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Sample records for community-dwelling elderly japanese

  1. Serum Uric Acid Is Positively Associated with Handgrip Strength among Japanese Community-Dwelling Elderly Women.

    PubMed

    Kawamoto, Ryuichi; Ninomiya, Daisuke; Kasai, Yoshihisa; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Kumagi, Teru; Abe, Masanori

    2016-01-01

    Serum uric acid (UA) has strong anti-oxidant properties. Muscle strength and mass decrease with age, and recently, this decrease has been defined as sarcopenia. Sarcopenia may be triggered by oxidative stress. We investigated whether serum UA is associated with handgrip strength (HGS), which is a useful indicator of sarcopenia, among Japanese community-dwelling elderly persons. The present study included 602 men aged 72 ± 7 years and 847 women aged 71 ± 6 years from a rural village. We examined the cross-sectional relationship between serum UA and HGS. In both genders, HGS increased significantly with increased serum UA levels. A multiple linear regression analysis using HGS as an objective variable and various confounding factors as explanatory variables showed that in men age, drinking status, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and estimated glomerular filtration ratio (eGFRCKDEPI) were independently and significantly associated with HGS, and in women, serum UA as well as age, body mass index, drinking status, diastolic blood pressure, and eGFRCKDEPI were independently and significantly associated with HGS. In women, age and multivariate-adjusted HGS were significantly higher in the Quartile-3 (4.8-5.4 mg/dL) and Quartile-4 groups (5.5-9.3 mg/dL) of serum UA than in the lower groups (0.7-4.7 mg/dL). These results suggest that serum UA may have a protective role in aging-associated decline in muscle strength in community-dwelling elderly women. PMID:27078883

  2. Serum Uric Acid Is Positively Associated with Handgrip Strength among Japanese Community-Dwelling Elderly Women

    PubMed Central

    Kawamoto, Ryuichi; Ninomiya, Daisuke; Kasai, Yoshihisa; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Kumagi, Teru; Abe, Masanori

    2016-01-01

    Serum uric acid (UA) has strong anti-oxidant properties. Muscle strength and mass decrease with age, and recently, this decrease has been defined as sarcopenia. Sarcopenia may be triggered by oxidative stress. We investigated whether serum UA is associated with handgrip strength (HGS), which is a useful indicator of sarcopenia, among Japanese community-dwelling elderly persons. The present study included 602 men aged 72 ± 7 years and 847 women aged 71 ± 6 years from a rural village. We examined the cross-sectional relationship between serum UA and HGS. In both genders, HGS increased significantly with increased serum UA levels. A multiple linear regression analysis using HGS as an objective variable and various confounding factors as explanatory variables showed that in men age, drinking status, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and estimated glomerular filtration ratio (eGFRCKDEPI) were independently and significantly associated with HGS, and in women, serum UA as well as age, body mass index, drinking status, diastolic blood pressure, and eGFRCKDEPI were independently and significantly associated with HGS. In women, age and multivariate-adjusted HGS were significantly higher in the Quartile-3 (4.8–5.4 mg/dL) and Quartile-4 groups (5.5–9.3 mg/dL) of serum UA than in the lower groups (0.7–4.7 mg/dL). These results suggest that serum UA may have a protective role in aging-associated decline in muscle strength in community-dwelling elderly women. PMID:27078883

  3. 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.

  4. Prevalence and risk factors of depression among community dwelling elderly.

    PubMed

    Yaka, Erdem; Keskinoglu, Pembe; Ucku, Reyhan; Yener, Görsev Gülmen; Tunca, Zeliha

    2014-01-01

    Depression in the elderly is associated with increased morbidity and mortality. The purpose of this study was to determine the prevalence and risk factors of depression among community-dwelling older population in an urban setting in Turkey. This cross-sectional study was conducted among 482 elderly individuals 65 years and over in an urban area. Cluster sampling method was used for sample size. Depression in the elderly had been diagnosed by a clinical interview and Geriatric Depression Scale. Data were collected by door-to-door survey. Chi square test was used for statistical analysis. P value, which was calculated by the results of chi square test and coefficient of phi (φ), below 0.05 was included in the analysis of logistic regression. Depression was significantly associated with female gender, being single or divorced, lower educational status, low income, unemployment, and lack of health insurance. However, logistic regression analysis revealed higher depression rates in the elderly with chronic obstructive pulmonary disease, psychiatric disease, cerebrovascular disease, low income and being dependent. Depression is common among community-dwelling older people in an urban area of Izmir, Turkey. Older adults living in community should be cautiously screened to prevent or manage depression. PMID:24767692

  5. 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

  6. 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.

  7. 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.

  8. 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. PMID:27390401

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

    PubMed Central

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

    2016-01-01

    [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. PMID:27390401

  10. Racial Differences in Anticholinergic Use among Community-Dwelling Elders

    PubMed Central

    Felton, Maria; Hanlon, Joseph T.; Perera, Subashan; Thorpe, Joshua M.; Marcum, Zachary A.

    2014-01-01

    Objective Few studies have examined racial differences in potentially inappropriate medication use. The objective of this study was to examine racial disparities in using prescription and/or non-prescription anticholinergics, a type of potentially inappropriate medication, over time. Design Longitudinal. Setting Health, Aging, and Body Composition Study (years 1, 5, and 10) Participants Three thousand fifty-five black and white community-dwelling older adults at year one Main Outcome Measure Highly anticholinergic medication use as per the 2012 American Geriatrics Society Beers Criteria. Results Blacks represented 41.4% of the participants at year 1. At year 1, 13.4% of blacks used an anticholinergic medication compared to 17.8% of whites, and this difference persisted over the ensuing ten-year period. Diphenhydramine was the most common anticholinergic medication reported at baseline and year 5 and meclizine at year 10 for both races. Controlling for demographics, health status and access to care factors, blacks were 24-45% less likely to use any anticholinergics compared to whites over the years considered (all p<0.05). Conclusion The use of prescription and/or non-prescription anticholinergic medications was less common in older blacks than whites over a ten-year period, and the difference was unexplained by demographics, health status and access-to-care. PMID:25893702

  11. Teeth and physical fitness in a community-dwelling 40 to 79-year-old Japanese population

    PubMed Central

    Inui, Akinari; Takahashi, Ippei; Sawada, Kaori; Naoki, Akimoto; Oyama, Toshirou; Tamura, Yoshihiro; Osanai, Toshiyuki; Satake, Anna; Nakaji, Shigeyuki; Kobayashi, Wataru

    2016-01-01

    Purpose Decline in the number of teeth and physical fitness begins from 40 years of age; however, several epidemiological studies have identified relationships between oral conditions and physical performance parameters in community-dwelling elderly population. The aim of this study was to validate the relationship between the muscle mass and its function and oral conditions (number of teeth and dental occlusion) after 40 years of age in a community-dwelling population in Japan. Materials and methods The subjects comprised of 552 volunteers (198 males and 354 females, 40–79 years) who participated in the Iwaki Health Promotion Project in 2013. Multiple linear regression analyses were performed with the measures of the muscle mass and its function as objective variables and the measures of the number of teeth, age, body mass index, medical history, serum albumin concentration, smoking status, habitual alcohol intake, marital status, education levels, and exercising habits as explanatory variables. The relationships between the Eichner index and the muscle mass and its function were analyzed using analysis of covariance, with adjustment for confounding factors. Results After adjusting for confounding factors, the number of teeth was shown to be an independent risk factor for the timed 10 m walk test (in females) and the skeletal muscle mass of the whole body (in males). The results also revealed that the timed 10 m walk test was significantly correlated with the Eichner index (Classes A and C in females were correlated). Conclusion This cross-sectional study on a Japanese community-dwelling population revealed relationships between oral conditions and the muscle mass and its function. However, the interpretation of our results was hampered by a lack of data, including those on socioeconomic status and longitudinal observations. Future research exploring teeth loss and the muscle mass and its function is warranted. PMID:27418813

  12. 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

  13. 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.

  14. 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

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

    PubMed

    Lund, Henrik Hautop; Jessen, Jari Due

    2014-10-01

    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 training

  16. 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.

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

    ERIC Educational Resources Information Center

    Borders, Tyrone F.

    2004-01-01

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

  18. Relationship of C-reactive protein and bone mineral density in community-dwelling elderly females.

    PubMed Central

    Ganesan, Kalpana; Teklehaimanot, Senait; Tran, The-Huy; Asuncion, Merlyn; Norris, Keith

    2005-01-01

    OBJECTIVE: Inflammatory cytokines have been shown to play an important role in bone remodeling. We hypothesized that higher levels of C-reactive protein (CRP) are associated with low bone mineral density (BMD) in elderly females. DESIGN: Secondary data analysis of the Third National Health and Nutrition Examination Survey. PARTICIPANTS: 2,807 females 65 years and older. RESULTS: CRP was associated with BMD in the bivariate sis (p<0.001) but not in the multivariate analysis (p=0.23) Age, ethnicity, body mass index (BMI), hormone replacement therapy (HRT) and immobility were independently associated with BMD. CONCLUSIONS: CRP may be useful in screening for osteoporosis among community-dwelling elderly females. However, CRP appears to act as a surrogate for other factorsdirectly associated with osteoporosis. Further studies are needed to validate these findings. PMID:15779496

  19. 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

  20. Factors affecting burden of family caregivers of community-dwelling ambulatory elders with dementia in Korea.

    PubMed

    Lim, Young Mi; Son, Gwi-Ryung; Song, Jun-Ah; Beattie, Elizabeth

    2008-08-01

    The purpose of the study was to test a staged causal model as a theoretical base to explain the burden of family caregivers of community-dwelling self-ambulatory persons with dementia (PWDs) in Korea. The model contained three stages including antecedents (Stage 1), behavior (Stage 2), and outcome (Stage 3). The antecedents were variables of the PWDs (e.g., cognitive impairment and activities of daily living [ADL] dependency of the PWDs) and caregiver variables (e.g., age, gender of caregiver, and the relationship of caregiver to PWD). Stage 2 focused on wandering behavior. In Stage 3, the outcome variable was caregiver burden. A total of 83 noninstitutionalized, community-dwelling elders with dementia and their family caregivers participated. The instruments used in this study were the Korean version of Mini Mental State Examination, K-PADL (Korean-Physical Activities of Daily Living), Korean-Revised Algase Wandering Scale-Community Version, and K-CWOB (Caregiver Worry, Overload, and Role Captivity Scale-Korean) Korean versions of standardized Western instruments. Results indicate that cognitive impairment and ADL dependency had an indirect influence on caregiver burden through wandering behavior. In addition, caregiver age had a direct impact on caregiver burden. The findings of this study suggest that further refinement of the underlying model is warranted.

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

    PubMed

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

    2013-01-01

    The aim of this study was to assess the home care needs and task difficulty of community-dwelling aged hip fracture and the association of functional recovery with care received. A cohort of hip fracture patients admitted to orthopedic wards for surgery was collected from August 2009 to December 2010. Patients transferred to long-term care facilities after surgery were excluded. Functional status (feeding, clothing, grooming, bathing, getting in/out of bed, walking, toileting, standing up/sitting down, and walking up/down stairs) and task difficulty for caregivers were recorded at discharge, one week and one month after discharge. In total, 116 patients (mean age: 79.4 ± 8.5 years, 51.7% males) were enrolled. The mean age of primary caregivers was 53.4 ± 14.2 years, and most were daughters or sons (54.3%), spouses (34.5%) or foreign workers (11.0%). The most common care needs were wound care (95.7%), medical visits (94.8%), cleaning and maintaining living quarters (92.2%) and vigilance to ensure patient safety (92.2%). The care needs and task difficulty significantly correlated with physical function before, one week and one month after discharge (r=-0.530, p<0.001; r=-0.326, p=0.001; r=-0.432, p<0.001; r=-0.684, p<0.001; and r=-0.475, p<0.001, respectively). The complex and taxing home care needs of community-dwelling elderly hip fracture patients were significantly associated with functional recovery. Comprehensive geriatric assessment and related special medical services may greatly help caregivers and promote the practice of aging in place. Further study is needed to develop appropriate caregiver education to promote the functional recovery of elderly hip fracture patients at home. PMID:23746577

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

    PubMed Central

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

    2016-01-01

    ABSTRACT 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. PMID:27437717

  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. 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

  5. [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.

  6. Are cognitive impairment and depressive mood associated with increased service utilisation in community-dwelling elderly people?

    PubMed

    Roelands, Marc; Van Oyen, Herman; Depoorter, AnneMarie; Baro, Franz; Van Oost, Paulette

    2003-01-01

    The healthcare and social services utilisation of elderly people with mental disorders has not been sufficiently described, although such knowledge could indicate directions for preventive and curative interventions, and suggest unmet service needs. The aim of the present study was to examine cognitive impairment and depressive mood as correlates of specific healthcare and social services utilisation of community-dwelling elderly people. A randomly selected population sample of 1134 community-dwelling individuals aged 65 years and over living in a defined area were interviewed at home. Cognitive impairment was measured by the Mini Mental State Examination and depressive mood by the Centre for Epidemiologic Studies -- Depression scale. Cognitive impairment and depressive mood were related to the number of home care services used, and to the utilisaton of every specific healthcare and social service. After controlling for confounding variables (i.e. age, sex, education, co-residence and disabilities), service utilisation was still predicted by depressive mood, but not by cognitive impairment. Interventions to prevent and cure depressive mood should be considered to decrease the service needs of community-dwelling elderly people. Unmet service needs are suggested since cognitive impairment does not result in increased service utilisation.

  7. 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

  8. 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.

  9. 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

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

    PubMed

    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

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

    PubMed Central

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

    2010-01-01

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

  12. 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

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

    PubMed Central

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

    2015-01-01

    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 points Accelerometer, that is capable to assess PA more precisely in large scale epidemiological studies, provides opportunity for improving

  15. Effect of group activities on health promotion for the community-dwelling elderly

    PubMed Central

    Fukasawa, Masako; Yamaguchi, Haruyasu

    2016-01-01

    Objective: In Japan, the Integrated Community Care System aims to support residents to live as independently as possible at home. Koreisya-Kyoshitsu and Fureaiikiiki salons are two types of group activities for community-dwelling elderly. We investigated effective ways of conducting such activities. Methods: We analyzed 96 subjects from 8 salons and 354 subjects from 10 Koreisya-Kyoshitsu. Self-completed questionnaires included the following: attributes, the Motor Fitness Scale (MFS), revised Philadelphia Geriatric Center Morale Scale (PGCMS), Measurement of Psychological Independence (MPI), instrumental activities of daily living (IADL), and self-rated health status (SRH). Follow-up assessment was conducted 6 months later. Representatives from 8 salons and staff members from 10 Koreisya-Kyoshitsu answered an additional questionnaire on management. Results: In Koreisya-Kyoshitsu, physical performance (MFS) (p = 0.007) and subjective well-being (PGCMS) (p = 0.001) improved significantly, whereas psychological independence (MPI) deteriorated significantly (p = 0.015). The MFS scores significantly improved in the sub-group with a high number of sessions (7 or more) (p = 0.043), as well as in the non-volunteer sub-group (p = 0.004). The PGCMS scores significantly improved in the sub-group with a high number of sessions (p < 0.001). The MPI scores significantly deteriorated in the sub-group with a low frequency of sessions (6 or less) and in the non-volunteer sub-group (p = 0.013 and p = 0.010, respectively). In salons, the frequency of going out decreased significantly (p = 0.049). Functional status (IADL) significantly improved in the “twice or more a month” sub-group (p = 0.046), whereas it significantly deteriorated in the “once a month” sub-group (p = 0.004). The proportion of volunteers/organizers in Koreisya-Kyoshitsu (23.4%) was significantly lower than that in salons (39.6%). Conclusion: The frequency (number) of sessions, but not the volunteer

  16. Verification of the Correlation between Cognitive Function and Lower Limb Muscle Strength for the Community-dwelling Elderly.

    PubMed

    Ohsugi, Hironori; Murata, Shin; Kubo, Atsuko; Hachiya, Mizuki; Hirao, Aya; Fujiwara, Kazuhiko; Kamijou, Kenji

    2014-12-01

    [Purpose] The purpose of this study was to evaluate the lower limb muscle strength of the community-dwelling elderly, with or without cognitive decline, using isometric knee extension strength (IKES) and the 30-second chair stand test (CS-30). [Subjects] A total of 306 community-dwelling elderly participated in this study. Assessment items were the CS-30, IKES, Mini-Mental State Examination (MMSE), and Trail-Making Test Part A (TMT-A). [Methods] Participants were divided into three groups according to their MMSE score: cognitive impairment (MMSE ≤ 24), cognitive decline (MMSE 25 to 27), and normal (MMSE ≥ 28). We compared IKES and CS-30 among the three groups. [Results] IKES was not significantly different among the three groups. However, the CS-30 was significantly different among the three groups. Upon further analysis the CS-30 score of each group, when adjusted for age and TMT-A, did not indicate a significant difference. [Conclusion] These results suggest that the lower limb muscle strength of the elderly does not differ with cognitive decline. Moreover, we suggest that when using the CS-30 score as an indicator of lower limb muscle strength attentional function should be taken into account.

  17. 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.

  18. 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

  19. Cost-effectiveness of the ‘Walcheren Integrated Care Model’ intervention for community-dwelling frail elderly

    PubMed Central

    Looman, Wilhelmina M; Huijsman, Robbert; Bouwmans-Frijters, Clazien A M; Stolk, Elly A; Fabbricotti, Isabelle N

    2016-01-01

    Background. An important aim of integrated care for frail elderly is to generate more cost-effective health care. However, empirical research on the cost-effectiveness of integrated care for community-dwelling frail elderly is limited. Objective. This study reports on the cost-effectiveness of the Walcheren Integrated Care Model (WICM) after 12 months from a societal perspective. Methods. The design of this study was quasi-experimental. In total, 184 frail elderly patients from 3 GP practices that implemented the WICM were compared with 193 frail elderly patients of 5 GP practices that provided care as usual. Effects were determined by health-related quality of life (EQ-5D questionnaire). Costs were assessed based on questionnaires, GP files, time registrations and reports from multidisciplinary meetings. Average costs and effects were compared using t-tests. The incremental cost-effectiveness ratio (ICER) was calculated, and bootstrap methods were used to determine its reliability. Results. Neither the WICM nor care as usual resulted in a change in health-related quality of life. The average total costs of the WICM were higher than care as usual (17089 euros versus 15189 euros). The incremental effects were 0.00, whereas the incremental costs were 1970 euros, indicating an ICER of 412450 euros. Conclusions. The WICM is not cost-effective, and the costs per quality-adjusted life year are high. The costs of the integrated care intervention do not outweigh the limited effects on health-related quality of life after 12 months. More analyses of the cost-effectiveness of integrated care for community-dwelling frail elderly are recommended as well as consideration of the specific costs and effects. PMID:26811438

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

    PubMed Central

    Adib-Hajbaghery, Mohsen; Faraji, Mona

    2015-01-01

    Background Several studies are available on the lifestyle, psychological and mental health of the elderly adults. This study aimed to compare the spiritual well-being and happiness in the elderly who lived in sanitariums with those lived in the community. Methods A comparative study was conducted on 384 elderly adults. A census sampling was used in sanitariums and a convenience sampling was performed to select the community dwelling (CD) older adults. A demographic questionnaire, the Pauloutzian and Ellison’s spiritual well-being scale and the Oxford happiness questionnaire were used in this study. Descriptive statistics and Kolmogorov-Smirnov, Chi-square and Mann-Whitney U tests and Spearman correlation coefficient were employed for data analysis, using the SPSS software, version 13.0. Results From the total participants, 56% were CD elderly and 44% were in sanitariums. Among the CD older adults, no one was at a high level of spiritual well-being while in sanitariums 24.4% were at a high level of spiritual well-being. Also, 71.2% of the community dwelling older adults were at a high level of happiness while only 3.6% of those living in sanitariums expressed a high level of happiness. A significant association was found between the level of spiritual well-being and happiness in those who lived in sanitariums (r=0.177, P<0.021). Conclusion Most of the elderly living in the community and in sanitariums showed moderate spiritual well-being and low happiness. Therefore, nurses and health authorities are responsible not only to inform the community about the importance of spiritual well-being and happiness, but also to establish some strategies in this regard. PMID:26171410

  1. 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

  2. Daily life functioning of community-dwelling elderly couples: an investigation of the feasibility and validity of Ecological Momentary Assessment.

    PubMed

    Rullier, Laetitia; Atzeni, Thierry; Husky, Mathilde; Bouisson, Jean; Dartigues, Jean-François; Swendsen, Joel; Bergua, Valerie

    2014-06-01

    Although ambulatory data collection techniques have been used in elderly populations, their feasibility and validity amongst elderly individuals with cognitive impairment and amongst couples remains unexplored. The main objective of this study is to examine the validity of Ecological Momentary Assessment (EMA) in elderly persons with or without cognitive impairment and their spouses. The sample included 58 retired farmers (mean 77.3 years, standard deviation [SD] 5.5) with or without cognitive impairment, recruited within a French cohort and 60 spouses (mean 73.4 years, SD 6.9). The presence of cognitive impairment determining by a panel of specialized neurologists permitted to define two groups: "The Cognitive Impairment Group" and "The Control Group". EMA procedures consisted of repeated telephone interviews five times per day during four days for each spouse. Our results demonstrate the validity of EMA procedures through a 92.1% level of compliance, the absence of fatigue effects, and the lack of evidence for major reactivity to the methods. However, the specificity of our sample may explain the acceptance (42%) and response (75%) rates and may reduce the generalizability of the results to the general population of elderly individuals. Finally, the validation of such techniques may contribute to future research examining community-dwelling elderly individuals and their spouses.

  3. 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

  4. 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…

  5. 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.

  6. 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. PMID:26334906

  7. Measuring the Quality of Care Provided to Community Dwelling Vulnerable Elders Dually Enrolled in Medicare and Medicaid

    PubMed Central

    Zingmond, David S.; Wilber, Kathleen H.; MacLean, Catherine H.; Wenger, Neil S.

    2010-01-01

    Context Small studies suggest that the quality of healthcare provided to older patients needs improvement. However, measuring the quality of care for larger groups of older adults is difficult. Objective To measure the quality of care in a community-dwelling vulnerable geriatric population using administrative data to apply quality indicators (QIs) from the Assessing Care of Vulnerable Elders project. Design, Setting, and Participants Cohort study of community-dwelling dual enrollees in Medicare and Medicaid, age 75 years and older, living in 19 California counties in 1999 and 2000. Main Outcome Measure Measurement of care provided for 43 QIs by condition (eg, heart failure) and by intervention type (eg, medication use), and identification of care inaccessible to measurement by linked Medicare and Medicaid claims. Results A total of 43 out of 230 QIs were captured using linked claims data. The 100,528 patients triggered 930,753 QIs (9.3 QIs/person). The overall QI pass rate (ie, successful receipt of care) was 65%. QIs with the highest pass rates measured avoidance of adverse medications and appropriate medication use. Fewer than half of the QIs were passed for ischemic heart disease, stroke, and osteoporosis. Few QIs aimed at geriatric care could be measured and none assessed counseling, history taking, or information continuity. Conclusions The use of claims data-derived quality-of-care process measures is feasible for the vulnerable older population, but requires development of data elements focused on geriatric care. QIs that could be applied to the older patients included in this study identified several areas of care that need improvement. PMID:17890990

  8. The Physical Activity Scale for the Elderly (PASE): Validity and Reliability Among Community-Dwelling Older Adults in Malaysia.

