and 2.49 (95% CI, 1.68-3.69), respectively, compared to participants with 27-32 teeth, demonstrating a significant relationship. The odds ratio of per 1 tooth decrease over 5 years was 1.08 (95% CI, 1.02-1.13), showing a significant association. Swallowing problems due to aging are more likely to develop in individuals with fewer teeth. © The Author 2015. 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.

  1. Discontinuation of anti-hypertensive drugs increases 11-year cardiovascular mortality risk in community-dwelling elderly (the Bambuí Cohort Study of Ageing)

    PubMed Central

    2014-01-01

    Background Hypertension remains a major public health problem whose management is hampered by poor persistence with pharmacological therapy. The aim of this study was to evaluate the association between discontinuing antihypertensive drugs (AHDs) and the risk of cardiovascular mortality in the elderly. Methods A population-based prospective cohort study of all of the ≥60-year-old residents in Bambuí city (Brazil) enrolled 1606 subjects (92.2%), of whom 1494 (93.0%) were included in this study. The use of AHDs was ascertained annually in a real-clinical context, and time-varying AHD exposure was categorised as non-use, current use or stopped. The predicted cardiovascular mortality rates were estimated using interval Poisson models for ungrouped person-time data, taking into account current levels of systolic blood pressure (BP). Results The overall adjusted cardiovascular mortality risk ratio of AHD stoppers vs current users was 3.12 (95% CI: 2.35-4.15). There was a significant interaction with BP levels: the association between discontinuing AHDs and the risk of cardiovascular mortality was stronger at higher systolic BP levels. The estimates of the risk of cardiovascular mortality over the follow-up period were similar in AHD users and non-users, for whom AHDs were never prescribed. Conclusion Discontinuing AHDs increases the risk of cardiovascular mortality in the elderly. Misconceptions about symptoms or drug-related adverse effects could underlie a subject’s decision to discontinue AHDs. Greater attention should be paid to the choice of AHDs and informative action. PMID:25030357

  2. Negative impact of oral health conditions on oral health related quality of life of community dwelling elders in Mexico city, a population based study.

    PubMed

    Castrejón-Pérez, Roberto Carlos; Borges-Yáñez, S Aída; Irigoyen-Camacho, Ma Esther; Cruz-Hervert, Luis Pablo

    2017-05-01

    Oral health in old persons is frequently poor; non-functional prostheses are common and negatively affect quality of life. The objective of this study was to estimate the impact of oral health problems on oral health related quality of life in a sample of home dwelling Mexican elders. Household survey in 655 persons 70 years old and over residing in one county in Mexico City. Oral Health Related Quality of Life (Short version of the Oral Health Impact Profile validated in Mexico-OHIP-14-sp), self-perception of general and oral health, xerostomia, utilization of dental services, utilization and functionality of removable dental prostheses, dental and periodontal conditions, age, gender, marital status, schooling, depression, cognitive impairment and independence in activities of daily living (ADL). A negative binomial regression model was fitted. Mean age was 79.2 ± 7.1 years; 54.2% were women. Mean OHIP-14-Sp score was 6.8 ± 8.7, median was 4. The final model showed that men (RR = 1.30); persons with xerostomia (RR = 1.41); no utilization of removable prostheses (RR = 1.55); utilization of non-functional removable prostheses (RR = 1.69); fair self-perception of general health (RR = 1.34); equal (RR = 1.43) or worse (RR = 2.32) self-perception of oral health compared with persons of the same age; and being dependent for at least one ADL (RR = 1.71) increased the probability of higher scores of the OHIP-14-sp. Age, schooling, depression, cognitive impairment and periodontal conditions showed no association. Oral rehabilitation can improve quality of life, health education and health promotion for the elder and their caregivers may reduce the risk of dental problems. Geriatr Gerontol Int 2017; 17: 744-752. © 2016 Japan Geriatrics Society.

  3. Effect of combined exercise training on bone, body balance, and gait ability: a randomized controlled study in community-dwelling elderly women.

    PubMed

    Park, Hyuntae; Kim, Kang Jung; Komatsu, Taiki; Park, Sang Kab; Mutoh, Yoshiteru

    2008-01-01

    The purpose of this study was to investigate whether a 48-week multicomponent exercise program could improve the risk factors for fall and hip fracture. Fifty elderly women 65-70 years of age participated. These participants were divided into an exercise group (25 subjects) that attended an exercise program and a control group (25 subjects) that did not. The exercise program included stretching for 9 min, strength training for 10 min followed by 23 min of weight-bearing exercise at an intensity above 65%-75% of the maximal heart rate, and 18 min of balance and posture correction training. The program was conducted three times per week for 48 weeks. The 10-m maximal walk time, maximal step length, and eyes-open-one-legged-stand time in the exercise group improved significantly (P < 0.05). Concerning deoxypyridinoline, the exercise group achieved a significant improvement (P < 0.05) after the 48 weeks. Bone mineral density (BMD) of the femoral neck and trochanter in the exercise group was significantly increased after the exercise program; also body sway was significantly improved (P < 0.05). In conclusion, a multi-component exercise program with weight-bearing exercise at a moderate intensity and gait training may be effective in offsetting a decline in BMD and improving aggravation of bone resorption in this population. In addition, this program has a positive effect on postural stability and gait ability.

  4. The Impact of Cognitive Training on Cerebral White Matter in Community-Dwelling Elderly: One-Year Prospective Longitudinal Diffusion Tensor Imaging Study

    PubMed Central

    Cao, Xinyi; Yao, Ye; Li, Ting; Cheng, Yan; Feng, Wei; Shen, Yuan; Li, Qingwei; Jiang, Lijuan; Wu, Wenyuan; Wang, Jijun; Sheng, Jianhua; Feng, Jianfeng; Li, Chunbo

    2016-01-01

    It has been shown that cognitive training (CogTr) is effective and recuperative for older adults, and can be used to fight against cognitive decline. In this study, we investigated whether behavioural gains from CogTr would extend to white matter (WM) microstructure, and whether training-induced changes in WM integrity would be associated with improvements in cognitive function, using diffusion tensor imaging (DTI). 48 healthy community elderly were either assigned to multi-domain or single-domain CogTr groups to receive 24 sessions over 12 weeks, or to a control group. DTI was performed at both baseline and 12-month follow-up. Positive effects of multi-domain CogTr on long-term changes in DTI indices were found in posterior parietal WM. Participants in the multi-domain group showed a trend of long-term decrease in axial diffusivity (AD) without significant change in fractional anisotropy (FA), mean diffusivity (MD) or radial diffusivity (RD), while those in the control group displayed a significant FA decrease, and an increase in MD and RD. In addition, significant relationships between an improvement in processing speed and changes in RD, MD and AD were found in the multi-domain group. These findings support the hypothesis that plasticity of WM can be modified by CogTr, even in late adulthood. PMID:27628682

  5. The Impact of Cognitive Training on Cerebral White Matter in Community-Dwelling Elderly: One-Year Prospective Longitudinal Diffusion Tensor Imaging Study.