    PubMed

    Ismail, Norliana; Hairi, Farizah; Choo, Wan Yuen; Hairi, Noran Naqiah; Peramalah, Devi; Bulgiba, Awang

    2015-11-01

    Physical Activity Scale for the Elderly (PASE) is among the frequently used self-reported physical activity assessment for older adults. This study aims to assess the validity and reliability of a Malay version of this scale (PASE-M). A total of 408 community-dwelling older adults were enrolled. Concurrent validity was evaluated by Spearman's rank correlation coefficients between PASE with physical and psychosocial measures. Test-retest reliability was determined by the intraclass correlation coefficient (ICC). The mean PASE-M scores at baseline and follow-up were 94.96 (SD 62.82) and 92.19 (SD 64.02). Fair to moderate correlation were found between PASE-M and physical function scale, IADL (rs = 0.429, P < .001), walking speed (rs = 0.270, P < .001), grip strength (rs = 0.313-0.339, P < .001), and perceived health status (rs = -0.124, P = .016). Test-retest reliability was adequate (ICC = 0.493). The Malay version of PASE was shown to have acceptable validity and reliability. This tool is useful for assessing the physical activity level of elderly Malaysians.

  9. [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.

  10. 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

  11. 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.

  12. 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.

  13. Interleukin-6 plasma levels and socioeconomic status in Brazilian elderly community-dwelling women.

    PubMed

    de Britto Rosa, Nayza Maciel; de Queiroz, Bárbara Zille; Pereira, Daniele Sirineu; di Sabatino Santos, Mary Luci Avelar; Oliveira, Daniela Matos Garcia; Narciso, Fabrícia Mendes E Silva; Pereira, Leani Souza Máximo

    2011-01-01

    Aging is related to a chronic increase in inflammatory cytokines. Adverse socioeconomic conditions are associated with increased plasma levels of these molecules, especially interleukin (IL)-6. Considering the differential profile of elderly Brazilians regarding their socioeconomic and cultural aspects, the objectives of this study were: to assess the correlation and differences between levels of IL-6 and socioeconomic status (education and income) in elderly women. IL-6 levels were measured using ELISA. The Spearman test was used to determine the correlation between IL-6 and socioeconomic status, and the Kruskal-Wallis and Mann-Whitney tests for cytokine level differences across education and income. IL-6 showed a significant inverse correlation with education (r = -0.205, p = 0.014) and income (r = -0.185, p = 0.028). Differences in IL-6 levels were registered across the education variables. The results corroborate evidence that low socioeconomic status is related to higher IL-6 plasma levels in elderly women.

  14. 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

  15. Testicular volume in relation to hormonal indices of gonadal function in community-dwelling elderly men.

    PubMed

    Mahmoud, A M; Goemaere, S; El-Garem, Y; Van Pottelbergh, I; Comhaire, F H; Kaufman, J M

    2003-01-01

    Aging is accompanied by involutional changes in testicular function; limited data suggest a decrease in bilateral testicular volume (BTV). We studied BTV by ultrasonography in relation to serum gonadal hormones in 115 healthy elderly men (median age, 78 yr) and 42 young men (median age, 26.5 yr). Elderly men had a clearly smaller BTV (mean, 20.6 vs. 29.7 ml; P < 0.001), whereas serum inhibin B was slightly but significantly decreased (mean, 176.8 vs. 212.8 ng/liter; P = 0.04); lower values in the elderly were observed for bioavailable (Bio) testosterone (T), Bio 17 beta-estradiol, inhibin B/FSH (mean, 18 vs. 58 ng/mU; P < 0.001), and T/LH ratios. In the elderly and the young, respectively, BTV was associated with inhibin B (r = 0.53, P < 0.001; r = 0.41, P < 0.01), FSH (r = -0.53, P < 0.001; r = -0.48, P < 0.01), and inhibin B/FSH ratio. Only in the old men was BTV significantly associated with LH (r = -0.32; P < 0.001), Bio T (r = 0.26; P < 0.01), and T/LH (r = 0.48; P < 0.001). In a multivariate analysis, FSH, inhibin B, and Bio T were independently associated with BTV in the elderly (R(2) = 0.34). Receiver operating characteristics curve analysis indicated that BTV at a criterion value of 14.3 ml had a sensitivity of 46% and a specificity of 79% to predict low serum Bio T levels in the elderly. In conclusion, the moderately decreased BTV observed in elderly men, strongly associated with a decrease of the inhibin B/FSH ratio, is consistent with a reduced Sertoli cell mass, compensated by increased FSH stimulation resulting in only limited decrease of Sertoli cell function. Finding of a low testicular volume in elderly men can contribute to the diagnosis of hypogonadism, but this criterion has low sensitivity to detect decreased T production. PMID:12519849

  16. 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. PMID:27065520

  17. 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

  18. 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

  19. 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

  20. Robotic agents for supporting community-dwelling elderly people with memory complaints: Perceived needs and preferences.

    PubMed

    Wu, Ya-Huei; Faucounau, Véronique; Boulay, Mélodie; Maestrutti, Marina; Rigaud, Anne-Sophie

    2011-03-01

    Researchers in robotics have been increasingly focusing on robots as a means of supporting older people with cognitive impairment at home. The aim of this study is to explore the elderly's needs and preferences towards having an assistive robot in the home. In order to ensure the appropriateness of this technology, 30 subjects aged 60 and older with memory complaints were recruited from the Memory Clinic of the Broca Hospital. We conducted an interview-administered questionnaire that included questions about their needs and preferences concerning robot functions and modes of action. The subjects reported a desire to retain their capacity to manage their daily activities, to maintain good health and to stimulate their memory. Regarding robot functions, the cognitive stimulation programme earned the highest proportion of positive responses, followed by the safeguarding functions, fall detection and the automatic help call.

  1. Malnutrition in Community-Dwelling Elderly in Turkey: A Multicenter, Cross-Sectional Study

    PubMed Central

    Gündüz, Ercan; Eskin, Fatih; Gündüz, Mehmet; Bentli, Recep; Zengin, Yılmaz; Dursun, Recep; İçer, Mustafa; Durgun, Hasan Mansur; Gürbüz, Hüseyin; Ekinci, Mustafa; Yeşil, Yusuf; Güloğlu, Cahfer

    2015-01-01

    Background This study aimed to investigate the prevalence of malnutrition and explore the somatic, psychological, functional, and social or lifestyle characteristics linked to malnutrition in elderly people at a hospital in Turkey. Material/Methods This study included 1030 patients older than 65 years of age who were seen at the internal medicine and geriatrics outpatient clinics of the study centers in Istanbul, Ankara, Duzce, Corum, Mardin, Malatya, and Diyarbakir provinces between January and December 2014. All patients underwent Mini Nutritional Assessment (MNA) and Geriatric Depression Scale (GDS) tests via one-on-one interview method. The demographic properties of the patients were also recorded during this interview. Results Among 1030 patients included in this study, 196 (19%) had malnutrition and 300 (29.1%) had malnutrition risk. The malnutrition group and the other groups were significantly different with respect to mean GDS score, income status, educational status, the number of children, functional status (ADL, IADL), the number of patients with depression, and the number of comorbid disorders. According to the results of the logistic regression analysis, age (OR=95% CI: 1.007–1.056; p=0.012), BMI (OR=95% CI: 0.702–0.796; p<0.001), educational status (OR=95% CI: 0.359–0.897; p=0.015), comorbidity (OR=95% CI: 2.296–5.448; p<0.001), and depression score (OR=95% CI: 1.104–3.051; p=0.02) were independently associated with malnutrition. Conclusions Our study demonstrates that age, depression, BMI, comorbidity, and the educational status were independently associated with malnutrition in an elderly population. PMID:26371941

  2. Soluble ICAM-1, Independent of IL-6, Is Associated with Prevalent Frailty in Community-Dwelling Elderly Taiwanese People

    PubMed Central

    Lee, Wei-Ju; Chen, Liang-Kung; Liang, Chih-Kuang; Peng, Li-Ning; Chiou, Shu-Ti; Chou, Pesus

    2016-01-01

    Background Activation of inflammatory pathway with elevation of inflammatory biomarkers such as Interleukin 6 (IL-6) has been considered a pathophysiological feature of frailty. In recent years, the association between Intercellular adhesive molecule -1 (ICAM-1) and vascular inflammatory was established. Provocation of inflammatory cascades from ICAM-1 is potential IL-6 related, although the association between the inflammatory process and frailty is little to known. The study was intended to evaluate the relationship between serum ICAM-1, IL-6 and frailty. Materials and Methods Data was derived from a representative national sampling cohort in Taiwan. The cross-sectional study included nine-hundred-forty-six community-dwelling people aged 53 and older. Frailty was defined as having three or more components (including, muscle shrinkage, slowness, weakness, exhaustion, and low activity) Serum IL-6 and ICAM-1 levels were measured using standard enzyme–linked immunosorbent assays. Results Soluble ICAM-1 (sICAM-1) levels were stepwise increased in non-frail, pre-frail and frail elderly people (the median levels were 255 vs. 265 vs. 285 ng/ml, respectively p<0.001). A multivariate multinomial logistic regression, which was adjusted for age, sex, smoking, education, BMI, and chronic disease number, was utilized to determine that the probability of being frail due to increased log (ICAM-1) and log (IL-6) standard deviation levels were 1.44 (95% CI 1.09–1.91) and 1.54 (95%CI 1.07–2.20), respectively. Conclusion sICAM-1 was significantly associated with frailty, independent of IL-6. This implied that leukocyte migration and inflammation cascade activation might contribute to frailty, in addition to monocyte/macrophage-mediated immuno-inflammation. PMID:27310835

  3. Handgrip strength is associated with metabolic syndrome among middle-aged and elderly community-dwelling persons.

    PubMed

    Kawamoto, Ryuichi; Ninomiya, Daisuke; Kasai, Yoshihisa; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Kumagi, Teru; Abe, Masanori

    2016-01-01

    The association of low muscle strength with cardio-metabolic risks remains controversial. The present study included 742 men aged 70 ± 9 years and 937 women aged 70 ± 8 years from a rural village. We examined the cross-sectional relationship between relative muscle strength defined by handgrip strength (HGS)/body weight (BW) ratio, and metabolic syndrome (MetS) based on the modified criteria of the National Cholesterol Education Program's Adult Treatment Panel (NCEP-ATP) III report and its components. Of these, 203 men (27.4%) and 448 women (47.8%) had MetS. In men, increasing quartile of HGS/BW ratio was significantly and independently associated with high waist circumference {odds ratio, 0.31; 95% confidence interval (CI), 0.24-0.41} and elevated triglyceridemia (0.71, 0.59-0.86). In women, it was also significantly and independently associated with high waist circumference (0.41; 0.36-0.48), high blood pressure (0.78; 0.66-0.92), Low HDL-cholesterolemia (0.84; 0.73-0.98) and elevated triglyceridemia (0.65; 0.53-0.79). In both genders, the prevalence of MetS significantly decreased in relation to increasing HGS/BW ratio. After adjustment for age, smoking status, drinking status, LDL-C, estimated glomerular filtration ratio (eGFR), and medication, the respective odds ratio (95% CI) for the quartile of HGS/BW ratio for MetS was 1.00, 0.54 (0.34-0.85), 0.32 (0.19-0.53), and 0.16 (0.09-0.29) in men, and 1.00, 0.76 (0.50-1.16), 0.33 (0.22-0.51), and 0.16 (0.10-0.25) in women. These results suggest that HGS/BW ratio was significantly and negatively associated with an increased risk of cardio-metabolic disorders in Japanese-community dwelling persons.

  4. Characterization of multifocal T2*-weighted MRI hypointensities in the basal ganglia of elderly, community-dwelling subjects☆

    PubMed Central

    Glatz, Andreas; Valdés Hernández, Maria C.; Kiker, Alexander J.; Bastin, Mark E.; Deary, Ian J.; Wardlaw, Joanna M.

    2013-01-01

    Multifocal T2*-weighted (T2*w) hypointensities in the basal ganglia, which are believed to arise predominantly from mineralized small vessels and perivascular spaces, have been proposed as a biomarker for cerebral small vessel disease. This study provides baseline data on their appearance on conventional structural MRI for improving and automating current manual segmentation methods. Using a published thresholding method, multifocal T2*w hypointensities were manually segmented from whole brain T2*w volumes acquired from 98 community-dwelling subjects in their early 70s. Connected component analysis was used to derive the average T2*w hypointensity count and load per basal ganglia nucleus, as well as the morphology of their connected components, while nonlinear spatial probability mapping yielded their spatial distribution. T1-weighted (T1w), T2-weighted (T2w) and T2*w intensity distributions of basal ganglia T2*w hypointensities and their appearance on T1w and T2w MRI were investigated to gain further insights into the underlying tissue composition. In 75/98 subjects, on average, 3 T2*w hypointensities with a median total volume per intracranial volume of 50.3 ppm were located in and around the globus pallidus. Individual hypointensities appeared smooth and spherical with a median volume of 12 mm3 and median in-plane area of 4 mm2. Spatial probability maps suggested an association between T2*w hypointensities and the point of entry of lenticulostriate arterioles into the brain parenchyma. T1w and T2w and especially the T2*w intensity distributions of these hypointensities, which were negatively skewed, were generally not normally distributed indicating an underlying inhomogeneous tissue structure. Globus pallidus T2*w hypointensities tended to appear hypo- and isointense on T1w and T2w MRI, whereas those from other structures appeared iso- and hypointense. This pattern could be explained by an increased mineralization of the globus pallidus. In conclusion, the

  5. 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.

  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. PMID:27074407

  7. Impact of informal care levels on discontinuation of living at home in community-dwelling dependent elderly using various community-based services.

    PubMed

    Kuzuya, Masafumi; Hasegawa, Jun; Hirakawa, Yoshihisa; Enoki, Hiromi; Izawa, Sachiko; Hirose, Takahisa; Iguchi, Akihisa

    2011-01-01

    The aim of the study was to examine the effect of informal care levels on overall discontinuation of living at home, all-cause death, hospital admission, and long-term care placement for community-dwelling older people using various community-based services during a 3-year period. Prospective cohort study of 1582 community-dwelling disabled elderly and paired informal caregivers was conducted. Baseline data included the recipients and caregivers' demographic characteristics, comorbidities, informal care levels (sufficient, moderate, and insufficient care), which were evaluated by trained visiting nurses, and the level of formal community-based service use. Among 1582 participants, 97 died at home, 692 were admitted to hospitals, 318 died during their hospital stay, and 117 were institutionalized in long-term care facilities during 3 years of follow-up. A multivariate Cox hazard model demonstrated that when compared with a sufficient informal care level, an insufficient informal care level was associated with overall discontinuation of living at home, all-cause mortality, hospitalization, and institutionalization during 3 years of follow-up (hazard ratio: 1.65, 95% confidence interval: 1.15-2.36; 1.98, 1.17-3.34; 1.56, 1.04-2.35; 2.93, 1.25-6.86, respectively). The results suggested that informal caregiving is an important factor in the prevention of overall discontinuation of living at home in a population of disabled older people.

  8. 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

  9. 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. PMID:26835188

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

    PubMed Central

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

    2012-01-01

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

  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 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

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

    PubMed

    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

    2016-08-01

    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 elderly populations

  14. 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.

  15. 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.

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

    PubMed Central

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

    2016-01-01

    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. PMID:27322317

  17. 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.

  18. 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

    2016-01-01

    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. PMID:27322317

  19. 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

  20. 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

  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. 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

  3. Oral care needs, barriers and challenges among community dwelling elderly in New York State and northern Manhattan.

    PubMed

    Alfaro, David P; Ahluwalia, Kavita P

    2010-01-01

    Older adults are living longer and retaining their teeth, resulting in a concomitant increase in the need for oral care services. Despite improvements in oral health among the elderly, there continue to be profound disparities by race/ethnicity, socioeconomic and dentate status. Furthermore, challenges, such as limitations in activities of daily living, poor wheel-chair accessibility of dental clinics, poor geographic distribution of providers, difficulty navigating the oral health system and fiscal limitations make access to, and utilization of, dental services difficult among older adults. While dialogue around national policy, especially incorporation of dental benefits for adults in Medicare and Medicaid, is imperative, local efforts in New York and Northern Manhattan show promise in addressing the oral health and health care of older New Yorkers. PMID:21053640

  4. 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

  5. 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

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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...

  6. Association of CRP gene polymorphisms with serum CRP level and handgrip strength in community-dwelling elders in Taiwan: Taichung Community Health Study for Elders (TCHS-E).

    PubMed

    Lin, Cheng-Chieh; Wu, Fang-Yang; Liao, Li-Na; Li, Chia-Ing; Lin, Chih-Hsueh; Yang, Chuan-Wei; Meng, Nai-Hsin; Chang, Chiu-Kai; Lin, Wen-Yuan; Liu, Chiu-Shong; Li, Tsai-Chung

    2014-09-01

    Low handgrip strength is one component of frailty, characterized by loss of reserves, including energy, physical ability, cognition and health. This study rated the effect of five single-nucleotide polymorphisms (SNPs) in C-reactive protein (CRP) gene on the serum CRP level and handgrip strength in elderly Taiwanese. Five SNPs (rs2794520, rs1205, rs1130864, rs1800947, and rs3093059) of CRP gene were utilized to genotype 472 unrelated elderly subjects (mean age 73.8years). Handgrip strength was measured by handgrip dynamometer (TTM Dynamometer, Tsutsumi, Tokyo). Our study demonstrated that minor alleles of rs2794520 and rs1205 were C, whereas they were T in most ethnic groups. There exist significant associations of three CRP polymorphisms (rs2794520, rs1205 and rs3093059) with serum CRP level and handgrip strength. All three had simultaneous influence on raising CRP levels and reducing handgrip strength. Genotype and sex interactions emerged for rs2794520 and rs1205 in relation to CRP levels (p<0.05). In addition, haplotype C-C-C-C-C was associated with higher levels of CRP (exp(β)=1.45; p<0.001) and lower handgrip strength (β=-1.00kg, p<0.05). We conclude that SNPs rs2794520, rs1205, and rs3093059 of CRP gene, as well as haplotype C-C-C-C-C may be important biomarkers for susceptibility to low handgrip strength and high serum CRP level in elders; further studies are required.

  7. 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

  8. 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

  9. Influenza A among community-dwelling elderly persons in Leicestershire during winter 1993-4; cigarette smoking as a risk factor and the efficacy of influenza vaccination.

    PubMed Central

    Nicholson, K. G.; Kent, J.; Hammersley, V.

    1999-01-01

    In a prospective study of community-dwelling people 60-90 years of age, we examined the coverage of influenza vaccine during 1992-3 and 1993-4, the efficacy of vaccination in reducing serologically-confirmed clinical episodes of influenza A during 1993, and the effect of cigarette smoking. During 1992 and 1993, influenza vaccine was given to 106/215 (49%) and 120/204 (59%) people with risk conditions, and 84/225 (37%) and 103/235 (44%) without risk conditions. Influenza vaccination and general practitioner consultations during 1992 were independent predictors of vaccination in 1993, but current smoking was a negative predictor. Of 209 unimmunized people, 8/35 (23%) smokers had clinical influenza as compared with 11/174 (6%) non-smokers (OR 4.4, 95% CI 1.6 to 11.9). Of 371 non-smokers, 1/197 (0.5%) vaccinees had influenza as compared with 11/174 (6%) non-vaccinees (OR 0.075, 95% CI 0.587 to 0.009). No cases of influenza occurred among 21 current smokers who were vaccinated. PMID:10487646

  10. 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.

  11. Elderly Men Have Low Levels of Anti-Müllerian Hormone and Inhibin B, but with High Interpersonal Variation: A Cross-Sectional Study of the Sertoli Cell Hormones in 615 Community-Dwelling Men

    PubMed Central

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

    2013-01-01

    The Sertoli cells of the testes secrete anti-Müllerian hormone (Müllerian inhibiting Substance, AMH) and inhibin B (InhB). AMH triggers the degeneration of the uterine precursor in male embryos, whereas InhB is part of the gonadal-pituitary axis for the regulation of sperm production in adults. However, both hormones are also putative regulators of homeostasis, and age-related changes in these hormones may therefore be important to the health status of elderly men. The levels of AMH in elderly men are unknown, with limited information being available about age-related changes in InhB. We have therefore used ELISAs to measure Sertoli cell hormone levels in 3 cohorts of community-dwelling men in New Zealand. In total, 615 men were examined, 493 of which were aged 65 or older. Serum AMH and InhB levels inversely correlated with age in men older than 50 years (p<0.001) but not in the younger men. A minority of elderly men had undetectable levels of AMH and InhB. The variation in hormone levels between similarly aged men increased with the age of men. AMH and InhB partially correlated with each other as expected (r = 0.48, p<0.001). However, the ratio of the two Sertoli hormones varied significantly between men, with this variation increasing with age. Elderly men selected for the absence of cardiovascular disease had AMH levels similar to those of young men whereas their InhB levels did not differ from aged-matched controls. These data suggests that Sertoli cell number and function changes with age, but with the extent and nature of the changes varying between men. PMID:23940675

  12. 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

  13. 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…

  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. Real-world comparative study of behavioral group therapy program vs education program implemented for smoking cessation in community-dwelling elderly smokers

    PubMed Central

    Pothirat, Chaicharn; Phetsuk, Nittaya; Liwsrisakun, Chalerm; Deesomchok, Athavudh

    2015-01-01

    Background Tobacco smoking is known to be an important contributor to a wide variety of chronic diseases, especially in older adults. Information on health policy and practice, as well as evaluation of smoking cessation programs targeting older people, is almost nonexistent. Purpose To compare the real-world implementation of behavioral group therapy in relation to education alone for elderly smokers. Materials and methods Elderly smokers ready to quit smoking were identified from a cohort who completed a questionnaire at a smoking exhibition. They were allocated into two groups, behavioral therapy (3 days 9 hours) and education (2 hours), depending on their preferences. Demographic data, the Fagerstrom test for nicotine dependence (FTND) score, and exhaled carbon monoxide level were recorded at baseline. Smoking status of all subjects was followed at months 3, 6, and 12. Statistical differences in continuous abstinence rate (CAR) between the two groups were analyzed using chi-square tests. Results Two hundred and twenty-four out of 372 smoking exhibition attendants met the enrollment criteria; 120 and 104 elected to be in behavioral group therapy and education-alone therapy, respectively. Demographic characteristics and smoking history were similar between both groups, including age, age of onset of smoking, years of smoking, smoking pack-years, education level, and nicotine dependence as measured by the FTND scale. The CAR of the behavioral therapy group at the end of the study (month 12) was significantly higher than the education group (40.1% vs 33.3%, P=0.034). Similar results were also found throughout all follow-up visits at month 3 (57.3% vs 27.0%, P<0.001) and month 6 (51.7% vs 25%, P<0.001). Conclusion Behavioral group therapy targeting elderly smokers could achieve higher short-and long-term CARs than education alone in real-world practice. PMID:25926726

  16. 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

  17. 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

  18. 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

    2016-01-01

    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

  19. 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. PMID:27079329

  20. 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.