    PubMed

    Cao, Xinyi; Yao, Ye; Li, Ting; Cheng, Yan; Feng, Wei; Shen, Yuan; Li, Qingwei; Jiang, Lijuan; Wu, Wenyuan; Wang, Jijun; Sheng, Jianhua; Feng, Jianfeng; Li, Chunbo

    2016-09-15

    It has been shown that cognitive training (CogTr) is effective and recuperative for older adults, and can be used to fight against cognitive decline. In this study, we investigated whether behavioural gains from CogTr would extend to white matter (WM) microstructure, and whether training-induced changes in WM integrity would be associated with improvements in cognitive function, using diffusion tensor imaging (DTI). 48 healthy community elderly were either assigned to multi-domain or single-domain CogTr groups to receive 24 sessions over 12 weeks, or to a control group. DTI was performed at both baseline and 12-month follow-up. Positive effects of multi-domain CogTr on long-term changes in DTI indices were found in posterior parietal WM. Participants in the multi-domain group showed a trend of long-term decrease in axial diffusivity (AD) without significant change in fractional anisotropy (FA), mean diffusivity (MD) or radial diffusivity (RD), while those in the control group displayed a significant FA decrease, and an increase in MD and RD. In addition, significant relationships between an improvement in processing speed and changes in RD, MD and AD were found in the multi-domain group. These findings support the hypothesis that plasticity of WM can be modified by CogTr, even in late adulthood.

  6. The symptom of low mood in the prodromal stage of mild cognitive impairment and dementia: a cohort study of a community dwelling elderly population.

    PubMed

    Caracciolo, B; Bäckman, L; Monastero, R; Winblad, B; Fratiglioni, L

    2011-07-01

    To investigate the symptom of low mood as a predictor of mild cognitive impairment (MCI) and its progression to dementia, taking into account: (i) MCI severity, (ii) time of assessment and (iii) interaction with other factors. 764 cognitively healthy elderly subjects living in the community, from the Kungsholmen Project. Participants were assessed by direct interview to detect low mood. Subjects were then followed for 6 years to identify those who developed MCI. People with incident MCI were followed for a further 3 years to assess progression to dementia. People with low mood at baseline had a 2.7-fold (95% CI 1.9 to 3.7) increased risk of developing MCI at follow-up. The association was stronger for amnestic MCI (aMCI: HR 5.8; 95% CI 3.1 to 10.9) compared with global cognitive impairment (other cognitive impairment no dementia, oCIND: HR 2.2; 95% CI 1.5 to 3.3). ApoE-ε4 interacted with low mood in a synergistic fashion, increasing the risk of aMCI, while no interaction with psychiatric, vascular, frailty related or psychosocial factors was observed. Low mood at baseline, as opposed to low mood co-occurring with MCI, was associated with a 5.3-fold (95% CI 1.2 to 23.3) increased risk of progression to dementia in aMCI. In contrast, no association was found in oCIND. Low mood was more strongly associated with aMCI than with global cognitive impairment. Progression towards dementia was predicted only by low mood manifest in the prodromal stage of MCI. These findings indicate that low mood is particularly prominent in the very early stages of cognitive decline.

  7. Serum betaine is inversely associated with low lean mass mainly in men in a Chinese middle-aged and elderly community-dwelling population.

    PubMed

    Huang, Bi-Xia; Zhu, Ying-Ying; Tan, Xu-Ying; Lan, Qiu-Ye; Li, Chun-Lei; Chen, Yu-Ming; Zhu, Hui-Lian

    2016-06-01

    Previous studies have demonstrated that betaine supplements increase lean body mass in livestock and improve muscle performance in human beings, but evidence for its effect on human lean mass is limited. Our study assessed the association of circulating betaine with lean mass and its composition in Chinese adults. A community-based study was conducted on 1996 Guangzhou residents (weight/mass: 1381/615) aged 50-75 years between 2008 and 2010. An interviewer-administered questionnaire was used to collect general baseline information. Fasting serum betaine was assessed using HPLC-MS. A total of 1590 participants completed the body composition analysis performed using dual-energy X-ray absorptiometry during a mean of 3·2 years of follow-up. After adjustment for age, regression analyses demonstrated a positive association of serum betaine with percentage of lean mass (LM%) of the entire body, trunk and limbs in men (all P<0·05) and LM% of the trunk in women (P=0·016). Each sd increase in serum betaine was associated with increases in LM% of 0·609 (whole body), 0·811 (trunk), 0·422 (limbs), 0·632 (arms) and 0·346 (legs) in men and 0·350 (trunk) in women. Multiple logistic regression analysis revealed that the prevalence of lower LM% decreased by 17 % (whole body) and 14 % (trunk) in women and 23 % (whole body), 28 % (trunk), 22 % (arms) and 26 % (percentage skeletal muscle index) in men with each sd increment in serum betaine. Elevated circulating betaine was associated with a higher LM% and lower prevalence of lower LM% in middle-aged and elderly Chinese adults, particularly men.

  8. Performance of cognitive tests, individually and combined, for the detection of cognitive disorders amongst community-dwelling elderly people with memory complaints: the EVATEM study.