  1. Caregiver burden among Japanese informal caregivers of cognitively impaired elderly in community settings.

    PubMed

    Hirakawa, Yoshihisa; Kuzuya, Masafumi; Enoki, Hiromi; Hasegawa, Jun; Iguch, Akihisa

    2008-01-01

    Because dementia is a progressive disease, formal long-term care providers and care managers need information on how the severity of cognitive impairment affects caregiver burden in order to better assist family caregivers. However, research to guide care providers in behavioral symptom-management is not well developed. The purpose of this study was to examine the relationship between dementia status and burden of family caregivers. The subjects were 1875 community-dwelling elderly eligible for public long-term care insurance. The data we used in this analysis included the caregivers' and dependents' characteristics. The main outcome was subjective caregiver burden assessed by the Japanese version of the Zarit Burden Interview (J-ZBI). A total of 1559 pairs of dependents and caregivers were included in the analysis. The pairs were sorted into three mutually exclusive categories: no dementia, mild dementia, and severe dementia. Two hundred sixty-one dependents had severe dementia, and 725 had mild dementia. Although differences were found among the dementia categories in levels of caregiver burden according to the J-ZBI before and after adjusting for these baseline variables, the odds ratios equal nearly 1. The present study shows that severity of dementia is not associated with caregiver burden in Japan. PMID:17767968

  2. Falls and Fear of Falling among Community-Dwelling Seniors: The Dynamic Tension between Exercising Precaution and Striving for Independence

    ERIC Educational Resources Information Center

    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…

  3. 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.

  4. Lymph node hyalinization in elderly Japanese.

    PubMed

    Taniguchi, I; Murakami, G; Sato, A; Fujiwara, D; Ichikawa, H; Yajima, T; Kohama, G

    2003-10-01

    Lymph node hyalinization has been comprehensively investigated using specimens obtained from elderly Japanese and white Americans. Onion-peel lesions and associated meshwork areas were often found in the medullary sinus of the thoracic node (mediastinal-type hyalinization), while eosinophilic, glassy and spotty lesions were consistently seen in B lymphocyte areas of the pelvic node (pelvic-type hyalinization). The mediastinal-type hyalinization was comprised of thin collagen fibrils (ca 50 nm in diameter), whereas the pelvic-type hyalinization had thick fibrils (ca 150 nm in diameter). This difference seemed to be consistent with a difference in composite collagen fibrils of vascular walls between the thoracic and pelvic regions. The pelvic-type hyalinization was often or sometimes seen in other nodes, such as cervical, axillary, abdominal and inguinal nodes, especially in white Americans. The mediastinal-type hyalinization, usually in combination with a sinus filled with anthracotic macrophages, tended to be observed in Japanese more frequently than in white Americans. Anthracosis seemed to be connected to the pathogenesis of the hyalinization. On the other hand, because the lesion was weakly positive for Factor VIII immunohistochemistry and because lesions were located along thin vessels, the pelvic-type hyalinization seemed to originate from vascular degeneration in the nodal cortex. Due to the high incidence and large proportion in total volume of the node, the hyalinization seems to be one of the major events that diminish the nodal filtration function and ruin the node with aging. PMID:12973685

  5. Joint effect of gene-physical activity and the interactions among CRP, TNF-α, and LTA polymorphisms on serum CRP, TNF-α levels, and handgrip strength in community-dwelling elders in Taiwan - TCHS-E.

    PubMed

    Li, Chia-Ing; Li, Tsai-Chung; Liao, Li-Na; Liu, Chiu-Shong; Yang, Chuan-Wei; Lin, Chih-Hsueh; Hsiao, Jen-Hao; Meng, Nai-Hsin; Lin, Wen-Yuan; Wu, Fang-Yang; Lin, Cheng-Chieh

    2016-04-01

    This study assesses interactions of tumor necrosis factor α (TNF-α) gene polymorphisms with C-reactive protein (CRP) or lymphotoxin α (LTA) gene on serum CRP and TNF-α levels and handgrip strength. Eleven single nucleotide polymorphisms (SNPs), including rs2794520, rs1205, rs1130864, rs1800947, and rs3093059 in CRP; rs1799964, rs1800629, and rs3093662 in TNF-α; and rs2239704, rs909253, and rs1041981 in LTA, were genotyped in 472 unrelated elders (mean age 73.8 years). Among elders with TNF-α rs1799964 AA genotype, adjusted mean difference for handgrip strength decreased by -2.60 (-4.82, -0.38) and -2.51 kg (-4.75, -0.28) for LTA rs909253 and rs1041981 in women and by -2.39 kg (-3.98, -0.81) for CRP rs3093059 in men. Among elders with TNF-α rs1799964 AA genotype, adjusted mean ratios for hs-CRP levels increased by 2.32 (1.38, 3.90) and 2.27 (1.35, 3.84) for both CRP rs909253 and rs1041981 in women. The A-A-C LTA haplotype was associated with TNF-α levels that were 1.55 times higher than those of the C-G-A haplotype (P = 0.005). The joint effects of SNPs (the rs1800947 or rs3093059 of CRP, rs1799964 or rs1800629 of TNF-α, and rs909253 or rs1041981 of LTA) and physical inactivity appeared to have greater magnitude of decreased handgrip strength than main effects of these SNPs and physical inactivity. Our data showed that significant interactions of TNF-αrs1799964 and LTA rs909253 were observed. Moreover, joint effects of these CRP, TNF-α, and LTA risk alleles with physical inactivity in elders were observed, suggesting that physical activity may modulate effects of genotypes on handgrip strength.

  6. The ability of self-rated health to predict mortality among community-dwelling elderly individuals differs according to the specific cause of death: data from the NEDICES Cohort

    PubMed Central

    Fernández-Ruiz, Mario; Guerra-Vales, Juan M.; Trincado, Rocío; Fernández, Rebeca; Medrano, María José; Villarejo, Alberto; Benito-León, Julián; Bermejo-Pareja, Félix

    2013-01-01

    Background The biomedical and psychosocial mechanisms underlying the relationship between self-rated health (SRH) and mortality in elderly individuals remain unclear. Objective To assess the association between different measurements of subjective health (global, age-comparative, and time-comparative SRH) and cause-specific mortality. Methods Neurological Disorders in Central Spain (NEDICES) is a prospective population-based survey of the prevalence and incidence of major age-associated conditions. Data on demographic and health-related variables were collected from 5,278 subjects (≥65 years) at the baseline questionnaire. Thirteen-year mortality and cause of death were obtained from the National Death Registry. Adjusted hazard ratios (aHR) for SRH and all-cause and cause-specific mortality were estimated by Cox proportional hazard models. Results At baseline, 4,958 participants (93.9%) answered the SRH questionnaire. At the end of follow-up 2,468 (49.8%) participants had died (of whom 723 [29.2%] died from cardiovascular diseases, 609 [24.7%] from cancer, and 359 [14.5%] from respiratory diseases). Global SRH predicted independently all-cause mortality (aHR for “poor or very poor” vs. “very good” category: 1.39; 95% confidence interval [CI]: 1.15–1.69). Analysis of cause-specific mortality revealed that global SRH was an independent predictor for death due to respiratory diseases (aHR for “poor or very poor” vs. “very good” category: 2.61; 95% CI: 1.55–4.39), whereas age-comparative SRH exhibited a gradient effect on the risk of death due to stroke. Time-comparative SRH provided small additional predictive value. Conclusions The predictive ability of SRH for mortality largely differs according to the specific cause of death, with the strongest associations found for respiratory disease and stroke mortality. PMID:23615509

  7. The cricothyroid joint in elderly Japanese individuals.

    PubMed

    Serikawa, Masamitu; Yamamoto, Masahito; Kawamoto, Ai; Katori, Yukio; Kinoshita, Hideaki; Matsunaga, Satoru; Abe, Shin-Ichi

    2016-06-01

    Using 15 cricothyroid joint (CT joint) specimens obtained from donated cadavers of elderly individuals, we examined the morphologies of the ceratocricoid ligaments as well as the synovial tissue. The ligaments consistently contained abundant elastic fibers: the fibers tended to be straight on the anterior side in contrast to a mesh-like arrangement on the posterior side. Thick and/or long synovial folds were often evident in the CT joint. The synovial tissue usually contained CD68-positive macrophages, but the positive cells were often restricted to certain parts of the tissue. Factor VIII-positive capillaries were present but few in number, and CD3- or IgM-positive lymphocytes were absent in the synovial tissue. Degenerative changes in the joint cartilage, such as roughness or thinning, were often present, but no cartilage defects were evident. Therefore, in contrast to the small, non-weight-bearing joints of the musculoskeletal system, we considered the degeneration of the CT joint to be a specific, silent form of osteoarthritis. For high-pitched phonation and ossification of the laryngeal cartilage, the CT joint in elderly individuals seemed to maintain its anterior gliding and rotation with the aid of elastic fiber-rich tissues compensating for the loss of congruity between the joint cartilage surfaces. PMID:26286109

  8. 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…

  9. 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…

  10. 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…

  11. 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

  12. Determinants of healthy eating in community-dwelling elderly people.

    PubMed

    Payette, Hélène; Shatenstein, Bryna

    2005-01-01

    Among seniors, food choice and related activities are affected by health status, biological changes wrought by aging and functional abilities, which are mediated in the larger arena by familial, social and economic factors. Determinants of healthy eating stem from individual and collective factors. Individual components include age, sex, education, physiological and health issues, psychological attributes, lifestyle practices, and knowledge, attitudes, beliefs and behaviours, in addition to other universal dietary determinants such as income, social status and culture. Collective determinants of healthy eating, such as accessible food labels, an appropriate food shopping environment, the marketing of the "healthy eating" message, adequate social support and provision of effective, community-based meal delivery services have the potential to mediate dietary habits and thus foster healthy eating. However, there is a startling paucity of research in this area, and this is particularly so in Canada. Using search and inclusion criteria and key search strings to guide the research, this article outlines the state of knowledge and research gaps in the area of determinants of healthy eating among Canadian seniors. In conclusion, dietary self-management persists in well, independent seniors without financial constraints, whatever their living arrangements, whereas nutritional risk is high among those in poor health and lacking in resources. Further study is necessary to clarify contributors to healthy eating in order to permit the development and evaluation of programs and services designed to encourage and facilitate healthy eating in older Canadians.

  13. [Functional fitness and related factors in community-dwelling elderly].

    PubMed

    Arao, T; Oida, Y; Nagamatsu, T

    1998-05-01

    To examine the association of level of functional fitness to demographic, health, and life behavioral or social factors, cross sectional data were obtained for 737 persons aged 60 years or older, and who were independently living in the community. Functional fitness was measured with a functional fitness test containing 4 task items: standing, walking, hand performance, and self-care performance. Among the demographic factors, statistically significant associations with functional fitness were found for age in both male and female and for the presence of spouse in male. Health status, previous or present history of circulatory diseases and musculo-skeletal diseases were significantly associated with lower levels of functional fitness in male, and previous or present history of musculo-skeletal diseases and presence of higher obesity associated with lower fitness level in female. With life behaviors, men who had habitual exercise activities and women who had no habitual nap but habitual exercise activities and frequent out-of-home activities showed significantly higher fitness level than their counterparts. These results suggest that level of functional fitness in independently living aged people in the community was significantly associated with the presence of spouse, history of circulatory and musculo-skeletal diseases, and habitual exercise activities in males; and with the history of musculo-skeletal diseases, obesity, and habitual exercise activities, napping, and frequent out-of-home activities in females.

  14. 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

  15. Postcard intervention for depression in community-dwelling older adults: A randomised controlled trial.

    PubMed

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

    2015-09-30

    Depression in older adults erodes their health, quality of life and the economy. Existing interventions are not feasible for broad application at the community. Postcard intervention only requires a few resources, and previous studies have shown its effectiveness for patients following drug overdose, self-harm and hospitalisation for major depression. The purpose of the present study is to evaluate the effectiveness of a postcard intervention. Participants were community-dwelling individuals, aged 65 or older, who eat meals alone and with the score of 4 or higher on the 15-item Geriatric Depression Scale (GDS-15). We enrolled 184 eligible participants, with 93 in the intervention and 91 in the control arm. Postcards were sent to participants once a month for eight months. Primary outcome was the GDS-15 score at post-intervention. Secondary outcomes were quality of life and activities of daily living. There was no significant difference in primary and secondary outcomes between completers of the intervention and the control arm. However, most of the participants who received intervention thought the intervention was effective. The postcard intervention for depression in community-dwelling elderly people in Japan is neither feasible nor effective. However, the descriptive results suggest that the intervention may be effective given different parameters.

  16. 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

  17. Environmental and behavioral conditions of bathing among elderly Japanese.

    PubMed

    Takasaki, Yuji; Ohnaka, Tadakatsu; Tochihara, Yutaka; Nagai, Yumiko; Ito, Hiromitsu; Yoshitake, Shiro

    2007-03-01

    This study investigated the bathing conditions of elderly Japanese, and sought to find factors relating to regional differences in death rates from bathtub accidents. A questionnaire survey was carried out in 11 areas of Japan. Questionnaires including questions regarding the length of time since houses had been built, types of facilities, and subjects' indoor thermal sensations and behavior while bathing were distributed to detached houses in each area twice, once in summer and once in winter. Completed questionnaires were collected from approximately 160 elderly people over 65 years old. Information regarding thermal sensations of rooms in winter revealed that a prefabricated bath and insulating window glass eased the cold in the bathroom. Unexpectedly, more subjects in the southern region than in the northern region reported being cold or a little cold while bathing in winter. In the present study, thermal sensations and behaviors while bathing seemed to be more affected by facilities and the location of houses than by the sex and age of the subjects. PMID:17435371

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

    PubMed

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

    2011-01-01

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

  19. Loneliness and mental health in a representative sample of community-dwelling Spanish older adults.

    PubMed

    Losada, Andrés; Márquez-González, María; García-Ortiz, Luis; Gómez-Marcos, Manuel Angel; Fernández-Fernández, Virginia; Rodríguez-Sánchez, Emiliano

    2012-01-01

    Research seems to support loneliness as a risk factor for mental health problems in the elderly. Most studies analyzing the effects of loneliness on older adults' mental health have relied on convenience samples. In this study, the prevalence and predictors of feelings of loneliness were studied in a representative sample of 272 community-dwelling Spanish older adults. The potential of feelings of loneliness to significantly contribute to the explanation of mental health of the elderly was also explored. The percentage of people reporting feelings of loneliness was 23.1%. Being a woman, being older, living alone, having fewer economic resources, having lower perceived health, and being dissatisfied with the frequency of contact with relatives and friends were found to be significant predictors of feelings of loneliness. Loneliness contributed significantly to the explanation of mental health, even when other significant variables were statistically controlled. The results of this study suggest that loneliness is a relevant factor for the analysis and understanding of mental health in the elderly.

  20. Reducing depression among community-dwelling older adults using life-story review: a pilot study.

    PubMed

    Chan, Moon Fai; Leong, Katherine S P; Heng, Boon Ling; Mathew, Blessy Koottappal; Khan, Sher Banu A L; Lourdusamy, Sumathi Sagayamary; Nagapan, Mina; Woo, Sook Fan; Chee, Wai Yan; Ho, Roger C M; Taylor, Beverley Joan

    2014-01-01

    A life-story review can serve as an effective intervention to express one's inner feelings and provide emotional catharsis. The research aim was to examine the effects of life-story review on depression levels in community-dwelling older adults in Singapore. This pilot experimental pre-post-follow-up study was conducted from July 2012 to February 2013. Twenty-nine older Malays aged 60 and above, with mild to moderate depression, were randomly allocated to the life-story review (intervention) group (n = 15) or the non life-story review (control) group (n = 14). Depressive symptoms were measured by the Geriatric Depression Scale-15 and collected five times over eight weeks. Generalized estimating equations were used to examine the effects of the intervention on the elders' depression levels, controlled for age, gender, medication use, existence of chronic disease, and diary writing experience. Reductions in depression scores were found in the intervention group from week 1 (Mean ± SD 5.9 ± 2.3) to week 8 (1.9 ± 1.6) compared with the control group (week 1: 5.0 ± 1.3; week 8: 3.5 ± 1.5). At week 8, the intervention group showed a significantly lower level of depression than the control group (χ(2) = 14.61, p < 0.001). This study adds to prior research supporting the use of life story review in improving depression levels in cognitively intact community dwelling older adults.

  1. Community-dwelling older adults with memory loss

    PubMed Central

    Parsons, Karen; Surprenant, Aimee; Tracey, Anne-Marie; Godwin, Marshall

    2013-01-01

    Abstract Objective To identify the health-related needs of community-dwelling older adults with mild memory loss. Design Qualitative study using semistructured, audiotaped, face-to-face interviews and focus groups. Setting A large community in Newfoundland. Participants Twenty-two adults between the ages of 58 and 80 years. Methods This needs assessment used a qualitative methodology of collecting and analyzing narrative data to develop an understanding of the issues, resources, and constraints of community-dwelling older adults with mild memory loss. Data were collected through semistructured, audiotaped, face-to-face interviews and focus groups. Transcripts of the interviews were analyzed using interpretive phenomenologic analysis. Main findings Three constitutive patterns with relational themes and subthemes were identified: forgetting and remembering, normalizing yet questioning, and having limited knowledge of resources. Participants described many examples of how their daily lives were affected by forgetfulness. They had very little knowledge of resources that provided information or support. Most of the participants believed they could not discuss their memory problems with their family doctors. Conclusion It is important for older adults with mild memory loss to have access to resources that will assist them in understanding their condition and make them feel supported. PMID:23486801

  2. Lifestyle determinants for social activity levels among the Japanese elderly.

    PubMed

    Aoki, R; Ohno, Y; Tamakoshi, A; Kawakami, N; Nagai, M; Hashimoto, S; Ikari, A; Shimizu, H; Sakata, K; Kawamura, T; Wakai, K; Senda, M

    1996-01-01

    We conducted a self-administered questionnaire survey to a total of 5239 elderly persons in four areas in Japan in 1993, which inquired about past lifestyles and present social activities. Based on the survey data, we first developed social activity measures, and then examined associations of the present total social activity measure with past lifestyles and physical conditions. The lifestyles significantly associated with high social activity after 65 years of age were 'high educational attainment'; having been 'healthy', 'plump', 'physically active' and 'having had hobbies' at about 50 years of age; and having 'frequent intake of many kinds of foods' during 30-50 years of age. Intake during 30-50 years of age of Japanese-style foods (rice, soybean paste soup, bean curd, pickles), noodles, beans, plant roots and potatoes was not significantly linked with the social activity levels at old age in either males or females. The same was true for smoking and drinking habits at about 50 years of age. Our findings essentially suggest the importance of a positive attitude at middle age to maintain and promote health status and improve lifestyles in order to attain high social activity at old age.

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

    ERIC Educational Resources Information Center

    Cohen-Mansfield, Jiska; Frank, Julia

    2008-01-01

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

  4. Association between polymorphisms of the α-kinase 1 gene and type 2 diabetes mellitus in community-dwelling individuals

    PubMed Central

    SHIMOKATA, SHIGETAKA; OGURI, MITSUTOSHI; FUJIMAKI, TETSUO; HORIBE, HIDEKI; KATO, KIMIHIKO; YAMADA, YOSHIJI

    2013-01-01

    We previously demonstrated that the α-kinase 1 gene (ALPK1) is a susceptibility locus for chronic kidney disease in individuals with diabetes mellitus (DM) by a genome-wide association study. Although genetic variants of ALPK1 have been associated with chronic kidney disease in individuals with DM, whether ALPK1 is a susceptibility locus for DM has not been elucidated. The purpose of the present study was to investigate a possible association of the rs2074388 (A→G, Asp565Gly) or rs2074379 (A→G, Ile732Met) variants of ALPK1 with type 2 DM in community-dwelling individuals. The study subjects comprised 5,959 community-dwelling individuals (495 subjects with type 2 DM and 5,464 controls) who were recruited to a population-based cohort study in Inabe, Mie, Japan. The comparisons of allele frequencies or genotype distributions using the Chi-square test revealed that the rs2074388 and rs2074379 variants of ALPK1 were significantly associated with type 2 DM (P<0.05). A multivariable logistic regression analysis with adjustment for age, gender, body mass index and smoking status revealed that the rs2074388 (P=0.0051; odds ratio, 1.32) and rs2074379 (P=0.0058; odds ratio, 1.32) variants were significantly associated with type 2 DM. The haplotype analysis of these polymorphisms revealed that the frequency of the major haplotype, A (rs2074388)-A (rs2074379), was significantly lower, whereas that of the minor haplotype G-G was significantly higher in subjects with type 2 DM compared to controls. Thus, ALPK1 may be a susceptible gene for type 2 DM in community-dwelling Japanese individuals. PMID:24649057

  5. Psychological needs of Japanese American elders: implications for culturally competent interventions.

    PubMed

    Machizawa, Sayaka; Lau, Denys T

    2010-06-01

    This qualitative study aims to explore the psychological needs of Nikkei (individuals of Japanese ancestry) elders that might influence their treatment seeking behaviors and service preferences. We conducted in-depth interviews with multiple community sources, including 41 Nikkei elders; 11 adult family members, friends, or personal caregivers; and 8 professional providers who served Nikkei elders in the greater Chicago metropolitan area. Data were analyzed using the Atlas.ti software. Applying the life course perspective, we aimed to understand similarities and differences among Nikkei elders in terms of their psychological needs. Results indicated that Nikkei elders shared five psychological needs including independence, cultural connection, social connection, feeling useful, and maintaining pride and dignity. Variations in psychological needs among Nikkei elders existed according to life experiences, generation, acculturation level, gender, socioeconomic status, and proximity to family members. We concluded by discussing the implications of our findings and suggestions to better meet the diverse health and service needs of Nikkei elders. PMID:20414712

  6. 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

  7. 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

  8. 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. PMID:25114901

  9. Efficacy of Nutrition Education-Based Cooking Workshops in Community-Dwelling Adults Aged 50 Years and Older.

    PubMed

    Moreau, Mireille; Plourde, Hugues; Hendrickson-Nelson, Mary; Martin, Joanne

    2015-01-01

    Nutrition interventions offer an opportunity to meet the nutritional needs of community-dwelling older adults. This retrospective qualitative observational study aimed to determine if nutrition education-based cooking workshops offered in Southern Quebec helped improve dietary habits and nutrition-related knowledge, autonomy, and confidence among older adults. Participants (n = 144) in an 8-session cooking workshop program completed pre- and post-workshop session questionnaires. Baseline nutritional risk (n = 116) and body mass index (n = 112) were assessed using the Elderly Nutrition Screening Questionnaire. Paired sample t-tests and McNemar analyses were performed to determine changes over time for knowledge, autonomy, confidence and dietary habits, and specific dietary behaviors, respectively. Pearson correlation tests were performed to assess associations between variables. Significant improvements were observed over time in knowledge, confidence, and desired dietary habits but not in autonomy. At the end of the intervention a greater proportion of participants reported always consuming recommended amounts of whole grains, fruits and vegetables, water, and milk or milk alternatives. A significant association was observed between confidence and dietary habits and between knowledge and confidence. Food skills interventions that link nutrition knowledge with cooking competence offer the opportunity to improve dietary habits among community-dwelling older adults. PMID:26571355

  10. 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

  11. 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

  12. Gait patterns in a community-dwelling population aged 50 years and older.

    PubMed

    Verlinden, V J A; van der Geest, J N; Hoogendam, Y Y; Hofman, A; Breteler, M M B; Ikram, M A

    2013-04-01

    Poor gait is an important risk factor for falls and associated with higher morbidity and mortality. It is well established that older age is associated with worse gait, but it remains unclear at what age this association is first seen. Moreover, previous studies focused mainly on normal walking, but gait also encompasses turning and tandem walking. In a large study of community-dwelling middle-aged and elderly persons we investigated the association of age with gait, focusing on normal walking, turning and tandem walking. In 1500 persons aged 50 years and over, we measured gait using an electronic walkway. Participants performed normal walks, turning and a tandem walk. With principal components analysis of 30 variables we summarized gait into five known gait factors: Rhythm, Variability, Phases, Pace and Base of Support; and uncovered two novel gait factors: Tandem and Turning. The strongest associations with age were found for Variability (difference in Z-score -0.29 per 10 years increase (95% confidence interval: -0.34; -0.24)), Phases (-0.31 per 10 years (-0.36; -0.27)) and Tandem (-0.25 per 10 years (-0.30; -0.20)). Additionally, these factors already showed association with the youngest age groups, from 55 to 60 years of age and older. Our study shows that Variability, Phases and Tandem have the strongest association with age and are the earliest to demonstrate a poorer gait pattern with higher age. Future research should further investigate how these gait factors relate with gait-related diseases in their earliest stages.