    PubMed

    Vannier-Nitenberg, C; Dauphinot, V; Bongue, B; Sass, C; Bathsavanis, A; Rouch, I; Deville, N; Beauchet, O; Krolak-Salmon, P; Fantino, B

    2016-03-01

    Dementia is a leading cause of dependence amongst the aged population. Early identification of cognitive impairment could help to delay advanced stages of dependence. This study aimed at assessing the performance of three neuropsychological tests to detect cognitive disorders in elderly subjects with memory complaints. The EVATEM study is a prospective multicentre cohort with a 1-year follow-up. Subjects with memory complaints were selected during preventive health examinations, and three neuropsychological tests (five-word, cognitive disorders examination, verbal fluency) were administered. Two groups were identified in memory clinics: (i) cognitively healthy individuals (CHI) and (ii) mild cognitive impairment or demented individuals (MCI-DI). Cross-sectional analyses were performed on data at inclusion. The relationship between the diagnosis of MCI-DI/CHI and the neuropsychological tests was assessed using logistic regressions. The performance of the neuropsychological tests, individually and combined, to detect cognitive disorders was calculated. Of 585 subjects, 31.11% had cognitive disorders (MCI, 176 subjects; DI, six subjects). Amongst the three tests studied, the odds ratio for MCI-DI was higher for the five-word test <10 [odds ratio 3.2 (1.81; 5.63)]. The best performance was observed when the three tests were combined: specificity 90.5% and sensitivity 42.4% compared to respectively 89.2% and 28.3% for the five-word test. Despite the poor sensitivity of the five-word test, it seems to be the most adapted for the diagnosis of MCI-DI in older adults with a memory complaint, in prevention centres, taking into account its high specificity and its rapid administration compared to the other tests. © 2015 EAN.

  9. [Memory complaints among community-dwelling elderly in Japan: comprehensive health examination for the community elderly for prevention of the geriatric syndrome and a bed-ridden state ("Otasha-kenshin") part III].

    PubMed

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

    2005-02-01

    Previous studies have indicated that memory complaints may predict cognitive decline and dementia among the elderly. The present study was therefore conducted to clarify memory complaint characteristics among elderly dwelling in an urban community in Japan. The participants analyzed in the present study were 453 men and 385 women aged 70 to 84 years living in an urban Japanese community. Data on problems related to memory complaints, cognitive decline (below 24 points on Mini-Mental State Examination), depression (measured by Mini-International Neuropsychiatric Interview), hearing and vision problems, I-ADL (measured by TMIG Index of Competence), self-rated health, age, sex, and years of education were collected at a comprehensive mass health examination for the elderly ("Otasha-kenshin"). Twenty-seven percent of male respondents and 32% of female respondents reported having current trouble remembering things (reported as "frequently" or "sometimes"). We collected specific descriptions of the memory complaint difficulties the subjects were experiencing. A quarter of the responses indicated problems with forgetting persons' names, a fifth with forgetting where things had been left, 15% with leaving things behind, and a quarter with prospective memory failure. The results of multivariate logistic regression analysis to explore correlates showed that in men self-rated health and cognitive decline, and in women hearing problems and self-rated health were significantly and independently related to the memory complaint. These findings suggest that in addition to cognitive decline, self-rated health and hearing problems may influence memory complaints, and that memory complaints in men may be a reliable, simple indicator of cognitive decline. We now need to carry out a longitudinal study to clarify predictive validity.

  10. [Demographic and socioeconomic factors associated with needs for home assistance among community-dwelling elderly: a study from the French Home Survey Handicaps-Disabilities-Dependence].

    PubMed

    Davin, B; Paraponaris, A; Verger, P

    2005-11-01

    Gains in life expectancy in western countries have mainly come hand in hand with growing chronic diseases and disabilities related to the activities of daily living (ADL) and instrumental activities of daily living (IADL). Although these disabilities have been identified as predictors of institutionalization, the elderly in France continue to live at home, in the community, alone or with others. This work aims at identifying and assessing their needs for assistance and looks especially at the demographic and socioeconomic associated features. Reported needs for assistance with ADL and IADL are studied through a representative sample of 8,745 people aged 60 years and older and living at home in 1999, taken from the French cross-sectional "Handicaps-Disabilities-Dependence" survey. Statistical associations (non-adjusted and adjusted Odds-Ratio-OR) have been computed in a conceptual framework derived from Andersen and Newman's behavioural model. More than 1 million people aged 60 years and older need assistance from another person to perform at least one ADL (bathing, dressing, going to toilet, eating, transferring, getting outside) and about 2.5 millions persons for at least one IADL (shopping, food preparation, housekeeping). Need for assistance for at least one ADL is associated with age (OR=1.4 for 70-79, 3.6 for 80+); male aged 80 and older (OR=0.5); low educational status (OR=1.5); being married (OR=1.7) or living with an other person (OR=2); a disposable income less than 540 euro per capita and per month or between 540 and 1,080 euro (OR=1.3); impairments: motor (OR=3), language (OR=2.1), visual (OR=1.7), mental (OR=1.5) and other (OR=1.2); availability of home equipment devices (OR=3.5), technical devices for moving inside (OR=3) and others (OR=2.1). Need for assistance is especially high among those who required assistance (OR=4) or proxies (OR=5.5) to answer. Declared need for assistance for at least one IADL is roughly associated with the same factors

  11. Effects of an integrated health education and elastic band resistance training program on physical function and muscle strength in community-dwelling elderly women: Healthy Aging and Happy Aging II study.

    PubMed

    Oh, Seung-Lyul; Kim, Hee-Jae; Woo, Shinae; Cho, Be-Long; Song, Misoon; Park, Yeon-Hwan; Lim, Jae-Young; Song, Wook

    2017-05-01

    In the present study, we determined the effect of an integrated health education and elastic band resistance training program on body composition, physical function, muscle strength and quality in community-dwelling elderly women. We recruited participants with eligibility inclusion criteria, and randomly assigned them to either the control group (n = 19) or the intervention group (n = 19). The integrated intervention program comprised of health education and individual counseling, and elastic band training for 18 weeks (8 weeks of supervised training and 10 weeks of self-directed training). We assessed body composition, muscle strength and quality, and physical function at pre-, after 8 weeks (mid-) and 18 weeks (post-training). After the intervention, there were no significant changes in skeletal muscle index, fat free mass, total lean mass and total fat mass for both the control group and intervention group. However, the interaction effect was significantly different in SPPB score (P < 0.05), isokinetic strength (60 deg/s, P < 0.001; 120 deg/s; P < 0.05) and muscle quality (P < 0.05) after 18 weeks of intervention relative to the baseline of the control and intervention groups. The supervised elastic band training of 8 weeks did not improve short physical performance battery score and isokinetic strength, whereas there was a significant increase of those outcomes (10.6% improvement, 9.8~23.5% improvement) after 10 weeks of following self-directed exercise compared with the baseline. These results show the effectiveness of following self-directed resistance training with health education after supervised training cessation in improvement of short physical performance battery and leg muscle strength. This intervention program might be an effective method to promote muscle strength and quality, and to prevent frailty in elderly women. Geriatr Gerontol Int 2017; 17: 825-833. © 2016 Japan Geriatrics Society.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

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

    PubMed Central

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

    2009-01-01

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

  19. The geriatric depression scale and the timed up and go test predict fear of falling in community-dwelling elderly women with type 2 diabetes mellitus: a cross-sectional study.

    PubMed

    Moreira, Bruno de Souza; Dos Anjos, Daniela Maria da Cruz; Pereira, Daniele Sirineu; Sampaio, Rosana Ferreira; Pereira, Leani Souza Máximo; Dias, Rosângela Corrêa; Kirkwood, Renata Noce

    2016-03-03

    Fear of falling is a common and potentially disabling problem among older adults. However, little is known about this condition in older adults with diabetes mellitus. The aims of this study were to investigate the impact of the fear of falling on clinical, functional and gait variables in older women with type 2 diabetes and to identify which variables could predict the fear of falling in this population. Ninety-nine community-dwelling older women with type 2 diabetes (aged 65 to 89 years) were stratified in two groups based on their Falls Efficacy Scale-International score. Participants with a score < 23 were assigned to the group without the fear of falling (n = 50) and those with a score ≥ 23 were assigned to the group with the fear of falling (n = 49). Clinical data included demographics, anthropometrics, number of diseases and medications, physical activity level, fall history, frailty level, cognition, depressive symptoms, fasting glucose level and disease duration. Functional measures included the Timed Up and Go test (TUG), the five times sit-to-stand test (5-STS) and handgrip strength. Gait parameters were obtained using the GAITRite® system. Participants with a fear of falling were frailer and presented more depressive symptoms and worse performance on the TUG and 5-STS tests compared with those without a fear of falling. The group with the fear of falling also walked with a lower velocity, cadence and step length and increased step time and swing time variability. The multivariate regression analysis showed that the likelihood of having a fear of falling increased 1.34 times (OR 1.34, 95 % CI 1.11-1.61) for a one-point increase in the Geriatric Depression Scale (GDS-15) score and 1.36 times (OR 1.36, 95 % CI 1.07-1.73) for each second of increase in the TUG performance. The fear of falling in community-dwelling older women with type 2 diabetes mellitus is associated with frailty, depressive symptoms and dynamic balance, functional mobility and gait

  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. Spatiotemporal components of the 3-D gait analysis of community-dwelling middle-aged and elderly Japanese: age- and sex-related differences.

    PubMed

    Doyo, Wataru; Kozakai, Rumi; Kim, Heung-Youl; Ando, Fujiko; Shimokata, Hiroshi

    2011-01-01

    To describe age- and sex-related differences in gait patterns of community-living men and women using 3-D gait analysis. Subjects (n=2006) aged 40-84 years participated in the National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA). Spatiotemporal components, including velocity, step length, step frequency, and double support time during a gait cycle, were calculated from 3-D coordinates and vertical force data. Velocity, step length and step frequency were normalized by leg length and acceleration due to gravity, and double support time was normalized to gait cycle duration. Spatiotemporal walking variables of brisk velocity and step length were significantly greater in men than in women, while comfortable velocity and comfortable and brisk step frequencies and double support times were greater in women than in men. Age-related changes were marked at 70-84 years in most spatiotemporal variables in both sexes during comfortable walking. During brisk walking, age-related changes were observed from a younger age than during comfortable walking, and there were sex-related differences. The age-related gait alteration was obvious among those aged 70 years and older, and it accelerated markedly in women's brisk walking intensity. © 2010 Japan Geriatrics Society.

  2. 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

  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. 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.

  5. 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

  6. 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

  7. Prevalence of metabolic syndrome in elderly Japanese-Brazilians

    PubMed Central

    Xavier, Natasha Priscilla; Chaim, Rita Cristina; Gimeno, Suely Godoy Agostinh; Ferreira, Sandra Roberta Gouvea; Hirai, Amelia Toyomi; Rosa, Camila Moreno; Padovani, Carlos Roberto; Okoshi, Marina Politi; Okoshi, Katashi

    2012-01-01

    Summary Background Prevalence of individuals with a high cardiovascular risk is elevated in elderly populations. Although metabolic syndrome (MS) increases cardiovascular risk, information is scarce on the prevalence of MS in the elderly. In this study we assessed MS prevalence in a population of elderly Japanese-Brazilians using different MS definitions according to waist circumference cutoff values. Material/Methods We studied 339 elderly subjects, 44.8% males, aged between 60 to 88 years (70.1±6.8). MS was defined according to criteria proposed by the Joint Interim Statement in 2009. As waist circumference cutoff point values remain controversial for Asian and Japanese populations, we employed 3 different cutoffs that are commonly used in Japanese epidemiological studies: 1) ≥90 cm for men and ≥80 cm for women; 2) ≥85 cm for men and ≥90 cm for women; 3) ≥85 cm for men and ≥80 cm for women. Results MS prevalence ranged from 59.9% to 65.8% according to the different definitions. We observed 90% concordance and no statistical difference (p>0.05) in MS prevalence between the 3 definitions. MS diagnosis according to all 3 cutoff values was found in 55.8% of our population, while in only 34.2% was MS discarded by all cutoffs. The prevalence of altered MS components was as follows: arterial blood pressure 82%, fasting glycemia 65.8%, triglyceride 43.4%, and HDL-C levels 36.9%. Conclusions Elderly Japanese-Brazilians present high metabolic syndrome prevalence independent of waist circumference cutoff values. Concordance between the 3 definitions is high, suggesting that all 3 cutoff values yield similar metabolic syndrome prevalence values in this population. PMID:22293888

  8. 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

  9. Prospective relationship of depressive symptoms, drinking, and tobacco smoking among middle-aged and elderly community-dwelling adults: Results from the China Health and Retirement Longitudinal Study (CHARLS).