  13. Controlled whole-body vibration training reduces risk of falls among community-dwelling older adults.

    PubMed

    Yang, Feng; King, George A; Dillon, Loretta; Su, Xiaogang

    2015-09-18

    The primary purpose of this study was to systematically examine the effects of an 8-week controlled whole-body vibration training on reducing the risk of falls among community-dwelling adults. Eighteen healthy elderlies received vibration training which was delivered on a side alternating vibration platform in an intermittent way: five repetitions of 1 min vibration followed by a 1 min rest. The vibration frequency and amplitude were 20 Hz and 3.0mm respectively. The same training was repeated 3 times a week, and the entire training lasted for 8 weeks for a total of 24 training sessions. Immediately prior to (or pre-training) and following (or post-training) the 8-week training course, all participants' risk of falls were evaluated in terms of body balance, functional mobility, muscle strength and power, bone density, range of motion at lower limb joints, foot cutaneous sensation level, and fear of falling. Our results revealed that the training was able to improve all fall risk factors examined with moderate to large effect sizes ranging between 0.55 and 1.26. The important findings of this study were that an 8-week vibration training could significantly increase the range of motion of ankle joints on the sagittal plane (6.4° at pre-training evaluation vs. 9.6° at post-training evaluation for dorsiflexion and 45.8° vs. 51.9° for plantar-flexion, p<0.05 for both); reduce the sensation threshold of the foot plantar surface (p<0.05); and lower the fear of falling (12.2 vs. 10.8, p<0.05). These findings could provide guidance to design optimal whole-body vibration training paradigm for fall prevention among older adults.

  14. A 5-year study of attachment loss and tooth loss in community-dwelling older adults.

    PubMed

    Beck, J D; Sharp, T; Koch, G G; Offenbacher, S

    1997-08-01

    Tooth loss is a widely recognized endpoint measure for the effects of periodontal diseases and the impact of periodontal therapy. In fact, traditional clinical measures of periodontal status often are considered to be surrogate endpoints in that they are assumed to be related to tooth loss. However, the strength of the relationship between attachment loss and tooth loss in a representative population of untreated subjects has not been studied extensively. The purpose of this paper is to present the trends in attachment loss over a 5-yr period in a population of community-dwelling elderly blacks and whites. Specifically, this paper presents attachment loss trends both at the person and tooth level to address the following issues; 1) whether teeth that experience attachment loss during 1 time period are more likely to be lost at the next time period; and 2) given similar levels of attachment loss, why are some people more likely to lose teeth? In 1988, the University of North Carolina School of Dentistry initiated the Piedmont 65+ Dental Study, which was designed to elicit 800 dentate respondents in the 5-country area who were examined again at 18, 36 and 60 months. Our findings indicated that teeth with poorer attachment level at baseline had a higher probability of being lost during the next 5 yr and teeth that experienced attachment loss during a time period were more likely to be lost during the next time period than teeth without additional attachment loss. In addition, it appears that there are person-level characteristics associated with increasing tendency towards tooth loss in people with similar periodontal status, a finding that may clarify the relationship between attachment loss and tooth loss. PMID:9379319

  15. Low Relative Lean Mass is Associated with Increased Likelihood of Abdominal Aortic Calcification in Community-Dwelling Older Australians.

    PubMed

    Rodríguez, Alexander J; Scott, David; Khan, Belal; Khan, Nayab; Hodge, Allison; English, Dallas R; Giles, Graham G; Ebeling, Peter R

    2016-10-01

    Age-related loss of skeletal muscle is associated with increased risk of functional limitation and cardiovascular (CV) mortality. In the elderly abdominal aortic calcification (AAC) can increase CV risk by altering aortic properties which may raise blood pressure and increase cardiac workload. This study investigated the association between low muscle mass and AAC in community-dwelling older Australians. Data for this cross-sectional analysis were drawn from a 2010 sub-study of the Melbourne Collaborative Cohort Study in the setting of community-dwelling older adults. Three hundred and twenty-seven participants [mean age = 71 ± 6 years; mean BMI = 28 ± 5 kg/m(2); females n = 199 (62 %)] had body composition determined by dual-energy x-ray absorptiometry (DXA) and AAC determined by radiography. Participants were stratified into tertiles of sex-specific BMI-normalised appendicular lean mass (ALM). Those in the lowest tertile were considered to have low relative muscle mass. Aortic calcification score (ACS) was determined visually as the extent of calcification on the aortic walls between L1 and L4 vertebrae (range: 0-24). Severe AAC was defined as ACS ≥ 6. Prevalence of any AAC was highest in participants with low relative muscle mass (74 %) compared to the middle (65 %) and upper (53 %) tertiles (p trend = 0.006). The lower ALM/BMI tertile had increased odds (Odds ratio = 2.3; 95 % confidence interval: 1.1-4.6; p = 0.021) of having any AAC; and having more severe AAC (2.2; 1.2-4.0; p = 0.009) independent of CV risk factors, serum calcium and physical activity. AAC is more prevalent and severe in community-dwelling older adults with low relative muscle mass. Maintaining muscle mass could form part of a broader primary prevention strategy in reducing AAC. PMID:27272030

  16. The Elderly Japanese American: Aging among First Generation Immigrants.

    ERIC Educational Resources Information Center

    Montero, Darrel

    The social disengagement theory suggests that older people often do not wish to maintain the same level of immersion in social relations as they did in their earlier years. Following this theory, then, social gerontologists suggest that voluntary mutual withdrawal takes place between the elderly and the rest of society. The present paper uses data…

  17. Are Sleep Onset/Maintenance Difficulties Associated with Medical or Psychiatric Comorbidities in Nondemented Community-Dwelling Older Adults?

    PubMed Central

    Zimmerman, Molly E.; Bigal, Marcelo E.; Katz, Mindy J.; Derby, Carol A.; Lipton, Richard B.

    2013-01-01

    Study Objectives: Older adults frequently report disruptions in their ability to initiate and maintain sleep. It remains unclear whether these sleep problems are consequent to associated medical comorbidities or if they represent primary sleep disturbances that exist independent of other disorders of senescence. Herein we describe sleep characteristics and associated medical and psychiatric comorbidities among ethnically diverse nondemented older adults. Methods: The cross-sectional sample consisted of 702 participants drawn from the Einstein Aging Study (EAS), a community-based study of aging. Sleep onset/maintenance difficulties (SO/MD) were ascertained using responses from the Medical Outcomes Study Sleep Scale (MOS-SS). Participants also completed assessments of medical history, psychological symptoms, and medication use. Results: Participants were an average of 80 ± 5.5 years of age and had 14 ± 3.4 years of education. Older adults reported sleeping an average of 6.5 ± 1.2 h/night. Mild SO/MD was reported in 43% of participants, while moderate/severe SO/MD was reported in 12% of participants. Sleep problems were associated with measures of obesity and symptoms of depression and anxiety. SO/MD was not associated with history of common medical conditions. Use rates of insomnia medication were low (0% to 3%). Conclusions: The prevalence of SO/MD is high in the elderly community-dwelling population and is associated with common psychiatric disorders. With the exception of obesity, SO/MD is not associated with common medical disorders. Further study is necessary to disentangle the nature of the relationship between sleep disturbance and psychiatric comorbidity among older adults. Citation: Zimmerman ME; Bigal ME; Katz MJ; Derby CA; Lipton RB. Are sleep onset/maintenance difficulties associated with medical or psychiatric comorbidities in nondemented community-dwelling older adults? J Clin Sleep Med 2013;9(4):363-369. PMID:23585752

  18. Impact of blunted perception of dyspnea on medical care use and expenditure, and mortality in elderly people.

    PubMed

    Ebihara, Satoru; Niu, Kaijun; Ebihara, Takae; Kuriyama, Shinichi; Hozawa, Atsushi; Ohmori-Matsuda, Kaori; Nakaya, Naoki; Nagatomi, Ryoichi; Arai, Hiroyuki; Kohzuki, Masahiro; Tsuji, Ichiro

    2012-01-01

    Dyspnea is an alarming symptom responsible for millions of patient visits each year. Poor perception of dyspnea might be reasonably attributed to an inappropriately low level of fear and inadequate earlier medical treatment for both patients and physicians, resulting in subsequent intensive care. This study was conducted to evaluate medical care use and cost, and mortality according to the perception of dyspnea in community-dwelling elderly people. We analyzed baseline data from a community-based Comprehensive Geriatric Assessment in 2002. The perception of dyspnea in 479 Japanese community-dwelling elderly people with normal lung function was measured in August 2002. The sensation of dyspnea during breathing with a linear inspiratory resistance of 10, 20, and 30 cmH(2)O/L/s was rated using the Borg scale. According to the perception of dyspnea, we divided the elderly into tertiles and compared all hospitalizations, out-patient visits, costs, and death through computerized linkage with National Health Insurance beneficiaries claims history files between August 2002 and March 2008. In-patient hospitalization days and medical care costs significantly increased with the blunted perception of dyspnea, resulting in an increase in total medical-costs with blunted perception of dyspnea. With low perception group as reference, the hazard ratios of all-cause mortality were 0.65 (95% CI 0.23-1.89) for intermediate perception group and 0.31 (0.10-0.97) for high perception group, indicating the mortality rate also significantly increased with the blunted perception of dyspnea after multivariates adjustment (p = 0.04). The blunted perception of dyspnea is related to hospitalization, large medical costs, and all-cause mortality in community-dwelling elderly people. These findings provide a rational for preventing serious illness with careful monitoring of objective conditions in the elderly.

  19. The attitude of Japanese family caregivers toward the elderly with dementia.

    PubMed

    Yamamoto-Mitani, N; Tamura, M; Deguchi, Y; Ito, K; Sugishita, C

    2000-10-01

    This research examined family caregivers' attitudes toward their elderly relatives living with dementia. A convenience sample of fifty-nine Japanese caregivers was used. Caregiver attitudes were investigated multi-dimensionally (negative attitude, attitude of acceptance, and attitude of active interaction) using a questionnaire developed specifically for this study. The dimensions did not correlate with one another but were associated with different caregiver/elderly characteristics: i.e., negative attitude with short stay use, length of time caregivers and elderly relatives were living together and problem behaviors; attitude of acceptance with sleeping pill use and the type of relationship; and attitude of active interaction with dementia diagnosis. The results have implications for nurses in facilitating constructive caregiver attitudes. PMID:10785532

  20. The attitude of Japanese family caregivers toward the elderly with dementia.

    PubMed

    Yamamoto-Mitani, N; Tamura, M; Deguchi, Y; Ito, K; Sugishita, C

    2000-10-01

    This research examined family caregivers' attitudes toward their elderly relatives living with dementia. A convenience sample of fifty-nine Japanese caregivers was used. Caregiver attitudes were investigated multi-dimensionally (negative attitude, attitude of acceptance, and attitude of active interaction) using a questionnaire developed specifically for this study. The dimensions did not correlate with one another but were associated with different caregiver/elderly characteristics: i.e., negative attitude with short stay use, length of time caregivers and elderly relatives were living together and problem behaviors; attitude of acceptance with sleeping pill use and the type of relationship; and attitude of active interaction with dementia diagnosis. The results have implications for nurses in facilitating constructive caregiver attitudes.

  1. Morphology of plantar interdigital neuroma: a comparative cadaveric study of elderly Finnish and Japanese individuals.

    PubMed

    Abe, Shinichi; Nakao, Tadashi; Yamane, Shigeki; Fukuda, Masayuki; Yamamoto, Masahito; Santti, Risto; Murakami, Gen

    2013-01-01

    To examine morphological differences in Morton's interdigital neuroma between two elderly human populations, we conducted comparative study using 40 Japanese (27 males, 13 females; mean age, 81.2 years) and 21 Finnish (6 males, 15 females; mean age, 80.5 years) cadavers. We defined the neuroma as a thickening of the nerve of at least two-fold relative to the non-pathological proximal part. The incidence of this neuroma was 25% (10/40) in the Japanese and 33.3% (7/21) in the Finnish cadavers. Moderate or severe hallux valgus (with an angle of more than 20 degrees) was seen in half of the 40 Japanese cadavers (7 males, 13 females), but was absent in the Finnish cadavers. Such hallux valgus was present in 7 (5 males, 2 females) of the 10 Japanese cadavers with neuroma. Moreover, in 2 Japanese cadavers, a paper-like, specialized type of neuroma was associated with the deformity. Pathogenesis of Morton's neuroma might be different between human populations with or without hallux valgus.

  2. Dietary patterns associated with fall-related fracture in elderly Japanese: a population based prospective study

    PubMed Central

    2010-01-01

    Background Diet is considered an important factor for bone health, but is composed of a wide variety of foods containing complex combinations of nutrients. Therefore we investigated the relationship between dietary patterns and fall-related fractures in the elderly. Methods We designed a population-based prospective survey of 1178 elderly people in Japan in 2002. Dietary intake was assessed with a 75-item food frequency questionnaire (FFQ), from which dietary patterns were created by factor analysis from 27 food groups. The frequency of fall-related fracture was investigated based on insurance claim records from 2002 until 2006. The relationship between the incidence of fall-related fracture and modifiable factors, including dietary patterns, were examined. The Cox proportional hazards regression model was used to examine the relationships between dietary patterns and incidence of fall-related fracture with adjustment for age, gender, Body Mass Index (BMI) and energy intake. Results Among 877 participants who agreed to a 4 year follow-up, 28 suffered from a fall-related fracture. Three dietary patterns were identified: mainly vegetable, mainly meat and mainly traditional Japanese. The moderately confirmed (see statistical methods) groups with a Meat pattern showed a reduced risk of fall-related fracture (Hazard ratio = 0.36, 95% CI = 0.13 - 0.94) after adjustment for age, gender, BMI and energy intake. The Vegetable pattern showed a significant risk increase (Hazard ratio = 2.67, 95% CI = 1.03 - 6.90) after adjustment for age, gender and BMI. The Traditional Japanese pattern had no relationship to the risk of fall-related fracture. Conclusions The results of this study have the potential to reduce fall-related fracture risk in elderly Japanese. The results should be interpreted in light of the overall low meat intake of the Japanese population. PMID:20513246

  3. Knowledge Obtained from an Elderly Case of Japanese Encephalitis.

    PubMed

    Itoh, Kyoko; Iwamoto, Kazuhide; Satoh, Yu; Fujita, Tomoaki; Takahashi, Kenta; Katano, Harutaka; Hasegawa, Hideki; Takasaki, Tomohiko; Tando, So; Fushiki, Shinji

    2016-01-01

    The nationwide introduction of a Japanese encephalitis (JE) vaccine has contributed to a reduction in the annual infection rate of JE in Japan. However, the current neutralizing antibody prevalence ratio in Japan is approximately 20% in children 3-4 years of age and in people in their forties and fifties. We herein report a man with JE who was definitively diagnosed by multi-virus real-time polymerase chain reaction employing biopsied brain tissue and serological examinations. JE should be kept in mind when a patient has severe encephalitis of unknown etiology. In order to protect the susceptible population from JE, vaccination is recommended, especially for children and middle-aged people. PMID:27580555

  4. Systematic Literature Review of Randomized Control Trials Assessing the Effectiveness of Nutrition Interventions in Community-Dwelling Older Adults

    ERIC Educational Resources Information Center

    Bandayrel, Kristofer; Wong, Sharon

    2011-01-01

    Objective: Nutrition interventions may play an important role in maintaining the health and quality of life in community-dwelling older adults. To the authors' knowledge, no systematic literature review has been conducted on the effectiveness of nutrition interventions in the community-dwelling older adult population. Design: Systematic literature…

  5. Accidental falls among community-dwelling older adults: improving the identification process of persons at risk by nursing staff.

    PubMed

    Coll-Planas, Laura; Kron, Martina; Sander, Silvia; Rissmann, Ulrich; Becker, Clemens; Nikolaus, Thorsten

    2006-08-01

    Elderly persons living in the community are a heterogeneous population. Among them, the screening of persons at risk of falling is still a matter of debate. The aim of this analysis was to improve the identification process of elderly persons living in the community at risk for falling by nursing staff of community- based services. A secondary analysis was performed with the data from a prospective non-randomized interventional trial. The study included 268 community-dwelling older adults (mean age of 82 years, 81.3% female) from Ulm and Neu-Ulm with a followup period of 12 months. Fall risk indicators were extracted from the nursing assessment and analysis with crude odds ratios revealed the following risk indicators for falls: assistance when transferring, bathing and climbing a flight of stairs as well as fall history. Afterwards, fall risk indicators were selected by backward elimination in a multiple logistic regression. Variable selection identified a positive fall history and the need for assistance when bathing as important risk indicators. These two risk indicators could be used as a screening tool, which would be easy to perform by nursing staff in their daily work. This screening test defined as more than one fall in the last 12 months or bathing assistance, the first ADL to be affected in the disablement process, has a sensitivity of 85.3% and a specificity of 42.1%.

  6. The consideration of cultural factors in the research of elder mistreatment with an in-depth look at the Japanese.

    PubMed

    Tomita, S K

    1994-01-01

    Within the context of elder mistreatment, little attention has been paid to ethnicity and cultural factors as independent or causal variables. Focusing on the Japanese as an example, this paper explores cultural factors that may be associated with family conflict and elder mistreatment, including the use of silence as an extreme form of punishment. Also explored are the interrelationships of dependency (amae), holding back (enryo), and being in the way (jama); of social obligation (giri), personal indebtedness (on), and natural feelings or desires (ninjo); and of filial piety and casting away the elder (obasute). Currently-used research and detection protocols will not identify elder mistreatment among the Japanese unless they are modified. This paper provides suggestions for these modifications, as well as suggestions for practitioners who may treat Asian victims of elder mistreatment. PMID:24390000

  7. Relationship between odor perception and depression in the Japanese elderly.

    PubMed

    Satoh, S; Morita, N; Matsuzaki, I; Konishi, T; Nakano, T; Minoshita, S; Arizono, H; Saito, S; Ayabe, A S

    1996-10-01

    Odor perception has been studied in patients with various mental disorders; however, no consensus has been reached as to its detection, identification, or pleasantness/unpleasantness of odors especially in patients with depression. One hundred and nineteen normal elderly individuals living at home were exposed to odors of rose, perfume, white ginger, Indian ink, cigarette smoke, milk, feces and orange scent using the scratch and sniff method. They were asked to rate the strength of each odor, its pleasantness or unpleasantness, their liking for it, and their familiarity with it. They were also asked to complete a self-rating depression scale (SDS). The relationship of the score of each psychological olfactory scale with the SDS score and the difference in the score of each psychological scale between high-SDS and low-SDS groups are discussed.

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  9. Discontinuation of Neuroleptics in Community-Dwelling Individuals with Mental Retardation and Mental Illness.

    ERIC Educational Resources Information Center

    Pary, Robert J.

    1995-01-01

    Sixty-eight community-dwelling individuals with mental retardation and mental illness were discontinued from neuroleptics. Those with a psychotic disorder were significantly more likely to be restarted on neuroleptics at 3 months and 12 months. Not having a history of delusions was significantly associated with remaining neuroleptic-free at 3…

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

    ERIC Educational Resources Information Center

    Clarke, Philippa; Colantonio, Angela

    2005-01-01

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

  11. Rural-Urban Differences in Preventable Hospitalizations among Community-Dwelling Veterans with Dementia

    ERIC Educational Resources Information Center

    Thorpe, Joshua M.; Van Houtven, Courtney H.; Sleath, Betsy L.; Thorpe, Carolyn T.

    2010-01-01

    Context: Alzheimer's patients living in rural communities may face significant barriers to effective outpatient medical care. Purpose: We sought to examine rural-urban differences in risk for ambulatory care sensitive hospitalizations (ACSH), an indicator of access to outpatient care, in community-dwelling veterans with dementia. Methods: Medicare…

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  13. Estimated Dietary Polyphenol Intake and Major Food and Beverage Sources among Elderly Japanese.