    PubMed

    Cheng, Hui G; Chen, Shengnan; McBride, Orla; Phillips, Michael R

    2016-05-01

    Previous studies in Western countries have consistently documented positive associations of smoking and heavy drinking with depressive symptoms but a prospective analysis of these relationships among middle-aged and elderly community members in China have not previously been reported. Using data from the China Health and Retirement Longitudinal Study, a two-wave nationally representative survey conducted in 15,628 adults 45 years of age and older, we estimated the prospective association between depressive symptoms and an array of smoking and drinking behaviors. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) short form. Inverse associations were the dominant pattern of association. For the population as a whole, individuals with baseline depressive symptoms were less likely to start drinking (OR=0.7, 95% CI=0.5, 0.9) or smoking (OR=0.6, 95% CI=0.4, 0.8). Similarly, baseline drinkers and smokers were less likely to develop depressive symptoms (ORdrinkers=0.6, 95% CI=0.5, 0.7; ORsmokers=0.7, 95% CJ=0.6, 0.9). No evidence was found for an increased incidence or persistence of depressive symptoms among high-frequency drinkers or heavy smokers or vice versa. Males who had never smoked prior to the onset of depressive symptoms tended to have more rapid onset of tobacco dependence compared to those without such symptoms. Males and females had different association patterns. The study is observational in nature and provides limited evidence for causality. The results are inconsistent with previous findings in Western countries, throwing into question the presumed universality of the association between alcohol drinking or tobacco use and depression among middle-aged and elderly adults. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  10. Tuberculous spondylitis in elderly Japanese patients.

    PubMed

    Maeda, Yuki; Izawa, Kazutaka; Nabeshima, Takaharu; Yonenobu, Kazuo

    2008-01-01

    Although the number of patients with tuberculous spondylitis in Japan is increasing slowly, the proportion of the elderly among these patients is increasing more quickly. The purpose of this study was to describe the clinical features and diagnostic imaging findings in elderly tuberculous spondylitis patients in order to enhance diagnosis of the condition in the elderly population. We conducted a retrospective review of 23 patients over 70 years of age previously diagnosed with tuberculous spondylitis. Clinical signs and symptoms, including local pain, fever, and neurological deficits, were analyzed. Routine laboratory tests, including the erythrocyte sedimentation rate, the white blood cell count, and the C-reactive protein level were also reviewed. The results of plain X-rays and magnetic resonance imaging were studied. Patients' signs and symptoms were as follows: local pain in 19 patients (83%); fever in 7 patients (30%) and no fever in 16 patients (70%); and neurological deficits in 13 patients (57%). C-Reactive protein was less than 1.0 mg/dl in 6 patients (26%). Radiography revealed several changes in the affected vertebrae; 3 patients had atypical changes involving only a single vertebra. It is difficult to diagnose tuberculous spondylitis in the elderly because there are atypical symptoms, a scarcity of inflammatory changes, and degenerative changes normally seen in the elderly may mask the radiographic changes due to tuberculous spondylitis. Tuberculous spondylitis should be considered a possibility in the differential diagnosis of back pain in the elderly, especially in countries with a significant history of tuberculosis in the population.

  11. Global cortical atrophy (GCA) associates with worse performance in the Montreal Cognitive Assessment (MoCA). A population-based study in community-dwelling elders living in rural Ecuador.

    PubMed

    Del Brutto, Oscar H; Mera, Robertino M; Zambrano, Mauricio; Soriano, Francisco; Lama, Julio

    2015-01-01

    Increasing numbers of individuals with cognitive impairment are posing economic threads to the developing world. Proper assessment of this condition may be complicated by illiteracy and cross-cultural factors. We conducted a population-based study in elders living in rural Ecuador to evaluate whether the MoCA associated with structural brain damage in less-educated populations. Atahualpa residents aged ≥60 years were identified during a door-to-door survey and invited to undergo MRI for grading GCA. Using a multivariate generalized linear model, we evaluated whether MoCA scores correlates with GCA, after adjusting for demographics, education, cardiovascular health (CVH) status, depression and edentulism. Out of 311 eligible persons, 241 (78%) were enrolled. Mean age was 69.2±7.5 years, 141 (59%) were women, 199 (83%) had primary school education, 175 (73%) had poor CVH status, 30 (12%) had symptoms of depression and 104 (43%) had edentulism. Average MoCA scores were 18.5±4.7 points. GCA was mild in 108, moderate in 95, and severe in 26 persons. Total and most domain-specific MoCA scores were significantly worse in persons with moderate to severe GCA. In the multivariate model, mean MoCA score was associated with GCA severity (β=2.38, SE=1.07, p=0.027). MoCA scores associate with severity of GCA after adjusting for potential confounders, and may be used as reliable estimates of structural brain damage. However, a lower cut-off than that recommended for developed countries, would be better for recognizing cognitive impairment in less educated populations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. 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…

  13. 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…

  14. 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…

  15. 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…

  16. 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…

  17. 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

  18. 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

  19. Factors associated with dry mouth in dependent Japanese elderly.

    PubMed

    Kakudate, Naoki; Muramatsu, Tsukasa; Endoh, Mami; Satomura, Kazuhito; Koseki, Takeyoshi; Sato, Yuji; Ito, Kayoko; Ogasawara, Tadashi; Nakamura, Seiji; Kishimoto, Etsuo; Kashiwazaki, Haruhiko; Yamashita, Yoshihisa; Uchiyama, Kimio; Nishihara, Tatsuji; Kiyohara, Yutaka; Kakinoki, Yasuaki

    2014-03-01

    To identify factors associated with dry mouth. Dry mouth adversely affects oropharyngeal health, particularly in elderly, and can lead to pneumonia. A better understanding of the epidemiology of dry mouth is therefore important in improving treatment strategies and oral health in high-risk elderly patients. We conducted a cross-sectional study involving 383 dependent Japanese elderly individuals (65-84 [n = 167] and ≥85 [n = 216] years) at eight long-term care facilities and hospitals. Thirty-four potential factors associated with dry mouth were examined by multiple logistic regression analysis. The primary outcome was dry mouth, as diagnosed by tongue dorsum moisture. We identified that body mass index and severity of physical disability were identified as a potential factors associated with dry mouth in the super-elderly (≥85 years) group, whereas severity of physical disability, outcome measurement time, high daily water consumption, mouth breathing, use of antidepressants and diuretics, and high frequency of daily brushing (≥2 times per day; Odds ratio: 5.56; 95% Confidence Interval: 1.52-20.00) were associated with dry mouth in the 65- to 84-year-old group. To our knowledge, this is the first study to identify a link between frequency of daily brushing and dry mouth and suggests that tooth brushing should be encouraged in high-risk dependent Japanese elderly (65-84 years), particularly those taking antidepressants and/or diuretics. © 2012 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  20. 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.

  1. 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.

  2. 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

  3. Worry Among Mexican American Caregivers of Community-Dwelling Elders

    PubMed Central

    Evans, Bronwynne C.; Coon, David W.; Belyea, Michael J.

    2015-01-01

    This mixed methods, multi-site, National Institute of Nursing Research (NINR)-funded, interdisciplinary, descriptive study aimed to identify expressions of worry in qualitative data obtained from caregiving Mexican American (MA) families assisting older adults. The purpose of this portion of the inquiry was to determine how worry is expressed, what happens to caregivers when they worry, and what adaptive strategies they used. We examined semi-structured interviews completed during six in-home visits with 116 caregivers. We identified 366 worry quotations from 639 primary documents in ATLAS.ti, entered them into matrices, and organized findings under thematic statements. Caregivers expressed cultural and contextual worries, worried about transitions and turning points in care, and identified adaptive strategies. Despite these strategies, worry persisted. Constant worry may be an allied, important aspect of caregiver burden. We need additional longitudinal research to better understand the experience of MA caregivers for older adults and to provide empirically supported interventions, programs, and services that reduce worry. PMID:27228120

  4. Day-to-Day Blood Pressure Variability and Risk of Dementia in a General Japanese Elderly Population: The Hisayama Study.

    PubMed

    Oishi, Emi; Ohara, Tomoyuki; Sakata, Satoko; Fukuhara, Masayo; Hata, Jun; Yoshida, Daigo; Shibata, Mao; Ohtsubo, Toshio; Kitazono, Takanari; Kiyohara, Yutaka; Ninomiya, Toshiharu

    2017-08-08

    Several observational studies have reported that higher visit-to-visit blood pressure variability is a risk factor for cognitive impairment and dementia. However, no studies have investigated the association of day-to-day blood pressure variability assessed by home blood pressure measurement with the development of dementia. A total of 1674 community-dwelling Japanese elderly without dementia, ≥60 years of age, were followed up for 5 years (2007-2012). Home blood pressure was measured 3 times every morning for a median of 28 days. Day-to-day systolic (SBP) and diastolic blood pressure variabilities, calculated as coefficients of variation (CoV) of home SBP and diastolic blood pressure, were categorized into quartiles. The hazard ratios and their 95% confidence intervals of the CoV levels of home blood pressure on the development of all-cause dementia, vascular dementia (VaD), and Alzheimer disease (AD) were computed with a Cox proportional hazards model. During the follow-up, 194 subjects developed all-cause dementia; of these, 47 had VaD and 134 had AD. The age- and sex-adjusted incidences of all-cause dementia, VaD, and AD increased significantly with increasing CoV levels of home SBP (all P for trend <0.05). These associations remained unchanged after adjustment for potential confounding factors, including home SBP. Compared with subjects in the first quartile of CoV levels of home SBP, the risks of the development of all-cause dementia, VaD, and AD were significantly higher in those in the fourth quartile (hazard ratio=2.27, 95% confidence interval=1.45-3.55, P<0.001 for all-cause dementia; hazard ratio=2.79, 95% confidence interval=1.04-7.51, P=0.03 for VaD; hazard ratio=2.22, 95% confidence interval=1.31-3.75, P<0.001 for AD). Similar associations were observed for CoV levels of home diastolic blood pressure. Meanwhile, home SBP levels were significantly associated with the risk of VaD but not with the risks of all-cause dementia and AD. There was no

  5. 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

  6. 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.

  7. 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.

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

    PubMed Central

    2009-01-01

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

  9. 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

  10. 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.

  11. Ethnographic study of a good death among elderly Japanese Americans.

    PubMed

    Hattori, Keiko; Ishida, Dianne N

    2012-12-01

    Most humans desire a good death, but the nursing literature on culture-specific responses to older life, especially on issues of death and dying among Japanese Americans, is still limited. The pattern of beliefs about a good death held by elderly Japanese Americans living in Hawaii was explored. A qualitative study using ethnography and in-depth interviewing was employed. Eighteen healthy and active elderly participants were interviewed, and data analyzed using ethnography to extract categories and themes, and four supplementary interviews with experts were held for triangulation of the data. Four themes emerged, however, in this paper, the predominate one, not being a burden to family, was discussed. The participants believed burdening someone in their culture has an extremely negative implication. Sufficient preparation for older life and death, family support, friends support, and finance were their strategies to avoid being a burden. Nurses need to understand that the concept of good death is unique to every culture. Such knowledge will help them to plan and provide appropriate end-of-life care, and will reduce the risk of living wills being ignored. © 2012 Wiley Publishing Asia Pty Ltd.

  12. 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

  13. 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.