    PubMed

    Taguchi, Chie; Fukushima, Yoichi; Kishimoto, Yoshimi; Suzuki-Sugihara, Norie; Saita, Emi; Takahashi, Yoshinari; Kondo, Kazuo

    2015-12-09

    Estimating polyphenol intake contributes to the understanding of polyphenols' health benefits. However, information about human polyphenol intake is scarce, especially in the elderly. This study aimed to estimate the dietary intake and major sources of polyphenols and to determine whether there is any relationship between polyphenol intake and micronutrient intake in healthy elderly Japanese. First, 610 subjects (569 men, 41 women; aged 67.3 ± 6.1 years) completed food frequency questionnaires. We then calculated their total polyphenol intake using our polyphenol content database. Their average total polyphenol intake was 1492 ± 665 mg/day, the greatest part of which was provided by beverages (79.1%). The daily polyphenol intake differed largely among individuals (183-4854 mg/day), also attributable mostly to beverage consumption. Coffee (43.2%) and green tea (26.6%) were the major sources of total polyphenol; the top 20 food items accounted for >90%. The polyphenol intake did not strongly correlate with the intake of any micronutrient, suggesting that polyphenols may exert health benefits independently of nutritional intake. The polyphenol intake in this elderly population was slightly higher than previous data in Japanese adults, and beverages such as coffee and green tea contributed highly to the intake.

  14. Estimated Dietary Polyphenol Intake and Major Food and Beverage Sources among Elderly Japanese.

    PubMed

    Taguchi, Chie; Fukushima, Yoichi; Kishimoto, Yoshimi; Suzuki-Sugihara, Norie; Saita, Emi; Takahashi, Yoshinari; Kondo, Kazuo

    2015-12-01

    Estimating polyphenol intake contributes to the understanding of polyphenols' health benefits. However, information about human polyphenol intake is scarce, especially in the elderly. This study aimed to estimate the dietary intake and major sources of polyphenols and to determine whether there is any relationship between polyphenol intake and micronutrient intake in healthy elderly Japanese. First, 610 subjects (569 men, 41 women; aged 67.3 ± 6.1 years) completed food frequency questionnaires. We then calculated their total polyphenol intake using our polyphenol content database. Their average total polyphenol intake was 1492 ± 665 mg/day, the greatest part of which was provided by beverages (79.1%). The daily polyphenol intake differed largely among individuals (183-4854 mg/day), also attributable mostly to beverage consumption. Coffee (43.2%) and green tea (26.6%) were the major sources of total polyphenol; the top 20 food items accounted for >90%. The polyphenol intake did not strongly correlate with the intake of any micronutrient, suggesting that polyphenols may exert health benefits independently of nutritional intake. The polyphenol intake in this elderly population was slightly higher than previous data in Japanese adults, and beverages such as coffee and green tea contributed highly to the intake. PMID:26690212

  15. Estimated Dietary Polyphenol Intake and Major Food and Beverage Sources among Elderly Japanese

    PubMed Central

    Taguchi, Chie; Fukushima, Yoichi; Kishimoto, Yoshimi; Suzuki-Sugihara, Norie; Saita, Emi; Takahashi, Yoshinari; Kondo, Kazuo

    2015-01-01

    Estimating polyphenol intake contributes to the understanding of polyphenols’ health benefits. However, information about human polyphenol intake is scarce, especially in the elderly. This study aimed to estimate the dietary intake and major sources of polyphenols and to determine whether there is any relationship between polyphenol intake and micronutrient intake in healthy elderly Japanese. First, 610 subjects (569 men, 41 women; aged 67.3 ± 6.1 years) completed food frequency questionnaires. We then calculated their total polyphenol intake using our polyphenol content database. Their average total polyphenol intake was 1492 ± 665 mg/day, the greatest part of which was provided by beverages (79.1%). The daily polyphenol intake differed largely among individuals (183–4854 mg/day), also attributable mostly to beverage consumption. Coffee (43.2%) and green tea (26.6%) were the major sources of total polyphenol; the top 20 food items accounted for >90%. The polyphenol intake did not strongly correlate with the intake of any micronutrient, suggesting that polyphenols may exert health benefits independently of nutritional intake. The polyphenol intake in this elderly population was slightly higher than previous data in Japanese adults, and beverages such as coffee and green tea contributed highly to the intake. PMID:26690212

  16. Assessing the Psychoeducational Approach to Transcendence and Health Program: An Intervention to Foster Self-Transcendence and Well-Being in Community-Dwelling Older Adults.

    PubMed

    McCarthy, Valerie Lander; Bowland, Sharon; Hall, Lynne A; Connelly, Jennifer

    2015-12-01

    The late-life developmental process of self-transcendence shapes elders' perspectives on self, others, the nature of this world, and of a dimension beyond the here and now. This qualitative pilot study evaluated the Psychoeducational Approach to Transcendence and Health (PATH) Program, a psychoeducational intervention to promote self-transcendence and well-being in community-dwelling women at a senior center. The intervention involved eight weekly group sessions using group processes, mindfulness practices, creative experiences, and independent at-home practice. The findings supported the underlying theory-based structure and content of the intervention and indicated the intervention may empower elders to attend to self-care, develop acceptance, and learn new skills associated with health and well-being, thus merits further study. Based on insights gained from facilitators' and participants' experiences and perceptions, the intervention will be revised and strengthened. PMID:26718794

  17. Polypharmacy and adverse drug reactions in Japanese elderly taking antihypertensives: a retrospective database study

    PubMed Central

    Sato, Izumi; Akazawa, Manabu

    2013-01-01

    Background The concomitant use of multiple medications by elderly patients with hypertension is a relatively common and growing phenomenon in Japan. This has been attributed to several factors, including treatment guidelines recommending prescription of multiple medications and a continuing increase in the elderly population with multiple comorbidities. Objective This study was aimed at investigating the association between polypharmacy, defined as the concomitant use of five or more medications, and risk of adverse drug reaction (ADR) in elderly Japanese hypertensive patients to examine the hypothesis that risk of ADR increases with the administration of an increasing number of co-medications. Methods Using a retrospective cohort design, the data regarding all hypertensive patients aged 65 years or older were extracted from the Risk/Benefit Assessment of Drugs – Analysis and Response Council antihypertensive medication database. The data were reviewed for classification of patients into one of three groups according to drug use at the initiation of therapy – a monotherapy group composed of patients who had taken the investigated drug only, a co-medication group composed of patients who had taken the investigated drug and a maximum of three other medications, and a polypharmacy group composed of patients who had taken the investigated drug and four or more other medications – and determination of the number of ADR events experienced. Estimated rate ratios (RRs) and 95% confidence intervals (CIs) were calculated using a Poisson regression model adjusted for drug category and patient age and sex. Various sensitivity analyses were performed to confirm the robustness of the study findings. Results Of 61,661 elderly Japanese patients (men, 41.8%; 75 years or older, 35.1%) registered in the database, 2491 patients (4.0%) experienced a total of 3144 ADR events during the study period. The rate of ADR per 10,000 person-days was 2.0 for the monotherapy group, 5.1 for

  18. Assessment of postural balance in community-dwelling older adults - methodological aspects and effects of biofeedback-based Nintendo Wii training.

    PubMed

    Jørgensen, Martin Grønbech

    2014-01-01

    weeks of biofeedback-based Nintendo Wii training on static postural balance, mechanical lower limb muscle function, and functional performance in 58 community-dwelling older adults. Additionally, the study investigated the participant motivation for this type of training (Exergaming). Marked improvements in maximal leg muscle strength, rapid force capacity and functional performance were observed following the period of biofeedback-based Nintendo Wii training. Unexpectedly, static bilateral postural balance remained unaltered following the period of intervention. The study participants perceived the Nintendo Wii training as enjoyable and highly motivating, which suggests that this type of exercise may be successfully implemented at senior citizens' centers and/or in the home of the elderly. The results presented in this thesis suggest that strict control of time-of-day is an important methodological aspect when evaluating postural balance in older adults, and an assessment protocol using the Nintendo Wii-Balance Board is reproducible and valid. Biofeedback-based Nintendo Wii exercise intervention appeared unsuccessful in improving static bilateral postural balance, most likely due to a test ceiling effect in the selected outcome measures, but the intervention elicited marked positive changes in various key risk factors associated to fall accidents. Notably, Wii based biofeedback exercise was perceived by the older adults as a highly motivating type of training.

  19. The well-being of community-dwelling near-centenarians and centenarians in Hong Kong a qualitative study

    PubMed Central

    2014-01-01

    Background Hong Kong has one of the highest life expectancy rankings in the world. The number of centenarians and near-centenarians has been increasing locally and internationally. The relative growth of this population is a topic of immense importance for population and health policy makers. Living long and living well are two overlapping but distinct research topics. We previously conducted a quantitative study on 153 near-centenarians and centenarians to explore a wide range of biopsychosocial correlates of health and “living long”. This paper reports a follow-up qualitative study examining the potential correlates of “living well” among near-centenarians and centenarians in Hong Kong. Methods Six cognitively, physically, and psychologically sound community-dwelling elders were purposively recruited from a previous quantitative study. Semi-structured interviews were conducted. Results Four major themes related to living long and well emerged from the responses of the participants: (a) Positive relations with others, (b) Positive events and happiness, (c) Hope for the future, and (d) Positive life attitude. Specifically, we found that having good interpersonal relationships, possessing a collection of positive life events, and maintaining salutary attitudes towards life are considered as important to psychological well-being by long-lived adults in Hong Kong. Most participants perceived their working life as most important to their life history and retired at very old ages. Conclusions These findings also shed light on the relationships between health, work, and old age. PMID:24886462

  20. Comparison of caregivers', residents', and community-dwelling spouses' opinions about expressing sexuality in an institutional setting.

    PubMed

    Gibson, M C; Bol, N; Woodbury, M G; Beaton, C; Janke, C

    1999-04-01

    Opinions regarding the appropriateness of elderly residents' sexual behaviors in a chronic care hospital and how to respond to inappropriate behaviors were surveyed. Study participation was open to all staff (N = 1,205), eligible residents (N = 182) and community-dwelling spouses (N = 103). Participation rates were 40% (residents), 42% (spouses), 34% (nursing staff), 50% (allied health staff), and 22% (support staff). Staff completed the questionnaire independently, while residents and spouses were offered self-completion or a structured interview. Almost all selected the interview. Residents and spouses were less tolerant than staff of residents' masturbating, engaging in sexual relationships, viewing sexual materials, and making sexual approaches to staff. Privacy was the primary determinant of appropriateness for behaviors for all groups. Staff and spouses were more likely to endorse counseling when behaviors were perceived as inappropriate than residents. Nurses endorsed counseling less frequently than allied health professionals and support staff. Nurses were more likely to have been approached sexually by a resident. Differences of opinion are interpreted in terms of cohort influences on values and contextual influences on behavior.

  1. The relationships between lifestyle factors and hypertension in community-dwelling Korean adults

    PubMed Central

    Kim, Ill-Gwang; So, Wi-Young; Sung, Dong Jun

    2015-01-01

    [Purpose] This study was performed to determine whether certain lifestyle factors are associated with hypertension in community-dwelling Korean adults. [Subjects and Methods] The subjects were 586 males and 1,135 females > 20 years old who had visited a public health promotion center in Seoul, Republic of Korea to take a survey related to lifestyle factors. Hypertension status was defined according to the criteria of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure VII report. [Results] The relationships between lifestyle factors and hypertension status were assessed using multivariate logistic regression analysis after adjusting for age and gender. Only mental stress and economic status significantly predicted hypertension status. [Conclusion] We conclude that sleep duration, education level, frequency of drinking and smoking status were not associated with hypertension status. However, economic status and mental stress were significantly associated with hypertension in community-dwelling Korean adults, regardless of age or gender. PMID:26834333

  2. Benzodiazepine (BZD) use in community-dwelling older adults: Longitudinal associations with mobility, functioning, and pain.

    PubMed

    Petrov, Megan E; Sawyer, Patricia; Kennedy, Richard; Bradley, Laurence A; Allman, Richard M

    2014-01-01

    The aim of the study was to determine the prospective association between baseline BZD use and mobility, functioning, and pain among urban and rural African-American and non-Hispanic white community-dwelling older adults. From 1999 to 2001, a cohort of 1000 community-dwelling adults, aged ≥ 65 years, representing a random sample of Medicare beneficiaries, stratified by ethnicity, sex, and urban/rural residence were recruited. BZD use was assessed at an in-home visit. Every six months thereafter, study outcomes were assessed via telephone for 8.5-years. Mobility was assessed with the Life-Space Assessment (LSA). Functioning was quantified with level of difficulty in five basic activities of daily living (ADL: bathing, dressing, transferring, toileting, eating), and six instrumental activities of daily living (IADL: shopping, managing money, preparing meals, light and heavy housework, telephone use). Pain was measured by frequency per week and the magnitude of interference with daily tasks. All analytic models were adjusted for relevant covariates and mental health symptoms. After multivariable adjustment, baseline BZD use was significantly associated with greater difficulty with basic ADL (Estimate=0.39, 95% confidence interval (CI): 0.04-0.74), and more frequent pain (Estimate=0.41, 95%CI: 0.09-0.74) in the total sample and declines in mobility among rural residents (Estimate=-0.67, t(5,902)=-1.98, p=0.048), over 8.5 years. BZD use was prospectively associated with greater risk for basic ADL difficulties and frequent pain among African-American and non-Hispanic white community-dwelling older adults, and life-space mobility declines among rural-dwellers, independently of relevant covariates. These findings highlight the potential long-term negative impact of BZD use among community-dwelling older adults.

  3. [Policy recommendations for the implementation of fall and fracture prevention in community-dwelling older persons].

    PubMed

    Vlaeyen, Ellen; Etienne, Jan; Geeraerts, Annelies; Leysens, Greet; Dejaeger, Eddy; Milisen, Koen

    2016-09-01

    Several factors impede the implementation of effective strategies for fall and fracture prevention. The Centre of Expertise for Fall & Fracture prevention Flanders organized a symposium, "Implementation of fall en fracture prevention in older people", with the aim to elaborate on the facilitation of effective strategies for falls and fall-related injuries in community-dwelling older people in Flanders. This article summarizes the main bottlenecks for implementation and provides recommendations for optimizing dissemination and implementation. PMID:27549629

  4. Intake and Urinary Amounts of Biotin in Japanese Elementary School Children, College Students, and Elderly Persons

    PubMed Central

    Shibata, Katsumi; Tsuji, Tomiko; Fukuwatari, Tsutomu

    2013-01-01

    Biotin enzymes such as pyruvate carboxylase and acetyl-CoA carboxylase are involved with the most basic metabolism. Thus, it is very important to monitor the biotin nutritional status for maintaining good health. We examined urinary excretion and the intake of biotin in a Japanese sample population of 60 boys and 36 girls (10–12 y), 37 male and 135 female college students (18–27 y), and 35 female elderly persons (70–84 y) living freely. All food consumed, and the corresponding weighing, for 4 consecutive days were recorded. A 24-hour urine sample was collected on the fourth day, and the urine biotin was measured. The urine biotin at the fourth day was 57.8, 50.9, 81.0, 66.2, and 82.3 nmol/day in boys, girls, male students, female students, and elderly persons, respectively. The average intake of biotin for 4 consecutive days was 35, 31, 28, 26, and 32 μg/day in boys, girls, male students, female students, and elderly persons, respectively. PMID:24812517

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

    PubMed

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

    2011-01-01

    Study of immigrant populations may contribute to a better understanding of the epidemiology of diseases associated with the aging process. We examined the prevalence of cardiovascular risk factors, including apolipoprotein E (ApoE) polymorphism, in elderly subjects who were born in Japan, migrated to South Brazil and have lived in that region for over 40 years, versus a group of elderly, locally born Brazilians living in the same region. These Japanese subjects came to Brazil after World War II (1950-1960) from several Japanese cities, mainly Nagasaki, Kumamoto and Hokkaido. Among 1007 subjects genotyped for ApoE polymorphism, we selected 540 elderly subjects (>60 years old), consisting of 270 Japanese-Brazilians and 270 Brazilians of European ancestry from Rio Grande do Sul State (Gaucha population). The Japanese-Brazilian group had significantly lower prevalences of obesity, type 2 diabetes mellitus, dyslipidemia, and metabolic syndrome than did the Gaucho population group. ApoE polymorphism frequencies were similar in the two groups. The differences in cardiovascular risk factors observed in the two populations cannot be explained by ApoE polymorphism; they could be related to conservation of Japanese lifestyle habits, such as diet. PMID:21948760

  6. Effect of structured physical activity on respiratory outcomes in sedentary elderly adults with mobility limitations

    Technology Transfer Automated Retrieval System (TEKTRAN)

    OBJECTIVES: To evaluate the effect of structured physical activity on respiratory outcomes in community dwelling elderly adults with mobility limitations. DESIGN: Multicenter, randomized trial of physical activity vs health education, with respiratory variables prespecified as tertiary outcomes over...

  7. Healthy Aging and Concerns Among Elderly Japanese: A Text Analysis Approach.

    PubMed

    Tsuchiya, Yoko; Shida, Naoki; Tsujiuchi, Takuya; Machida, Kazuhiko

    2015-01-01

    Japan is facing an unprecedented aging society. In 2013, 25.1% of the total population in Japan was 65 years old and over. One third of the population in Japan will be at least 65 years old in 2035; healthy aging is crucial for public health and society in Japan. Under the budget limitations of social security, policies and frequent policy changes have created great uncertainty and concern for the elderly population. Given these circumstances, we conducted questionnaire surveys in 2010 to examine concerns in this age-group. In 2010, we sent questionnaires to university graduates 65 years old and older, randomly selected from a list of an alumni association of 11 universities. The questionnaires were open-ended and asked them to write any concerns that they had about health care, health policy, health systems, and their future. We received 344 responses. Among those who responded, 271 (78.8%) respondents said that they had concerns. We conducted a text analysis (Trend Search-Keyword Associator 2008) and extracted the keywords from their responses. The keywords that were extracted frequently included hospitals, doctors, health-care system, health care, Japanese government policies, government, medical insurance system for the elderly, support, increase, copayment, health (their own), scarcities, and burdens. In this study, many elderly people in Japan are concerned about health-care expenditures, health-care systems, and health policies. This may be caused by frequent health policy changes and uncertainty due to frequent administration changes such as the lack of clarity concerning raising the out of pocket payment rate from 10% to 20% for elderly people under budget constraints in Japan. Correct policy making and determination to eliminate the concerns from this vulnerable population in Japan are necessary for healthy aging. PMID:25856638

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    PubMed

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

    2015-06-01

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

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

    PubMed

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

    2015-06-01

    The hyperalgesic effects of long-term opioid use in community-dwelling adults with chronic pain have not been widely reported. Therefore, the primary aim of this study was to determine the associations between opioid use and heat pain (HP) perception in a sample of community-dwelling adults with chronic pain. The study cohort involved 187 adults (85 opioid and 102 nonopioid) with chronic pain consecutively admitted to an outpatient interdisciplinary pain treatment program. Heat pain perception was assessed using a validated quantitative sensory test method of levels. An effect of opioid use was observed for nonstandardized (P = 0.004) and standardized (P = 0.005) values of HP 5-0.5 in which values of the opioid group were lower (more hyperalgesic) compared with those of the nonopioid group. HP 5-0.5 is a measure of the slope of the line connecting HP 0.5 (HP threshold) and HP 5 (intermediate measure of HP tolerance). In univariable (P = 0.019) and multiple variable (P = 0.003) linear regression analyses (adjusted for age, sex, body mass index, work status, pain diagnosis, pain severity, depression, and pain catastrophizing), opioid use was associated with lower (more hyperalgesic) nonstandardized values of HP 5-0.5. Similarly, in univariable (P = 0.004) and multiple variable (P = 0.011) linear regression analyses (adjusted for work status, pain diagnosis, pain severity, depression, and pain catastrophizing), opioid use was associated with lower standardized values of HP 5-0.5. In this sample of community-dwelling adults, these observations suggest that long-term opioid use was associated with hyperalgesia independent of other clinical factors known to influence HP perception. PMID:25815431

  11. Predicting sarcopenia from functional measures among community-dwelling older adults.

    PubMed

    Gray, Michelle; Glenn, Jordan M; Binns, Ashley

    2016-02-01

    Sarcopenia is defined as age-related lean tissue mass (LTM) loss resulting in reduced muscular strength, physical function, and mobility. Up to 33 % of older adults currently are sarcopenic, with likely many more undiagnosed. The purpose of this investigation was to predict sarcopenia status from easily accessible functional measures of community-dwelling older adults. Forty-three community-dwelling older adults (n = 32 females and n = 11 males) participated in the present investigation. Inclusion criteria included ≥65 years of age, mini-mental state examination score ≥24, and no falls within previous 12 months. All subjects completed their appendicular skeletal mass (ASM) assessment via dual-energy X-ray absorptiometry (DXA) and were categorized as either sarcopenic or non-sarcopenic. Physical assessments included 10-m usual walk, hand-grip (HG) strength, 6-min walk, 8-ft up-and-go, 30-s chair stand, 30-s arm curl, and sit-to-stand muscular power. A forward, stepwise multiple regression analysis revealed that age, sex, weight, height, 10-m walk, HG, and sit-to-stand muscular power account for 96.1 % of the variance in ASM. The area under the curve was 0.92 for correctly identifying sarcopenic participants compared to their actual classification. This is the first prediction model used to identify sarcopenia based on parameters of demographic and functional fitness measures in community-dwelling older adults. The ability to accurately identify sarcopenia in older adults is imperative to their quality of life and ability to perform activities of daily living.

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

    PubMed

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

    2015-12-01

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

  13. Combination therapy of hypertension in the elderly: a subgroup analysis of the Combination of OLMesartan and a calcium channel blocker or diuretic in Japanese elderly hypertensive patients trial.