  14. 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

  15. Barriers and catalysts of nutrition literacy among elderly Japanese people.

    PubMed

    Aihara, Yoko; Minai, Junko

    2011-12-01

    Improving skills for accessing and utilizing diet/nutrition information is important for preventing non-communicable diseases and frailty among elderly people. With the rapidly increasing number of elderly people in the world, promoting nutrition literacy among them is a pivotal health policy for maintaining and promoting health. This article describes the barriers and catalysts of nutrition literacy among elderly Japanese people (aged ≥75 years). A cross-sectional analysis of the responses to a questionnaire administered to 678 study participants (men = 347, women = 331) was conducted. Logistic regression analysis revealed that more men had limited nutrition literacy than did women. After stratification by gender, the limited nutrition literacy group was associated with cognitive difficulty in men and women, visual impairment in men and hearing impairment in women. Lower education level and economic status were associated with limited nutrition literacy among women. Adjusted odds ratios (ORs) controlling for age, education level and economic status, as well as cognitive, visual and hearing function, indicated that informational support [OR = 5.59, 95% confidence interval (95% CI) = 1.28-24.49] and diet/nutrition information obtained from friends of the participants (OR = 2.16, 95% CI = 1.11-4.20) were both associated with adequate nutrition literacy among men, whereas diet/nutrition information from health professionals (OR = 3.96, 95% CI = 1.97-7.95) had a significant relation with adequate nutrition literacy among women. Moreover, in the adequate nutrition literacy group, men were more likely to be overweight (OR = 2.17, 95% CI = 1.20-3.91). These findings suggested that cognitive and sensory functions should be taken into account when diet information is provided to older adults. Enhancement of social networks is also a key point in improving nutrition literacy. An effective intervention to improve nutrition literacy in elderly people, particular old men

  16. 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

  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. Predictors of oral health behaviors among elderly Japanese Americans.

    PubMed

    Diehnelt, D; Kiyak, H A; Beach, B H

    1990-01-01

    As part of a series of studies on oral health behaviors of older persons, 81 elderly Japanese Americans were interviewed regarding their dental service utilization patterns, oral health attitudes, and dental status. The sample consisted of 35 Issei (first generation) and 46 Nisei (second generation) Japanese Americans. Because of the significant age difference between the Issei and Nisei, it was difficult to examine generational differences between the two groups. When age differences were controlled, there was no difference between the two generations in interval since their last dental visit. However, reasons for dental visits differed between the two groups, with the Issei more likely to seek help with dentures or general restorative work while the Nisei were more likely to schedule appointments for dental check-ups and cleaning. The best predictors of dental service utilization for the entire sample were the use of complete dentures, age, and education (R2 = .38), but when the respondent's perceived importance of oral health was entered into the equation, this variable accounted for more variance than age or education. The combination of complete dentures, importance, and age accounted for 41% of the variance in recency of dental service utilization. Locus of control, the belief component of attitudes, and overall attitude scores did not add significantly to the prediction of dental utilization.

  20. 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.

  1. 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

  2. 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

  3. 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.

  4. Height indicates hematopoietic capacity in elderly Japanese men

    PubMed Central

    Shimizu, Yuji; Sato, Shimpei; Koyamatsu, Jun; Yamanashi, Hirotomo; Nagayoshi, Mako; Kadota, Koichiro; Maeda, Takahiro

    2016-01-01

    Previously, we reported that height is an indicator of the capacity of vascular repair in elderly men, especially hypertensive men. On the other hand, hemoglobin could act as a possible biochemical index of hypertension-induced vascular damage. However, no studies have clarified the correlation between height and hematopoietic activity. We conducted a cross-sectional study of 249 men aged 65-69 undergoing a general health check-up. Reticulocyte was used to evaluate hematopoietic activity. Because hemoglobin concentration should influence hematopoietic activity, analyses stratified by hemoglobin level were performed. Independent of known cardiovascular risk factors and other hematological parameters (white blood cell count), a significant positive correlation was seen between height and reticulocytes for total subjects and subjects with a high hemoglobin concentration (≥14.5 g/dL), but not in subjects with a low hemoglobin concentration (<14.5 g/dL). The standardized parameter estimates (β) were β=0.18, p=0.003 for total subjects, β=0.28, p=0.001 for subjects with a high hemoglobin concentration, and β=0.03, p=0.717 for subjects with low hemoglobin. Independently, height is significantly positively correlated with reticulocyte in elderly Japanese men, particularly in men with a high hemoglobin concentration. These results indicate that subjects with a short stature might have lower hematopoietic capacity than those with a high stature. PMID:27705902

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

    PubMed

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

    2004-01-01

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

  6. 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…

  7. 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…

  8. 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.

  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. 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.

  11. Bone mineral density obtained by peripheral quantitative computed tomography (pQCT) in middle-aged and elderly Japanese.

    PubMed

    Tsuzuku, S; Niino, N; Ando, F; Shimokata, H

    2000-04-01

    To clarify age-related changes in bone mineral density (BMD) by peripheral quantitative computed tomography (pQCT), 1,124 Japanese middle-aged and elderly community-dwelling people were examined. The BMD of the trabecular bone was assessed at the distal part of the radius (D50), and the BMD of the cortical bone was assessed at the diaphysis of the radius (P100). P100 during age 40 to 49 was significantly higher in females (1359.6 +/- 10.7 mg/cm3, mean +/- SE) than in males (1253.5 +/- 9.5 mg/cm3), while there was no difference in D50, 245.3 +/- 5.1 mg/cm3 in females and 293.0 +/- 5.5 mg/cm3 in males. Females and males aged 50 to 59 lost 8.09 +/- 2.08 (mean +/- SE) mg/cm3 and 3.80 +/- 1.77 mg/cm3 of D50 every year, respectively. As for P100, females lost 25.1 +/- 4.48 mg/cm3, and males lost 6.37 +/- 3.89 mg/cm3 every year. Because of these gender differences, both D50 and P100 were significantly higher in males than in females aged 50 and over. Assuming that the average BMD between ages 40 and 44 was the maximum bone mineral density (BMD max), the percentage change from the BMD max with age was examined. Females aged 60 to 69 whose BMD were under 70% of the BMD max made up 73.9% in D50 and 23.2% in P100. Only 21.1% of males aged 60 to 69 showed less than 70% of the BMD max in D50 and only 3.8% in P100. The percentage decrease in BMD by age was larger in D50 than in P100 in both males and females. The individual difference in BMD was larger in D50 than in P100. These results suggest that pQCT may be useful to independently assess aging effects on cortical and trabecular bone density.