    PubMed

    Ogihara, Toshio; Saruta, Takao; Rakugi, Hiromi; Saito, Ikuo; Shimamoto, Kazuaki; Matsuoka, Hiroaki; Teramukai, Satoshi; Higaki, Jitsuo; Ito, Sadayoshi; Shimada, Kazuyuki

    2015-01-01

    Combination of OLMesartan and a calcium channel blocker or a diuretic in Japanese elderly hypertensive patients (COLM) trial demonstrated that olmesartan combinations with a CCB or diuretic have similar effects on reducing cardiovascular risk in elderly hypertensive patients. However, the safety profiles suggest that olmesartan combined with CCB may be preferable to olmesartan combined with diuretic. In this subgroup analysis, we further evaluated the effects and safety of these combinations in elderly (65-74 years old (y.o.)) and very elderly (75-84 y.o.) hypertensive patients. In the COLM trial, 5141 patients (2918 elderly and 2223 very elderly) were randomly assigned to receive olmesartan-based therapy with either CCB or diuretic. The hazard ratios and 95% confidence intervals, respectively, in the elderly age group and in the very elderly group were: 1.04 (0.72-1.50; olmesartan plus CCB vs. olmesartan plus diuretic, P = 0.85) and 0.71 (0.51-0.99, P = 0.045) for the primary composite end point, and 1.07 (0.67-1.72, P = 0.77) and 0.64 (0.42-0.98, P = 0.036) for the composite of hard end points. The hazard ratios for stroke (fatal and non-fatal) were 1.48 (0.88-2.48; olmesartan plus CCB vs. olmesartan plus diuretic, P = 0.13) and 0.63 (0.39-1.02, P = 0.059) (interaction-P = 0.019). Withdrawal rates from the trial, withdrawal due to serious adverse event and the incidence of any adverse event were higher in the olmesartan plus diuretic group than in the olmesartan plus CCB group in both age groups. In conclusion, angiotensin receptor blocker (ARB) and CCB combination may be preferable to an ARB and diuretic combination in the very elderly hypertensive patients for the reduction of cardiovascular risk, particularly for the reduction in stroke risk. PMID:25253583

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

    PubMed Central

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

    2016-01-01

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

  15. Sleep Quality, Pain and Self-Efficacy among Community-Dwelling Adults with Sickle Cell Disease.

    PubMed

    Adegbola, Maxine

    2015-07-01

    The aim of this paper was to report the findings of a study examining relationships among sleep, pain, self-efficacy, and demographic attributes of community-dwelling adults with sickle cell disease (SCD). Sleep difficulty has been self-reported among adults with chronic pain. Past studies have demonstrated that chronic pain results in sleep difficulties and other complications that threaten effective functioning. Community-dwelling adults with SCD are living longer and need to be evaluated for sleep quality, pain, and self-efficacy. Little is known about whether adults with SCD-related pain have disturbances in sleep and self-efficacy, and if these disturbances are affected by age and/or gender. The purpose of this descriptive, correlational study was to examine the relationships among sleep, pain, self-efficacy, and demographic attributes among community-dwelling adults with SCD, and who use support services of state SCD Associations in the United States. For this secondary data analysis, the study was conducted from June, 2014 to December, 2014 and used a descriptive correlational design to analyze data from a primary study of a convenience sample of 90 subjects with SCD, who were 18 years of age and older. Linear regression was used to compute the relationship between dependent and independent variables. All measures were self-reported. It was found that gender did not significantly affect reports of sleep, pain, or self-efficacy. Self-efficacy accounted for direct relationships with sleep and inverse relationships with pain. Some individuals (16.7%) reported sleeping very well, however, the majority (83.3%) was not sleeping very well, and a greater number of individuals (93.3%) reported having some pain. Among adults with chronic SCD pain, self-efficacy is important in maintaining a stable quality of health. Future assessments, interventions, and research should include comprehensive sleep and pain evaluations, and measures to improve self-efficacy and sleep

  16. Predictors of Depression Among Community-Dwelling Older Women Living Alone in Korea.

    PubMed

    Lee, SiEun; Hong, Gwi-Ryung Son

    2016-10-01

    This study examined the prevalence and predicting factors of depression among community-dwelling older women living alone in Korea. Of the 2054 older women living alone in this study, 42.9% (881) were experiencing depression. Factors associated with a higher prevalence of depression were overall difficulty with living alone, taking more than six medications, limitations of instrumental activities of daily living, limitations of muscle strength, limitations of exercise performance in upper extremities, trouble with hearing, and perceptions of poor health status. These results provide a basis for designing preventive interventional programs to decrease depression among older women living alone in Korea. PMID:27654230

  17. Nutrition education intervention with community-dwelling older adults: research challenges and opportunities.

    PubMed

    Lyons, Beverly P

    2014-08-01

    This study critically reviewed empirical literature examining nutrition education intervention studies with community-dwelling older adults over the period 2003-2012 to: (1) determine the number, (2) evaluate the research designs, and (3) report the study outcomes. A search of online databases yielded 74 studies six of which met our criteria. The studies reported favorable intervention outcomes. Because of the number, variability in the types, designs, measures, scope, educational and behavioral strategies, results can only inform future studies and encourage scholars to use strong evaluation design. We recommend the utilization of an ecological conceptual model when conducting nutrition interventions studies and discussed implications in terms of research and practice. PMID:24368631

  18. Anticholinergic Use and Recurrent Falls in Community-Dwelling Older Adults: Findings From the Health ABC Study

    PubMed Central

    Marcum, Zachary A.; Perera, Subashan; Thorpe, Joshua M.; Switzer, Galen E.; Gray, Shelly L.; Castle, Nicholas G.; Strotmeyer, Elsa S.; Simonsick, Eleanor M.; Bauer, Douglas C.; Shorr, Ronald I.; Studenski, Stephanie A.; Hanlon, Joseph T.

    2015-01-01

    Background Although it is generally accepted that anticholinergic use may lead to a fall, results from studies assessing the association between anticholinergic use and falls are mixed. In addition, direct evidence of an association between use of anticholinergic medications and recurrent falls among community-dwelling elders is not available. Objective To assess the association between anticholinergic use across multiple anticholinergic subclasses, including over-the-counter medications, and recurrent falls. Methods This was a longitudinal analysis of 2948 participants, with data collected via interview at year 1 from the Health, Aging and Body Composition study and followed through year 7 (1997–2004). Self-reported use of anticholinergic medication was identified at years 1, 2, 3, 5, and 6 as defined by the list from the 2015 American Geriatrics Society Beers Criteria. Dosage and duration were also examined. The main outcome was recurrent falls (≥2) in an ensuing 12-month period from each medication data collection. Results Using multivariable generalized estimating equation models, controlling for demographic, health status/behaviors, and access-to-care factors, a 34% increase in likelihood of recurrent falls in anticholinergic users (adjusted odds ratio = 1.34; 95% CI = 0.93–1.93) was observed, but the results were not statistically significant; similar results were found with higher doses and longer duration of use. Conclusion Increased point estimates suggest an association of anticholinergic use with recurrent falls, but the associations did not reach statistical significance. Future studies are needed for more definitive evidence and to examine other measures of anticholinergic burden and associations with more intermediate adverse effects such as cognitive function. PMID:26228936

  19. Comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination to prevent functional decline in community-dwelling older persons: protocol of a cluster randomized trial

    PubMed Central

    2012-01-01

    Background Functional decline in community-dwelling older persons is associated with the loss of independence, the need for hospital and nursing-home care and premature death. The effectiveness of multifactorial interventions in preventing functional decline remains controversial. The aim of this study is to investigate whether functional decline in community-dwelling older persons can be delayed or prevented by a comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination. Methods/Design In a cluster randomized controlled trial, with the general practice as the unit of randomization, 1281 participants from 25 general practices will be enrolled in each condition to compare the intervention with usual care. The intervention will focus on older persons who are at increased risk for functional decline, identified by an Identification of Seniors at Risk Primary Care (ISAR-PC) score (≥ 2). These older persons will receive a comprehensive geriatric assessment, an individually tailored care and treatment plan, consisting of multifactorial, evidence-based interventions and subsequent nurse-led care coordination. The control group will receive 'care as usual' by the general practitioner (GP). The main outcome after 12 months is the level of physical functioning on the modified Katz-15 index score. The secondary outcomes are health-related quality of life, psychological and social functioning, healthcare utilization and institutionalization. Furthermore, a process evaluation and cost-effectiveness analysis will be performed. Discussion This study will provide new knowledge regarding the effectiveness and feasibility of a comprehensive geriatric assessment, multifactorial interventions and nurse-led elderly care in general practice. Trial registration NTR2653 Grant Unrestricted grant 'The Netherlands Organisation for Health Research and development' no 313020201 PMID:22462516

  20. How community-dwelling seniors with multimorbidity conceive the concept of mental health and factors that may influence it: a phenomenographic study.

    PubMed

    Grundberg, Ake; Ebbeskog, Britt; Dahlgren, Madeleine Abrandt; Religa, Dorota

    2012-12-13

    Multimorbidity, that is, the coexistence of chronic diseases, is associated with mental health issues among elderly people. In Sweden, seniors with multimorbidity often live at home and receive care from nursing aides and district nurses. The aim of this study was to describe the variation in how community-dwelling seniors with multimorbidity perceive the concept of mental health and what may influence it. Thirteen semi-structured interviews were analysed using a phenomenographic approach. Six qualitatively different ways of understanding the concept of mental health and factors that may influence it, reflecting key variations of meaning, were identified. The discerned categories were: mental health is dependent on desirable feelings and social contacts, mental health is dependent on undesirable feelings and social isolation, mental health is dependent on power of the mind and ability to control thoughts, mental health is dependent on powerlessness of the mind and inability to control thoughts, mental health is dependent on active behaviour and a healthy lifestyle, and mental health is dependent on passive behaviour and physical inactivity. According to the respondents' view, the concept of mental health can be defined as how an individual feels, thinks, and acts and also includes a positive as well as a negative aspect. Social contacts, physical activity, and optimism may improve mental health while social isolation, ageing, and chronic pain may worsen it. Findings highlight the importance of individually definitions of mental health and that community-dwelling seniors with multimorbidity may describe how multiple chronic conditions can affect their life situation. It is essential to organize the health care system to provide individual health promotion dialogues, and future research should address the prerequisites for conducting mental health promotion dialogues.

  1. Depression Affects the Scores of All Facets of the WHOQOL-BREF and May Mediate the Effects of Physical Disability among Community-Dwelling Older Adults

    PubMed Central

    Chang, Yu-Chen; Yao, Grace; Hu, Susan C.; Wang, Jung-Der

    2015-01-01

    Background Geriatric depression is associated with the overall quality of life (QOL). However, how depressive symptoms affect the different domains and facets of QOL in older adults, and whether depressive symptoms mediate the relationship between physical disability and QOL in older adults are unclear. Methods A total of 490 ambulatory community-dwelling older adults aged 65 years or above were interviewed using the brief version of the World Health Organisation Quality of Life instrument (WHOQOL-BREF), the Modified Barthel Index (MBI), the 15-item Geriatric Depression Scale (GDS-15), and the Mini-Mental State Examination (MMSE). Sequential models for multiple linear regressions were analysed to determine if the MBI, GDS-15 and MMSE scores predict the WHOQOL-BREF scores. The potential mediation effects of depression (as determined by the GDS-15) on the relationship between MBI and WHOQOL-BREF were also analysed. Results The GDS-15 score was predictive of the scores of the four domains and all 26 facets of the WHOQOL-BREF. The significant predictive effects of the MBI score on 15 of the 26 facets of the WHOQOL-BREF were reduced to three after the adjustment for the GDS-15 score. Depression (as assessed by the GDS-15) is a mediator of the relationship between MBI and the physical, psychological and environmental domains of the WHOQOL-BREF. Conclusions Depression (assessed by the GDS-15) may affect the scores of every domain and all facets of the WHOQOL-BREF in the elderly. Furthermore, it may mediate the relationship between the MBI and on QOL scores. We recommend taking depressive symptoms into consideration when measuring community-dwelling older adults’ QOL and providing active ageing programs. PMID:26010571

  2. Association between Frailty, Osteoporosis, Falls and Hip Fractures among Community-Dwelling People Aged 50 Years and Older in Taiwan: Results from I-Lan Longitudinal Aging Study

    PubMed Central

    Liu, Li-Kuo; Lee, Wei-Ju; Chen, Liang-Yu; Hwang, An-Chun; Lin, Ming-Hsien; Peng, Li-Ning; Chen, Liang-Kung

    2015-01-01

    Background Association of frailty with adverse clinical outcomes has been reported in Western countries, but data from the Asian population are scarce. This study aimed to evaluate the epidemiology of frailty among community-dwelling middle-aged and elderly population and to explore its association with musculoskeletal health in Taiwan. Methods I-Lan Longitudinal Aging Study (ILAS) data were retrieved for this study. Frailty was defined by the Fried’s criteria; a comparison of demographic characteristics, physical performance, and body composition, including skeletal muscle mass and bone mineral density (BMD), as well as recent falls, history of hip fractures and the functional status of subjects with different frailty statuses were accomplished. Results Overall, the data of 1,839 participants (mean age: 63.9±9.3 years, male 47.5%) were obtained for analysis. The prevalence of pre-frailty was 42.3% in men and 38.8% in women, whereas the prevalence of frailty was 6.9% and 6.7% in men and women, respectively. Frailty was significantly associated with older age, the male gender, larger waist circumference, lower skeletal muscle index, lower hip BMD, poorer physical function, poorer nutritional status, and poorer cognitive function. Also, frailty was significantly associated with osteoporosis (OR: 7.73, 95% CI: 5.01–11.90, p<0.001), history of hip fractures (OR: 8.66, 95% CI: 2.47–30.40, p = 0.001), and recent falls (O.R: 2.53, 95% CI: 1.35–4.76, p = 0.004). Conclusions Frailty and pre-frailty, in Taiwan, was closely associated with recent falls, history of hip fractures and osteoporosis among community-dwelling people 50 years of age and older. Furthermore, frailty intervention programs should take an integrated approach towards strengthening both and muscle mass, as well as prevention of falls. PMID:26348034

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

    PubMed

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

    2014-04-01

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

  4. Developing a personal health record for community-dwelling older adults and clinicians: technology and content.

    PubMed

    Monsen, Karen A; Westra, Bonnie L; Paitich, Nadine; Ekstrom, Dawn; Mehle, Susan C; Kaeding, Maggie; Abdo, Sajeda; Natarajan, Gowtham; Ruddarraju, Uday Kumar Raju

    2012-07-01

    To empower older consumers and improve health outcomes, a consumer-friendly personal health record (PHR) is needed. The purpose of this article was to evaluate PHR technology and content for older community-dwelling consumers. Specific aims were to: (a) develop a secure, web-based application for a PHR to enable interoperable exchanges of data between consumers and clinicians; (b) develop structured, evidence-based shared care plan content for the PHR using an interface terminology standard; and (c) validate the shared care plans with consumers. An interoperable web-based form was developed. The standardized PHR content was developed by expert panel consensus using the Omaha System problem list and care plans, and validated by consumer interviews. Evidence-based shared care plans for 21 problems common among community-dwelling older adults were developed and encoded with Omaha System terms for data capture in the PHR. An additional problem, Neighborhood-workplace safety, was identified by consumers and will be added to the care plans.

  5. Occupational engagement among community dwelling older people: A time-geographic perspective†.

    PubMed

    Nilsson, I; Blanchard, M; Wicks, A

    2015-09-01

    How older people spend their time in different occupations could contribute to our understanding of everyday life in healthy ageing. This study adopted a time-geographic method and occupational perspective to explore the occupational engagement of community dwelling older people. The term occupational engagement encompasses what people do, where and with whom they spend their time and the perceived level of competence and meaningfulness of their time use. Nineteen volunteers born between 1932 and 1933, living alone in an urban area in northern Sweden and receiving no home care services, completed open time-geographic diaries for 5 days in May 2010. The diary data were analyzed using Daily Life software program. The study revealed the complexity and the diversity of the older people's occupational engagement and that most of their time was spent alone in their home. The older people reported they were very good at doing almost half of the occupations in which they engaged and that their occupations were primarily either very meaningful or meaningful. While some methodological limitations were identified, time-geographic studies of community dwelling older people living independently are considered to have potential to contribute to community and social planning for older people as they can provide interesting insights to older persons' time use and occupational needs.

  6. Sedative load among community-dwelling older individuals: change over time and association with mortality.

    PubMed

    Taipale, Heidi T; Bell, J Simon; Hartikainen, Sirpa

    2012-07-01

    The aim of this study was to investigate the change in sedative load over time and the corresponding risk of death among community-dwelling older individuals. A random sample of 1000 individuals aged at least 75 years was invited to participate in 2004, of whom 700 were community dwelling. Demographic, diagnostic, and drug use data were obtained during annual nurse interviews. Sedative load was calculated according to a previously published model. The prevalence of sedative use increased from 29.3 to 36.1% from 2004 to 2007. In unadjusted analyses, sedative load was associated with an increased risk of death. After adjusting for clinically important covariates, sedative load was not associated with an increased risk of death [sedative load 1-2; hazard ratio 1.12 (95% confidence interval 0.76-1.64), sedative load of at least 3; hazard ratio 0.92 (95% confidence interval 0.55-1.56)]. In conclusion, sedative use increased during the follow-up but was not associated with an increased risk of death.

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

    PubMed

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

    2013-02-01

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

  8. Psychometric Properties of the Lower Extremity Subscale of the Fugl-Myer Assessment for Community-dwelling Hemiplegic Stroke Patients.

    PubMed

    Park, Eun Young; Choi, Yoo Im

    2014-11-01

    [Purpose] The purpose of this study was to investigate the psychometric properties of the lower extremity subscale of the Fugl-Meyer Assessment lower extremity (FMA-LE) for community-dwelling hemiplegic stroke patients. [Subjects] The participants were 140 community-dwelling hemiplegic stroke patients. [Methods] To determine the psychometric properties of the FMA-LE, we examined construct validity, response characteristics, item discrimination, and internal consistency. [Results] Factor analysis of the FMA-LE revealed that the first factor explained 61.73% of the variance and provided evidence of unidimensionality. The FMA-LE did not show ceiling or floor effects; Cronbach's α was 0.935 (95% CI: 0.919-0.950). [Conclusion] Because the FMA-LE seems to be both valid and reliable, we conclude that it is appropriate for the measurement of the lower extremity motor impairment of community-dwelling hemiplegic stroke patients.

  9. Low haemoglobin levels contribute to low grip strength independent of low-grade inflammation in Japanese elderly women.

    PubMed

    Yamada, Eriko; Takeuchi, Mika; Kurata, Miki; Tsuboi, Ayaka; Kazumi, Tsutomu; Fukuo, Keisuke

    2015-01-01

    Muscle strength declines with age. However, factors that contribute to such declines are not well documented and have not been extensively studied in elderly populations of Asian origin. Correlations of grip strength with a broad range of factors associated with declines in muscle strength were examined in 202 community-living elderly Japanese women. After adjustment for age, grip strength was positively correlated with body weight, height, serum albumin, haemoglobin, high-density lipoprotein cholesterol (HDL-C) and serum iron and inversely with serum copper, and log high-sensitivity C-reactive protein (hsCRP). Multiple linear regression analysis with grip strength as a dependent variable showed that 47.0% of variability of grip strength could be accounted for by height, age and haemoglobin in order of increasing R2. In conclusion, low haemoglobin may contribute to low muscle strength independently of age, anthropometric, nutritional, and inflammatory markers in the elderly, and may represent an important confounder of the association between grip strength and functional decline in community- living Japanese elderly women. PMID:26420185

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

    PubMed Central

    Endeshaw, Yohannes W.; Yoo, Wonsuk

    2016-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2011-07-01

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

  13. Depression and Psychosocial Risk Factors among Community-Dwelling Older Adults in Singapore.

    PubMed

    Li, Jinhui; Theng, Yin-Leng; Foo, Schubert

    2015-12-01

    Depression is the most common mental and emotional disorder that emerges in the late stages of life. It is closely associated with poor health, disability, mortality, and suicide. The study examines the risk factors of depression in late life, especially the psychosocial factors, among a sample comprising 162 community-dwelling Singaporean adults aged 65 years and above. An interview-based structured survey was conducted in multiple senior activity centers located in different parts of Singapore. Results from the hierarchical regression analysis show that 32.9% of the variance in geriatric depression can be explained by the three psychosocial factors, among which loneliness, perceived social support, and the emotional regulation component of resilience are significantly associated with depression in older adults. Large-scale studies should be conducted to confirm the findings of the present study, and to further examine the predictive effects of these psychosocial factors on depression among older adults.

  14. Personal factors predictive of health-related lifestyles of community-dwelling older adults.

    PubMed

    Peralta-Catipon, Terry; Hwang, Jengliang Eric

    2011-01-01

    We explored personal factors that can predict health-related lifestyles of community-dwelling older adults. A convenience sample of 253 older adults was recruited to complete the Health Enhancement Lifestyle Profile (HELP), a comprehensive measure of health-promoting behaviors. Data were analyzed through univariate correlational/comparative statistics followed by stepwise multiple regression analysis to determine significant predictor variables for different aspects of health-related lifestyle. Personal health conditions, including the number of chronic diseases or impairments and self-rated health, were two strong predictors for the HELP (R2 = .571, p < .0001). Demographic characteristics, including age, gender, race, education, and employment status, also demonstrated varied degrees of capability for predicting the different HELP scales (e.g., Exercise, Diet, Leisure). When developing individualized plans for older adults in community settings, occupational therapists should consider the clients' strengths and vulnerabilities potentially derived from personal health factors and demographic attributes to yield more effective lifestyle interventions.

  15. Perceived Need for Mental Health Care Among Community-Dwelling Older Adults

    PubMed Central

    Kane, Robert L.; Kaas, Merrie; Kane, Rosalie A.

    2009-01-01

    Only half of older adults with a mental disorder use mental health services, and little is known about the causes of perceived need for mental health care (MHC). We used logistic regression to examine relationships among depression, anxiety, chronic physical illness, alcohol abuse and/or dependence, sociodemographics, and perceived need among a national sample of community-dwelling individuals 65 years of age and older (the Collaborative Psychiatric Epidemiology Surveys data set). Less than half of respondents with depression or anxiety perceived a need for care. Perceived need was greater for respondents with more symptoms of depression regardless of whether they met diagnostic criteria for a mental illness. History of chronic physical conditions, history of depression or anxiety, and more severe mental illness were associated with greater perceived need for MHC. Future studies of perceived need should account for individual perceptions of mental illness and treatment and the influence of social networks. PMID:19820231

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

    PubMed Central

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Yen, Chia-Feng; Lin, Jin-Ding

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  20. Validity and reliability of the safe driving behavior measure in community-dwelling self-drivers with stroke.

    PubMed

    Song, Chiang-Soon; Choi, Yoo-Im; Hong, So-Young

    2016-05-01

    [Purpose] Driving is a vital component of recovery for stroke survivors facilitating restoration of their family roles and reintegration back into their communities and associations. The purpose of this study was to evaluate the validity and reliability of the Safe Driving Behavior Measure (SDBM) in community-dwelling self-drivers post-stroke. [Subjects and Methods] Participants were sixty-seven community-dwelling self-drivers who had received a diagnosis of first stroke in the past twelve months. To investigate the validity and reliability of the SDBM, this study evaluated two sessions, held three days apart in a quiet and well-organized assessment room. Cronbach's alpha and the Intraclass Correlation Coefficient [ICC (2.1)] were used to evaluate statistically concurrent validity and reliability of the overall and three domain scores. Pearson's correlations were used to quantify the bivariate associations among the three domains. [Results] The Cronbach's alpha coefficients for the three domains of person-vehicle (0.989), person-environment (0.997), and person-vehicle-environment (0.968) of the SDBM indicated high internal consistency in community-dwelling self-drivers with stroke, in addition to excellent rest-retest reliability. [Conclusion] The results of this study suggest that the SDBM could be a reliable measure to evaluate automobile driving in community-dwelling self-drivers with stroke. PMID:27313389

  1. Validity and reliability of the safe driving behavior measure in community-dwelling self-drivers with stroke

    PubMed Central

    Song, Chiang-Soon; Choi, Yoo-Im; Hong, So-Young

    2016-01-01

    [Purpose] Driving is a vital component of recovery for stroke survivors facilitating restoration of their family roles and reintegration back into their communities and associations. The purpose of this study was to evaluate the validity and reliability of the Safe Driving Behavior Measure (SDBM) in community-dwelling self-drivers post-stroke. [Subjects and Methods] Participants were sixty-seven community-dwelling self-drivers who had received a diagnosis of first stroke in the past twelve months. To investigate the validity and reliability of the SDBM, this study evaluated two sessions, held three days apart in a quiet and well-organized assessment room. Cronbach’s alpha and the Intraclass Correlation Coefficient [ICC (2.1)] were used to evaluate statistically concurrent validity and reliability of the overall and three domain scores. Pearson’s correlations were used to quantify the bivariate associations among the three domains. [Results] The Cronbach’s alpha coefficients for the three domains of person-vehicle (0.989), person-environment (0.997), and person-vehicle-environment (0.968) of the SDBM indicated high internal consistency in community-dwelling self-drivers with stroke, in addition to excellent rest-retest reliability. [Conclusion] The results of this study suggest that the SDBM could be a reliable measure to evaluate automobile driving in community-dwelling self-drivers with stroke. PMID:27313389

  2. Validity and reliability of the safe driving behavior measure in community-dwelling self-drivers with stroke.

    PubMed

    Song, Chiang-Soon; Choi, Yoo-Im; Hong, So-Young

    2016-05-01

    [Purpose] Driving is a vital component of recovery for stroke survivors facilitating restoration of their family roles and reintegration back into their communities and associations. The purpose of this study was to evaluate the validity and reliability of the Safe Driving Behavior Measure (SDBM) in community-dwelling self-drivers post-stroke. [Subjects and Methods] Participants were sixty-seven community-dwelling self-drivers who had received a diagnosis of first stroke in the past twelve months. To investigate the validity and reliability of the SDBM, this study evaluated two sessions, held three days apart in a quiet and well-organized assessment room. Cronbach's alpha and the Intraclass Correlation Coefficient [ICC (2.1)] were used to evaluate statistically concurrent validity and reliability of the overall and three domain scores. Pearson's correlations were used to quantify the bivariate associations among the three domains. [Results] The Cronbach's alpha coefficients for the three domains of person-vehicle (0.989), person-environment (0.997), and person-vehicle-environment (0.968) of the SDBM indicated high internal consistency in community-dwelling self-drivers with stroke, in addition to excellent rest-retest reliability. [Conclusion] The results of this study suggest that the SDBM could be a reliable measure to evaluate automobile driving in community-dwelling self-drivers with stroke.

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

    PubMed

    Tiedt, Andrew D

    2010-09-01

    Depression has been described as the world's most prevalent illness and a leading cause of disability across age groups. The global literature on aging and depression reports greater prevalence of depressive symptoms among women than men. This research applies data from the Nihon University Japanese Longitudinal Study of Aging to the gender gap in depressive symptoms reported by Japanese elders. This study takes the position that cultural norms centered on obligations to care determine both the prevalence of social support and its application by family members. Since gender is the lens through which social and cultural expectations are filtered, the experiences of men and women are distinguished from one another. This study hypothesized that coresidency and filial obligations should protect elders from depression. At the same time, combative relationships within households were posited to aggravate depressive symptoms among mothers-in-law and daughters-in-law. Weak social support networks, as captured through not being married, living alone and lack of community contact were also hypothesized to exacerbate isolation and heighten depressive symptoms. The analyses found that receipt of support both protected elders as well as worsened depressive symptoms. While women reported greater frequency of depressive symptoms overall, results indicated that men experienced a larger effect of decreased mobility and transitions to poor physical health on depressive symptoms than women. PMID:20552391

  4. Body mass index and the risk of incident functional disability in elderly Japanese

    PubMed Central

    Zhang, Shu; Tomata, Yasutake; Sugiyama, Kemmyo; Kaiho, Yu; Honkura, Kenji; Watanabe, Takashi; Tanji, Fumiya; Sugawara, Yumi; Tsuji, Ichiro

    2016-01-01

    Abstract The relationship between the body mass index (BMI) and the incidence of cause-specific disability remains unclear. We conducted a prospective cohort study of 12,376 Japanese individuals aged ≥65 years who were followed up for 5.7 years. Information on BMI and other lifestyle factors was collected via a questionnaire in 2006. Functional disability data were retrieved from the public Long-term Care Insurance database. BMI was divided into 6 groups (<21, 21–<23, 23–<25, 25–<27[reference], 27–<29 and ≥29). Hazard ratios and 95% confidence intervals for cause-specific disability were estimated using Cox proportional hazards regression models. A U-shaped relationship between BMI and functional disability was observed, with a nadir at 26. The nadir BMI values with the lowest disability risk were 28 for dementia, 25 for stroke, and 23 for joint disease. A low BMI (<23) was a risk factor for disability due to dementia, the HR values (95% CI) being 2.48 (1.70–3.63) for BMI <21 and 2.25 (1.54–3.27) for BMI 21 to <23; a high BMI (≥29) was a risk factor for disability due to joint disease, the HR value (95% CI) being 2.17 (1.40–3.35). There was no significant relationship between BMI and disability due to stroke. The BMI nadirs for cause-specific disability differed: a low BMI (<23) was a risk factor for disability due to dementia, and a high BMI (≥29) was a risk factor for disability due to joint disease. Because BMI values of 23 to <29 did not pose a significantly higher risk for each cause of disability, this range should be regarded as the optimal one for the elderly population. PMID:27495075

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

    PubMed Central

    Singh, Devinder KA; Pillai, Sharmila GK; Tan, Sin Thien; Tai, Chu Chiau; Shahar, Suzana

    2015-01-01

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

  6. Vitamin D Status and the Risk of Anemia in Community-Dwelling Adults

    PubMed Central

    Monlezun, Dominique J.; Camargo, Carlos A.; Mullen, John T.; Quraishi, Sadeq A.

    2015-01-01

    Abstract Low vitamin D status has been implicated in several chronic medical conditions and unfavorable health outcomes. Our goal was to investigate whether serum 25-hydroxyvitamin D (25OHD) levels are a potentially modifiable risk factor for anemia in a nationally representative cohort of community-dwelling individuals in the United States. We performed a cross-sectional study of 5456 individuals (≥17 years) from the National Health and Nutrition Examination Survey from 2001 to 2006. Locally weighted scatterplot smoothing (LOWESS) was used to graphically depict the relationship between serum 25OHD levels and the cumulative frequency of anemia. Multivariable logistic regression models were then used to assess the independent association of 25OHD levels with anemia, while controlling for age, sex, race, body mass index, chronic kidney disease, as well as serum levels of C-reactive protein, ferritin, iron, vitamin B12, and folic acid. The mean (standard error) 25OHD and hemoglobin levels in the analytic group were 23.5 (0.4) ng/mL and 14.4 (0.1) g/dL, respectively. Prevalence of anemia was 3.9%. Locally weighted scatterplot smoothing analysis demonstrated a near-linear relationship between vitamin D status and cumulative frequency of anemia up to 25OHD levels of approximately 20 ng/mL. With increasing 25OHD levels, the curve flattened out progressively. Multivariable regression analysis demonstrated an inverse association of 25OHD levels with the risk of anemia (adjusted odds ratio 0.97; 95% confidence interval 0.95–0.99 per 1 ng/mL change in 25OHD). Compared to individuals with ≥20 ng/mL, individuals with 25OHD levels <20 ng/mL were more likely to be anemic (adjusted odds ratio 1.64; 95% confidence interval 1.08–2.49). In a nationally representative sample of community-dwelling individuals in the United States, low 25OHD levels were associated with increased risk of anemia. Randomized controlled trials are needed to determine whether optimizing

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

    PubMed Central

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

    2014-01-01

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

  8. Examining the Disability Model From the International Classification of Functioning, Disability, and Health Using a Large Data Set of Community-Dwelling Malaysian Older Adults

    PubMed Central

    Loke, Seng Cheong; Lim, Wee Shiong; Someya, Yoshiko; Hamid, Tengku A.; Nudin, Siti S. H.

    2015-01-01

    Objective: This study examines the International Classification of Functioning, Disability, and Health model (ICF) using a data set of 2,563 community-dwelling elderly with disease-independent measures of mobility, physical activity, and social networking, to represent ICF constructs. Method: The relationship between chronic disease and disability (independent and dependent variables) was examined using logistic regression. To demonstrate variability in activity performance with functional impairment, graphing was used. The relationship between functional impairment, activity performance, and social participation was examined graphically and using ANOVA. The impact of cognitive deficits was quantified through stratifying by dementia. Results: Disability is strongly related to chronic disease (Wald 25.5, p < .001), functional impairment with activity performance (F = 34.2, p < .001), and social participation (F= 43.6, p < .001). With good function, there is considerable variability in activity performance (inter-quartile range [IQR] = 2.00), but diminishes with high impairment (IQR = 0.00) especially with cognitive deficits. Discussion: Environment modification benefits those with moderate functional impairment, but not with higher grades of functional loss. PMID:26472747

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

    PubMed

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

    2015-04-28

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

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed

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

    2015-05-01

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

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

    PubMed Central

    Cramm, Jane Murray; Nieboer, Anna Petra

    2016-01-01

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

  13. Sleep Architecture and Mental Health Among Community-Dwelling Older Men

    PubMed Central

    Smagula, Stephen F.; Reynolds, Charles F.; Ancoli-Israel, Sonia; Barrett-Connor, Elizabeth; Dam, Thuy-Tien; Hughes-Austin, Jan M.; Paudel, Misti; Redline, Susan; Stone, Katie L.

    2015-01-01

    Objectives. To investigate the association of mood and anxiety symptoms with sleep architecture (the distribution of sleep stages) in community-dwelling older men. Method. We used in-home unattended polysomnography to measure sleep architecture in older men. Men were categorized into 4 mental health categories: (a) significant depressive symptoms only (DEP+ only, Geriatric Depression Scale ≥ 6), (b) significant anxiety symptoms only (ANX+ only, Goldberg Anxiety Scale ≥ 5), (c) significant depressive and anxiety symptoms (DEP+/ANX+), or (d) no significant depressive or anxiety symptoms (DEP−/ANX−). Results. Compared with men without clinically significant symptomology, men with depressive symptoms spent a higher percentage of time in Stage 2 sleep (65.42% DEP+ only vs 62.47% DEP−/ANX−, p = .003) and a lower percentage of time in rapid eye movement sleep (17.05% DEP+ only vs 19.44% DEP−/ANX−, p = .0005). These differences persisted after adjustment for demographic/lifestyle characteristics, medical conditions, medications, and sleep disturbances, and after excluding participants using psychotropic medications. The sleep architecture of ANX+ or DEP+/ANX+ men did not differ from asymptomatic men. Discussion. Depressed mood in older adults may be associated with accelerated age-related changes in sleep architecture. Longitudinal community-based studies using diagnostic measures are needed to further clarify relationships among common mental disorders, aging, and sleep. PMID:24326077

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

    PubMed

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

    2015-05-01

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

  15. Dietary protein intake is associated with lean body mass in community-dwelling older adults.

    PubMed

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

    2013-08-01

    Lean body mass (LBM) is important to maintain physical function during aging. We hypothesized that dietary protein intake and leisure-time physical activity are associated with LBM in community-dwelling older adults. To test the hypothesis, participants (n = 237; age, 65-92 years) did 3-day weighed food records and reported physical activity. Body composition was assessed using dual-energy x-ray absorptiometry. Protein intake was 0.98 ± 0.28 and 0.95 ± 0.29 g/kg body weight in male and female participants, respectively. Protein intake (in grams per kilogram of body weight) was associated with LBM (in kilograms); that is, the differences in LBM were 2.3 kg (P < .05) and 2.0 kg (P = .054) between the fourth vs the first and the fourth vs the second quartiles of protein intake, respectively. Only a minor part of this association was explained by increased energy intake, which follows an increased protein intake. Our study shows that dietary protein intake was positively associated with LBM in older adults with a mean protein intake higher than the current recommended daily allowance of 0.8 g/kg per day. Leisure-time physical activity, predominantly consisting of endurance type exercises, was not related to LBM in this group.

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

    PubMed Central

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

    2015-01-01

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

  17. Neighborhood Food Environment and Obesity in Community-Dwelling Older Adults: Individual and Neighborhood Effects

    PubMed Central

    Wilson-Genderson, Maureen; Gupta, Adarsh K.

    2014-01-01

    Objectives. We tested hypotheses about the relationship between neighborhood-level food sources and obesity, controlling for individual-level characteristics. Methods. Data (collected November 2006–April 2008) derived from a random-digit-dial sample of 5688 community-dwelling adults aged 50 to 74 years residing in 1644 census tracts in New Jersey. Using multilevel structural equation models, we created latent constructs representing density of fast-food establishments and storefronts (convenience stores, bars and pubs, grocery stores) and an observed indicator for supermarkets at the neighborhood level, simultaneously modeling obesity and demographic characteristics (age, gender, race, education, household income) at the individual level. Results. When we controlled for individual-level age, gender, race, education, and household income, densities of fast-food establishments and storefronts were positively associated with obesity. Supermarkets were not associated with obesity. Conclusions. Because people living in neighborhoods with a higher density of fast food and storefronts are more likely to be obese, these neighborhoods may be optimal sites for interventions. PMID:24625148

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

    PubMed Central

    Cramm, Jane Murray; Nieboer, Anna Petra

    2016-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  20. [Assessment of balance in community dwelling older adults: reliability and validity of the German version of the Fullerton Advanced Balance Scale].

    PubMed

    Schott, N

    2011-12-01

    The purpose of this study was to validate the German translation of the originally English Fullerton Advanced Balance Scale (FAB-D). The 10-item test battery is a performance-based measure that addresses the multiple dimensions of balance. The German FAB-D using a forward-backward procedure was examined by a sample of n = 96 community dwelling older adults (71,6 ± 7,5 years of age) who had reported no history of a fall in the previous 6 months (non-fallers) and 66 older adults (age 75,3 ± 7,3 years of age) who reported falling one or more times (recurrent fallers). The following internationally accepted instruments were used for validation: The Berg-Balance-Scale (BBS), the Activities-Specific Balance Confidence (ABC-D) scale, the Short Form Health Survey (SF-36), the Physical Activity Scale for the Elderly (PASE), the Trail-Making-Test (TMT), and motor tests (balance, strength, mobility). Explorative and confirmative factor analysis showed the best fit for a one dimensional solution. Cronbach's alpha of the German version of the FAB-D was 0.988. Test-retest reliability for the total score was 0.965 and ranged from 0.86-0.88 for individual items. The scales correlate with convergent measures assessing postural control and falls-related confidence (BBS, r = 0.685; Timed-Up-and-Go-Test, r = -0.632; ABC-D, r = 0.561). Criterion validity of the FAB-D was established by statistically significant correlations between the total scale, and the subdimensions of the SF-36 (physical 0.52, mental 0.38), the PASE (0.29), the TMT A (-0.30) and B (-0.41), the Chair Rising Test (0.59) and the 10 m walk (normal velocity -0.49; fast velocity -0.56). Significant differences in the FAB-D scores were found in older adults with (30,3 ± 8,6) and without falls (36,1 ± 4,2). Older adults with a recent fall history scored lower on the FAB-D than older adults without a recent fall history. To conclude, the German version of the FAB-D has properties analogous to the original English

  1. [Assessment of balance in community dwelling older adults: reliability and validity of the German version of the Fullerton Advanced Balance Scale].

    PubMed

    Schott, N

    2011-12-01

    The purpose of this study was to validate the German translation of the originally English Fullerton Advanced Balance Scale (FAB-D). The 10-item test battery is a performance-based measure that addresses the multiple dimensions of balance. The German FAB-D using a forward-backward procedure was examined by a sample of n = 96 community dwelling older adults (71,6 ± 7,5 years of age) who had reported no history of a fall in the previous 6 months (non-fallers) and 66 older adults (age 75,3 ± 7,3 years of age) who reported falling one or more times (recurrent fallers). The following internationally accepted instruments were used for validation: The Berg-Balance-Scale (BBS), the Activities-Specific Balance Confidence (ABC-D) scale, the Short Form Health Survey (SF-36), the Physical Activity Scale for the Elderly (PASE), the Trail-Making-Test (TMT), and motor tests (balance, strength, mobility). Explorative and confirmative factor analysis showed the best fit for a one dimensional solution. Cronbach's alpha of the German version of the FAB-D was 0.988. Test-retest reliability for the total score was 0.965 and ranged from 0.86-0.88 for individual items. The scales correlate with convergent measures assessing postural control and falls-related confidence (BBS, r = 0.685; Timed-Up-and-Go-Test, r = -0.632; ABC-D, r = 0.561). Criterion validity of the FAB-D was established by statistically significant correlations between the total scale, and the subdimensions of the SF-36 (physical 0.52, mental 0.38), the PASE (0.29), the TMT A (-0.30) and B (-0.41), the Chair Rising Test (0.59) and the 10 m walk (normal velocity -0.49; fast velocity -0.56). Significant differences in the FAB-D scores were found in older adults with (30,3 ± 8,6) and without falls (36,1 ± 4,2). Older adults with a recent fall history scored lower on the FAB-D than older adults without a recent fall history. To conclude, the German version of the FAB-D has properties analogous to the original English

  2. What community resources do older community-dwelling adults use to manage their osteoarthritis? A formative examination.

    PubMed

    Martin, Kathryn Remmes; Schoster, Britta; Woodard, Janice; Callahan, Leigh F

    2012-10-01

    Community resources can influence health outcomes, yet little research has examined how older individuals use community resources for osteoarthritis (OA) management. Six focus groups were conducted with 37 community-dwelling older adult African Americans and Caucasians who self-reported OA and resided in Johnston County, North Carolina. Descriptive analyses and qualitative constant comparison methodology revealed individuals use local recreational facilities, senior centers, shopping centers, religious organizations, medical providers, pharmacies and their social network for OA management. Participants also identified environmental characteristics (e.g., sidewalk conditions, curb-cuts, handicapped parking, automatic doors) that both facilitated and hindered use of community resources for OA management. Identified resources and environmental characteristics were organized around Corbin & Strauss framework tasks: medical/behavioral, role, and emotional management. As older Americans live with multiple chronic diseases, better understanding of what community resources are used for disease management may help improve the health of community-dwelling adults, both with and without OA.

  3. What community resources do older community-dwelling adults use to manage their osteoarthritis? A formative examination

    PubMed Central

    Martin, Kathryn Remmes; Schoster, Britta; Woodard, Janice

    2011-01-01

    Community resources can influence health outcomes, yet little research has examined how older individuals use community resources for osteoarthritis (OA) management. Six focus groups were conducted with 37 community-dwelling older adult African Americans and Caucasians who self-reported OA and resided in Johnston County, North Carolina. Descriptive analyses and qualitative constant comparison methodology revealed individuals use local recreational facilities, senior centers, shopping centers, religious organizations, medical providers, pharmacies and their social network for OA management. Participants also identified environmental characteristics (e.g., sidewalk conditions, curb-cuts, handicapped parking, automatic doors) that both facilitated and hindered use of community resources for OA management. Identified resources and environmental characteristics were organized around Corbin & Strauss framework tasks: medical/behavioral, role, and emotional management. As older Americans live with multiple chronic diseases, better understanding of what community resources are used for disease management may help improve the health of community-dwelling adults, both with and without OA. PMID:23049159

  4. Sleep health, lifestyle and mental health in the Japanese elderly: ensuring sleep to promote a healthy brain and mind.

    PubMed

    Tanaka, Hideki; Shirakawa, Shuichiro

    2004-05-01

    The Ministry of Health, Labor and Welfare in Japan proposed a plan called "Health Japan 21," which adopted sleep as one of the specific living habits needing improvement. This has led to increased interest in mental health needs at community public health sites. In addition, it was reported from a recent 2000 survey that one in five Japanese, and one in three elderly Japanese, suffer from insomnia. Insomnia is becoming a serious social problem; so much so that alarm bells are ringing with insomnia listed as one of the refractory diseases of the 21st century. Against this background, in January 2001, Japan began a national project called "Establishing a Science of Sleep." This article is an overview of sleep and health in the elderly, sleep mechanisms and the characteristics of insomnia among the elderly. At the same time, it introduces the scientific basis for lifestyle guidance that is effective for ensuring comfortable sleep, an essential condition for a healthy, energetic old age, with actual examples from community public health sites. The present authors reported that a short nap (30 min between 1300 and 1500 h) and moderate exercise such as walking in the evening are important in the maintenance and improvement of sleep quality. The study was to examine the effects of short nap and exercise on the sleep quality and mental health of elderly people. "Interventions" by short nap after lunch and exercise with moderate intensity in the evening were carried out for 4 weeks. After the "intervention," wake time after sleep onset significantly decreased and sleep efficiency significantly increased, showing that sleep quality was improved. The frequency of nodding in the evening significantly decreased. As a result, the frequency of nodding before going to sleep decreased, and the quality of nocturnal sleep was improved. Present results demonstrated that the proper awakening maintenance during evening was effective in improving sleep quality. After the "intervention

  5. The effects of continuous application of sunscreen on photoaged skin in Japanese elderly people – the relationship with the usage

    PubMed Central

    Mizuno, Makoto; Kunimoto, Kayo; Naru, Eiji; Kameyama, Koichi; Furukawa, Fukumi; Yamamoto, Yuki

    2016-01-01

    Since photoaging of skin is caused by chronic sun exposure, it is well-recognized that regular sunscreen use can help prevent photoaging of skin in fair-skinned people. Therefore, application of sunscreen is recommended for the prevention of photoaging in many countries. However, the relationship between UV exposure and photoaging has rarely been investigated in clinical studies in Japan. In addition, there have been almost no long-term interventional studies in Japanese people. We have previously conducted a study where Japanese actinic keratosis patients were instructed to continuously apply sunscreen. The results indicated that long-term application of sunscreen is effective in suppressing actinic keratosis progression and generation. In the present study, we investigated the effects of sunscreen on photoaged skin in 14 elderly Japanese people. Skin conditions such as water content, transepidermal water loss, the number of spots, wrinkles, and skin color tone uniformity were measured and compared before and after the study. A statistically significant difference was observed only in skin surface hydration. There were large inter-individual differences in amount of sunscreen used throughout the study. The changes in the number of spots and skin color tone uniformity during the 18 months showed good correlation with amount of sunscreen being used. These results suggest an increase in the number of spots and deterioration in skin color tone uniformity in the 18-month non-sunscreen application period, and that such skin conditions improved with increasing use of sunscreen. In this study, we suggested an inhibitory effect on photoaging symptoms such as spots and skin color tone non-uniformity, by application of the appropriate amount of sunscreen over a long period of time in Japanese people, similar to Caucasians. PMID:27217789

  6. The effects of continuous application of sunscreen on photoaged skin in Japanese elderly people - the relationship with the usage.