  12. 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

  13. Cognitive Impairment, Oral Self-care Function and Dental Caries Severity in Community-dwelling Older Adults

    PubMed Central

    Chen, Xi; Clark, Jennifer JJ; Chen, Hong; Naorungroj, Supawadee

    2013-01-01

    Objective To investigate whether oral self-care function mediates the associations between cognitive impairment and caries severity in community-dwelling older adults. Background Cognitive impairment significantly affects activities of daily living and compromises oral health, systemic health and quality of life in older adults. However, the associations among cognitive impairment, oral self-care capacity and caries severity remain unclear. This increases difficulty in developing effective interventions for cognitively impaired patients. Materials and methods Medical, dental, cognitive and functional assessments were abstracted from the dental records of 600 community-dwelling elderly. 230 participants were selected using propensity score matching and categorised into normal, cognitive impairment but no dementia (CIND) and dementia groups based on their cognitive status and a diagnosis of dementia. Multivariable regressions were developed to examine the mediating effect of oral self-care function on the association between cognitive status and number of caries or retained roots. Results Cognitive impairment, oral self-care function and dental caries severity were intercorrelated. Multivariable analysis showed that without adjusting for oral self-care capacity, cognition was significantly associated with the number of caries or retained roots (p = 0.003). However, the association was not significant when oral self-care capacity was adjusted (p = 0.125). In contrast, individuals with impaired oral self-care capacity had a greater risk of having a caries or retained root (RR = 1.67, 95% CI 1.15, 2.44). Conclusion Oral care capacity mediates the association between cognition and dental caries severity in community-dwelling older adults. PMID:23758583

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

    PubMed

    Ju, Haewon

    2017-11-01

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

  15. 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

  16. 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

  17. Six-year longitudinal changes in body composition of middle-aged and elderly Japanese: age and sex differences in appendicular skeletal muscle mass.

    PubMed

    Kitamura, Itsuko; Koda, Michiko; Otsuka, Rei; Ando, Fujiko; Shimokata, Hiroshi

    2014-04-01

    Little is known about longitudinal changes of body composition measured by dual-energy X-ray absorptiometry (DXA) in middle-aged and elderly individuals. We evaluated longitudinal changes of body composition, and age and sex differences in appendicular skeletal muscle mass. Participants were 1454 community-dwelling Japanese men and women aged 40-79 years. Body composition at baseline and 6-year follow up was measured by DXA. Fat increased significantly in men of all ages, and in women aged in their 40s and 50s. Among men, arm lean tissue mass (LTM) changed by 0.9%, -0.5%, -1.4% and -3.7%, respectively, for the 40s to the 70s, and decreased significantly in the 60s and 70s. Leg LTM in men changed by -0.4%, -1.3%, -1.7% and -3.9%, respectively, and decreased significantly from the 50s to the 70s. Compared with the preceding age groups, significant differences were observed between the 60s and 70s in arm and leg LTM change in men. Among women, arm LTM changed by 0.7%, 0.2%, 1.6% and -1.5%, respectively, which was significant in the 60s and 70s. Leg LTM decreased significantly in all age groups of women by -2.0%, -2.8%, -2.4% and -3.9%, respectively. With respect to sex differences, leg LTM loss rates were significantly higher in women than men at the 40s and 50s. Longitudinal data suggest that arm and leg LTM decreased markedly in men in their 70s, and leg LTM had already decreased in women in their 40s. © 2013 Japan Geriatrics Society.

  18. Aromatherapy: Does It Help to Relieve Pain, Depression, Anxiety, and Stress in Community-Dwelling Older Persons?

    PubMed Central

    Tse, M. Y. Mimi

    2014-01-01

    To examine the effectiveness of an aromatherapy programme for older persons with chronic pain. The community-dwelling elderly people who participated in this study underwent a four-week aromatherapy programme or were assigned to the control group, which did not receive any interventions. Their levels of pain, depression, anxiety, and stress were collected at the baseline and at the postintervention assessment after the conclusion of the four-week programme. Eighty-two participants took part in the study. Forty-four participants (37 females, 7 males) were in the intervention group and 38 participants (30 females, 8 males) were in the control group. The pain scores were 4.75 (SD 2.32) on a 10-point scale for the intervention group and 5.24 (SD 2.14) for the control group before the programme. There was a slight reduction in the pain score of the intervention group. No significant differences were found in the same-group and between-group comparisons for the baseline and postintervention assessments. The depression, anxiety, and stress scores for the intervention group before the programme were 11.18 (SD 6.18), 9.64 (SD 7.05), and 12.91 (SD 7.70), respectively. A significant reduction in negative emotions was found in the intervention group (P < 0.05). The aromatherapy programme can be an effective tool to reduce pain, depression, anxiety, and stress levels among community-dwelling older adults. PMID:25114901

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

    PubMed

    Tang, Shuk Kwan; Tse, M Y Mimi

    2014-01-01

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

  20. 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.

  1. 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.

  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. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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

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

    PubMed Central

    2013-01-01

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

  11. Impact of a medication management system on nursing home admission rate in a community-dwelling nursing home-eligible Medicaid population.

    PubMed

    Schulz, Richard M; Porter, Candace; Lane, Marcia; Cornman, Carol; Branham, Len

    2011-02-01

    Community-dwelling frail elderly have an increased need for effective medication management to reside in their homes and delay or avoid admission to nursing homes. The objective of this study was to examine the impact of a medication management system on nursing home admission within the community-dwelling frail elderly. This prospective cohort study compared nursing home admission rates in intervention and control clients of a state Medicaid home and community-based waiver program. Groups were matched on age (±5 years), race, gender, and waiver program start date (±120 days). The medication management service consisted of 2 parts: 1) prescription medicines dispensed from the client's local pharmacy in a calendar card, and 2) a coordinating service by a health educator to address medication-related problems as they arose. The primary dependent variable was admission to a nursing home. A total of 273 clients agreed to participate, enrolled, and had at least 1 prescription dispensed. The matched control group was composed of 800 other clients. The client sample was 72 years of age, 73% (785/1073) non-white, 75% (804/1073) female, and enrolled in the waiver program approximately 50 months. The 2 groups were similar on all demographic variables examined. Six clients (2.2%) in the intervention group and 40 clients (5.0%) in the control group were admitted to a nursing home at least once during the study period. Logistic regression was used to test the model predicting at least 1 nursing home admission. Control group clients were 2.94 times more likely to be admitted to a nursing home than clients in the intervention group. The medication management service implemented within this study was effective in reducing nursing home admissions in a group of frail community-dwelling elderly. Copyright © 2011. Published by EM Inc USA.

  12. 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 preval