    PubMed

    Mizuno, Makoto; Kunimoto, Kayo; Naru, Eiji; Kameyama, Koichi; Furukawa, Fukumi; Yamamoto, Yuki

    2016-01-01

    Since photoaging of skin is caused by chronic sun exposure, it is well-recognized that regular sunscreen use can help prevent photoaging of skin in fair-skinned people. Therefore, application of sunscreen is recommended for the prevention of photoaging in many countries. However, the relationship between UV exposure and photoaging has rarely been investigated in clinical studies in Japan. In addition, there have been almost no long-term interventional studies in Japanese people. We have previously conducted a study where Japanese actinic keratosis patients were instructed to continuously apply sunscreen. The results indicated that long-term application of sunscreen is effective in suppressing actinic keratosis progression and generation. In the present study, we investigated the effects of sunscreen on photoaged skin in 14 elderly Japanese people. Skin conditions such as water content, transepidermal water loss, the number of spots, wrinkles, and skin color tone uniformity were measured and compared before and after the study. A statistically significant difference was observed only in skin surface hydration. There were large inter-individual differences in amount of sunscreen used throughout the study. The changes in the number of spots and skin color tone uniformity during the 18 months showed good correlation with amount of sunscreen being used. These results suggest an increase in the number of spots and deterioration in skin color tone uniformity in the 18-month non-sunscreen application period, and that such skin conditions improved with increasing use of sunscreen. In this study, we suggested an inhibitory effect on photoaging symptoms such as spots and skin color tone non-uniformity, by application of the appropriate amount of sunscreen over a long period of time in Japanese people, similar to Caucasians. PMID:27217789

  7. Elders Who Delay Medication because of Cost: Health Insurance, Demographic, Health, and Financial Correlates

    ERIC Educational Resources Information Center

    Klein, Dawn; Turvey, Carolyn; Wallace, Robert

    2004-01-01

    Purpose: Prescription medication use is essential to the health and well-being of many elderly persons. However, the cost of medications may be prohibitive and contribute to noncompliance with medical recommendations. This study identifies community-dwelling elders who reported a delay in medication use because of prescription medication cost.…

  8. Licorice in leviathan: the medicalization of care for the Japanese elderly.

    PubMed

    Lock, M

    1984-06-01

    Attitudes towards, and treatment of the elderly in Japan are discussed and the medicalization of their health care is examined. It is suggested that the ready availability of medical care will not eliminate the major problems that the elderly experience. The process by which traditional medicine has been incorporated systematically into the socialized health care system and its use in connection with the problems of elderly patients is documented. Modifications in the application of herbal medicine made by biomedical practitioners have been linked to cases of iatrogenesis in the elderly. In conclusion, the social construction of both traditional East Asian medicine and biomedicine in Japan is briefly examined; in both systems the somatic aspects of the problems of the elderly are emphasized while the social dimensions remain largely unquestioned.

  9. Caregiver Abuse of Chicago Chinese Older Adults in a Community-Dwelling Population

    PubMed Central

    Dong, Xin Qi; Li, Ge

    2016-01-01

    Objectives This study aimed to examine the prevalence and correlates of elder abuse reported by adult children among U.S Chinese populations. Method A community-based participatory research approach was implemented. A total of 548 Chinese adult children aged 21 years and over participated in this study. Elder abuse reported by adult children was assessed using Caregiver Abuse Screen (CASE). Results This study found a prevalence of 59.8%for elder abuse among 548 adult children. Younger age (r = −0.10, p < .05), higher level of education (r = 0.20, p < .001), higher income (r = 0.14, p < .01), more years in the U.S. (r = 0.12, p < .05), not born in Mainland China (r = −0.13, p < .01), and English-speaking (r = 0.16, p < .001) were positively correlated with elder abuse reported by adult children. Discussion Elder abuse by adult children is prevalent among U.S. Chinese populations. It is necessary for researchers, health care providers and policy makers to put more attention on elder abuse by adult children. Longitudinal research is needed to explore the risk factors associated with elder abuse by adult children. Health care providers should improve detection of elder abuse and support at-risk caregivers. Policy makers may consider cultural sensitive approaches to address elder abuse. PMID:27606358

  10. Grey matter correlates of susceptibility to scams in community-dwelling older adults.

    PubMed

    Duke Han, S; Boyle, Patricia A; Yu, Lei; Arfanakis, Konstantinos; James, Bryan D; Fleischman, Debra A; Bennett, David A

    2016-06-01

    Susceptibility to scams is a significant issue among older adults, even among those with intact cognition. Age-related changes in brain macrostructure may be associated with susceptibility to scams; however, this has yet to be explored. Based on previous work implicating frontal and temporal lobe functioning as important in decision making, we tested the hypothesis that susceptibility to scams is associated with smaller grey matter volume in frontal and temporal lobe regions in a large community-dwelling cohort of non-demented older adults. Participants (N = 327, mean age = 81.55, mean education = 15.30, 78.9 % female) completed a self-report measure used to assess susceptibility to scams and an MRI brain scan. Results indicated an inverse association between overall grey matter and susceptibility to scams in models adjusted for age, education, and sex; and in models further adjusted for cognitive function. No significant associations were observed for white matter, cerebrospinal fluid, or total brain volume. Models adjusted for age, education, and sex revealed seven clusters showing smaller grey matter in the right parahippocampal/hippocampal/fusiform, left middle temporal, left orbitofrontal, right ventromedial prefrontal, right middle temporal, right precuneus, and right dorsolateral prefrontal regions. In models further adjusted for cognitive function, results revealed three significant clusters showing smaller grey matter in the right parahippocampal/hippocampal/fusiform, right hippocampal, and right middle temporal regions. Lower grey matter concentration in specific brain regions may be associated with susceptibility to scams, even after adjusting for cognitive ability. Future research is needed to determine whether grey matter reductions in these regions may be a biomarker for susceptibility to scams in old age.

  11. Oily Fish Intake and Cognitive Performance in Community-Dwelling Older Adults: The Atahualpa Project.

    PubMed

    Del Brutto, Oscar H; Mera, Robertino M; Gillman, Jennifer; Zambrano, Mauricio; Ha, Jung-eun

    2016-02-01

    Due to their high content of omega-3 polyunsaturated fatty acids, oily fish consumption is likely associated with a better cognitive performance. However, information on this association is controversial, with some studies showing a positive effect while others showing no association. We aimed to assess the effects of oily fish consumption on cognitive performance in a population of frequent fish consumers living in rural coastal Ecuador. Atahualpa residents aged ≥60 years were identified during a door-to-door survey and evaluated by the use of the Montreal Cognitive Assessment (MoCA). Oily fish servings per week were calculated in all participants. We estimated whether fish intake correlated with MoCA scores in generalized multivariate linear models adjusted for demographics, cardiovascular risk factors, edentulism and symptoms of depression. Out of 330 eligible persons, 307 (93%) were enrolled. Mean MoCA scores were 19 ± 4.8 points, and mean oily fish consumption was 8.6 ± 5.3 servings per week. In multivariate analyses, MoCA scores were related to fish servings (β 0.097, 95% CI 0.005-0.188, p = 0.038). Locally weighted scatterplot smoothing showed an inflection point in the total MoCA score curve at four fish servings per week. However, predictive margins of the MoCA score were similar across groups below and above this point, suggesting a direct linear relationship between oily fish intake and cognitive performance. Simple preventive measures, such as modifying dietary habits might be of value to reduce the rate of cognitive decline in community-dwelling older adults living in underserved populations.

  12. Outcome among community dwelling older adults with schizophrenia: results using five conceptual models.

    PubMed

    Cohen, Carl I; Pathak, Richa; Ramirez, Paul M; Vahia, Ipsit

    2009-04-01

    There have been few studies examining the outcome of schizophrenia in later life. Using five conceptual models, we test two hypotheses with respect to range of outcomes among older schizophrenia outpatients and how they compare to their age peers in the community. We operationalized five outcome measures from the following conceptual models: Remission, adapting criteria of Andreasen et al. (The American Journal of Psychiatry, 162:441-449, 2005); Recovery, adapting the criteria by Liberman et al. (International Review of Psychiatry, 14:256-272, 2002); Community Integration using the model of Wong and Solomon (Mental Health Services Research, 4:13-28, 2002); Subjective and Objective Successful Aging using the model of Rowe and Kahn (Science, 237:143-149, 1987). The schizophrenia (S) group consisted of 198 community-dwelling persons aged 55 and over who developed schizophrenia before age 45 and a community comparison (CC) group (N = 113). Remission and recovery criteria were met by 49 and 17% of the S group, respectively. There were significant differences between the S and CC groups in the distribution of community integration and successful aging scales: 41% of the CC group met at least 10 of 12 criteria versus 23% of the S group on the Community Integration Scale; 19% of the CC group met all six criteria vs. 2% of the S group on the Objective Successful Aging Scale; 27% of the CC group vs. 13% of the S group met all six criteria on the Subjective Successful Aging Scale. Correlations among the five outcome measures ranged from r = .19 to .48 (median value: r = .26 or 7% shared variance). There is wide variability in outcome in later life depending on which measure is used. Rather than one universal indicator, each measure offers a different perspective that can provide useful guidelines for researchers, clinicians, and policy makers. PMID:18787951

  13. Moderate, Regular Alcohol Consumption is Associated with Higher Cognitive Function in Older Community-Dwelling Adults

    PubMed Central

    Reas, E.T.; Laughlin, G.A.; Kritz-Silverstein, D.; Barrett-Connor, E.; McEvoy, L.K.

    2016-01-01

    BACKGROUND Evidence suggests that moderate alcohol consumption may protect against cognitive decline and dementia. However, uncertainty remains over the patterns of drinking that are most beneficial. OBJECTIVE To examine associations between amount and frequency of alcohol consumption with multiple domains of cognitive function in a well-characterized cohort of older community-dwelling adults in southern California. DESIGN Observational, cross-sectional cohort study. SETTING A research visit between 1988–1992 in Rancho Bernardo, California. PARTICIPANTS 1624 participants of the Rancho Bernardo Study (mean age ± SD = 73.2 ± 9.3 years). Measurements Participants completed a neuropsychological test battery, self-administered questionnaires on alcohol consumption and lifestyle, and a clinical health evaluation. We classified participants according to average amount of alcohol intake into never, former, moderate, heavy and excessive drinkers, and according to frequency of alcohol intake, into non-drinkers, rare, infrequent, frequent and daily drinkers. We examined the association between alcohol intake and cognitive function, controlling for age, sex, education, exercise, smoking, waist-hip ratio, hypertension and self-assessed health. RESULTS Amount and frequency of alcohol intake were significantly associated with cognitive function, even after controlling for potentially related health and lifestyle variables. Global and executive function showed positive linear associations with amount and frequency of alcohol intake, whereas visual memory showed an inverted U-shaped association with alcohol intake, with better performance for moderate and infrequent drinkers than for non-drinkers, excessive drinkers or daily drinkers. CONCLUSIONS In several cognitive domains, moderate, regular alcohol intake was associated with better cognitive function relative to not drinking or drinking less frequently. This suggests that beneficial cognitive effects of alcohol intake may be

  14. Muscle weakness is related to slip-initiated falls among community-dwelling older adults.

    PubMed

    Ding, Li; Yang, Feng

    2016-01-25

    The purposes of this study were (1) to investigate the relationship between muscle weakness and slip-related falls among community-dwelling older adults, and (2) to determine optimal cut-off values with respect to the knee strength capacity which can be used to identify individuals at high risk of falls. Thirty-six healthy older adults participated in this study. Their muscle strength (torque) was assessed at the right knee under maximum voluntary isometric (flexion and extension) contractions. They were then moved to a special treadmill. After walking regularly five times on the treadmill, they experienced an identical and unannounced slip during walking on the treadmill with the protection of a safety harness. This treadmill could be considered a standardized platform, inducing an unexpected slip. Accuracy of predicting slip outcome (fall vs. recovery) was examined for both strength measurements (i.e., the strength capacity of knee extensor and flexor) using univariate logistic regressions. The optimal cutoff values for the two strength measurements were determined by the receiver operating characteristic analysis. Results showed that fallers displayed significantly lower knee strength capacities compared to their recovery counterpart (1.10 vs. 1.44Nm/kg, p<0.01, effect size Cohen׳s d=0.95 for extensor; 0.93 vs. 1.13Nm/kg, p<0.05, d=0.69 for flexor). Such results suggested that muscle weakness contributes to falls initiated by a slip during gait. Our findings could provide guidance to identify individuals at increased risk of falling using the derived optimal cutoff values of knee strength capacity among older adults.

  15. Estimation of lean body weight in older community-dwelling men

    PubMed Central

    Mitchell, Sarah J; Kirkpatrick, Carl M J; Le Couteur, David G; Naganathan, Vasi; Sambrook, Philip N; Seibel, Markus J; Blyth, Fiona M; Waite, Louise M; Handelsman, David J; Cumming, Robert G; Hilmer, Sarah N

    2010-01-01

    AIMS Lean body weight (LBW) decreases with age while total body fat increases, altering drug pharmacokinetics. The aim of this study was to evaluate the ability of the LBW equation to predict dual-energy X-ray absorptiometry (DXA)-derived fat free mass (FFMDXA) in older community-dwelling males compared with that of two existing FFM equations: the Heitmann and Deurenberg equations. METHODS Data were obtained from 1655 older men enrolled in the Concord Health and Ageing in Men Project. The predictive performance of the LBW and FFM equations to predict FFMDXA accurately was assessed graphically using Bland–Altman plots and quantitatively for precision and bias using the method of Sheiner and Beal in all participants and in frailty and body mass index (BMI) subgroups. RESULTS The LBW and Heitmann equations consistently overestimated FFMDXA for all frailty and BMI subgroups with a mean difference [95% confidence interval (CI)] of 5.5 kg (−0.65, 11.63 kg) and 3.34 kg (−2.84, 9.64 kg), respectively. The Deurenberg equation overestimated FFMDXA for overweight participants but underestimated FFMDXA for not-frail participants, with a mean difference (95% CI) of 1 kg (−7.23, 5.25 kg) for all participants. CONCLUSION LBW and FFM estimated using these equations give results comparable to DXA-derived FFM. The LBW and Heitmann equations provide a more consistent estimate of FFMDXA in all frailty and BMI groups despite the Deurenberg equation having the smallest mean difference. Further studies to determine whether the LBW equation is a clinically useful substitute for weight when determining drug dose in older people appear warranted. PMID:20233174

  16. Sexual Activity and Satisfaction in Healthy Community-dwelling Older Women

    PubMed Central

    Trompeter, Susan E.; Bettencourt, Ricki; Barrett-Connor, Elizabeth

    2011-01-01

    BACKGROUND Female sexual dysfunction is a focus of medical research but few studies describe the prevalence and covariates of recent sexual activity and satisfaction in older community-dwelling women. METHODS 1303 older women from the Rancho Bernardo Study were mailed a questionnaire on general health, recent sexual activity, sexual satisfaction, and the Female Sexual Function Index (FSFI). RESULTS 806 of 921 respondents (87.5%) age ≥40 years answered questions about recent sexual activity. Their median age was 67; mean years since menopause, 25; most were upper-middle class; 57% had attended at least one year of college; 90% reported good to excellent health. Half (49.8%) reported sexual activity within the past month with or without a partner, the majority of whom reported arousal (64.5%), lubrication (69%), and orgasm (67.1%) at least most of the time, although one-third reported low, very low, or no sexual desire. Although frequency of arousal, lubrication, and orgasm decrease with age, the youngest (<55 yrs) and oldest (>80 yrs) women reported a higher frequency of orgasm satisfaction. Emotional closeness during sex was associated with more frequent arousal, lubrication, and orgasm; estrogen therapy was not. Overall, two-thirds of sexually active women were moderately or very satisfied with their sex life, as were almost half of sexually inactive women. CONCLUSION Half these women were sexually active, with arousal, lubrication, and orgasm maintained into old age, despite low libido in one-third. Sexual satisfaction increased with age and did not require sexual activity. PMID:22195529

  17. Objective but not subjective sleep predicts memory in community-dwelling older adults.

    PubMed

    Cavuoto, Marina G; Ong, Ben; Pike, Kerryn E; Nicholas, Christian L; Bei, Bei; Kinsella, Glynda J

    2016-08-01

    Research on the relationship between habitual sleep patterns and memory performance in older adults is limited. No previous study has used objective and subjective memory measures in a large, older-aged sample to examine the association between sleep and various domains of memory. The aim of this study was to examine the association between objective and subjective measures of sleep with memory performance in older adults, controlling for the effects of potential confounds. One-hundred and seventy-three community-dwelling older adults aged 65-89 years in Victoria, Australia completed the study. Objective sleep quality and length were ascertained using the Actiwatch 2 Mini-Mitter, while subjective sleep was measured using the Pittsburgh Sleep Quality Index. Memory was indexed by tests of retrospective memory (Hopkins Verbal Learning Test - Revised), working memory (n-back, 2-back accuracy) and prospective memory (a habitual button pressing task). Compared with normative data, overall performance on retrospective memory function was within the average range. Hierarchical regression was used to determine whether objective or subjective measures of sleep predicted memory performances after controlling for demographics, health and mood. After controlling for confounds, actigraphic sleep indices (greater wake after sleep onset, longer sleep-onset latency and longer total sleep time) predicted poorer retrospective (∆R(2)  = 0.05, P = 0.016) and working memory (∆R(2)  = 0.05, P = 0.047). In contrast, subjective sleep indices did not significantly predict memory performances. In community-based older adults, objectively-measured, habitual sleep indices predict poorer memory performances. It will be important to follow the sample longitudinally to determine trajectories of change over time. PMID:26868539

  18. Systematic review of EASY-care needs assessment for community-dwelling older people

    PubMed Central

    Craig, Christopher; Chadborn, Neil; Sands, Gina; Tuomainen, Helena; Gladman, John

    2015-01-01

    Background: undertaking comprehensive geriatric assessments (CGAs) combined with long-term health and social care management can improve the quality of life of older people [ 1]. The EASY-Care tool is a CGA instrument designed for assessing the physical, mental and social functioning and unmet health and social needs of older people in community settings or primary care. It has also been used as a frailty assessment tool and for gathering population-level data. Objective: to review the evidence of reliability, validity and acceptability of EASY-Care and its appropriateness for assessing the needs of community-dwelling older people. Methods: systematic search of literature databases using pre-defined search terms (January 1994—May 2014) for English language articles reporting on the reliability, validity, acceptability and implementation of EASY-Care in primary care and community settings. Eligible articles were critically reviewed. Discussion papers mapping professionals' use of the tool were also included as these could be considered an aspect of validity. Results: twenty-nine papers met the inclusion criteria and underwent data extraction. A narrative synthesis was performed, because there was a variety of quantitative and qualitative outcomes and characteristics. Reliability evidence for EASY-Care is minimal. Evidence for validity is good, and it has received numerous positive endorsements of acceptability in international settings from older people and practitioners. Conclusion: evidence supports the use of EASY-Care for individual needs assessment; further research is needed for other uses. Of the papers that made statements about who should administer EASY-Care, the majority indicated that nurses were preferable to self-completion. PMID:25911539

  19. The Prevalence of Medical Conditions Among U.S. Chinese Community-Dwelling Older Adults

    PubMed Central

    Chen, Ruijia; Simon, Melissa A.

    2014-01-01

    Background. The burden of medical conditions is increasing among U.S. older adults, yet we have very limited knowledge about medical conditions among Chinese older adults in the United States. This study aimed to examine the prevalence of medical conditions and its sociodemographic and health-related correlates within the context of a population-based cohort study of U.S. Chinese older adults. Method. Using a community-based participatory research approach, community-dwelling Chinese older adults aged 60 years and older in the Greater Chicago area were interviewed between 2011 and 2013. Results. Of the 3,159 participants interviewed, 58.9% were female and the mean age was 72.8 years. In total, 84.3% of older adults had one or more medical condition, 24.6% reported two conditions, 19.5% had three conditions, and 17.0% reported four or more conditions. A sizeable percentage of older adults had never been screened for dyslipidemia (24.4%) or had never been screened for diabetes mellitus (35.7%).For those who reported high cholesterol, 73.0% were taking medications when compared with 76.1% of those who reported having diabetes and 88.3% of those who reported having high blood pressure. Various sociodemographic and health-related characteristics were correlated with medical conditions. Conclusion. Medical conditions were common among U.S. Chinese older adults, yet screening and treatment rates were fairly low. Future longitudinal studies should be conducted to better understand the risk and protective factors associated with medical conditions. PMID:25378445

  20. Correlates of excessive daytime sleepiness in community-dwelling older adults: an exploratory study.

    PubMed

    Lima, Camila Astolphi; Soares, Wuber Jefferson de Souza; Bilton, Tereza Loffredo; Dias, Rosângela Corrêa; Ferrioll, Eduardo; Perracini, Monica Rodrigues

    2015-01-01

    Excessive daytime sleepiness (EDS) imposes a wide range of adverse health-related outcomes in older people, such as disability, which impair everyday activities and may increase the risk of fall. Few studies have explored EDS in Brazilian older people living in the community who are typically cared in primary health services. This study aims to investigate the prevalence of EDS and its sociodemographic, physical and mental health correlates among community-dwelling older adults. This is an exploratory, population-based study derived from Frailty in Brazilian Older Adults (FIBRA) study including adults aged 65 years and older. Participants with a score ≥ 11 points on the Epworth Sleepiness Scale were considered as having excessive daytime sleepiness. A structured, multidimensional questionnaire was used to investigate sociodemographic, physical and mental health, and self-rated health variables. The sample was composed of 776 older adults, of whom 21% (n = 162) presented excessive daytime sleepiness. Multivariate regression analysis revealed that EDS is associated with obesity (OR = 1.50; 95%CI 1.02 - 2.20), urinary incontinence (OR = 1.53; 95%CI 1.01 - 2.31), poor self-rated health (OR = 1.54; 95%CI 1.06 - 2.24), and depression symptoms (OR = 1.49; 95%CI 1.00 - 2.20). Our results suggest that healthcare professionals should identify older adults with EDS and implement intervention strategies to minimize the negative impact of the co-occurrence of this condition with obesity, depression and urinary incontinence over health and quality of life.

  1. Weight loss and rapid cognitive decline in community-dwelling patients with Alzheimer's disease.

    PubMed

    Soto, Maria E; Secher, Marion; Gillette-Guyonnet, Sophie; Abellan van Kan, Gabor; Andrieu, Sandrine; Nourhashemi, Fati; Rolland, Yves; Vellas, Bruno

    2012-01-01

    Weight loss is a frequent complication of Alzheimer's disease (AD) and a strong predictor of adverse outcomes in patients suffering from this disease. The aim of this study was to determine whether weight loss was a predictor of rapid cognitive decline (RCD) in AD. Four hundred fourteen community-dwelling ambulatory patients with a diagnosis of probable AD and a Mini-Mental State Examination (MMSE) score between 10 and 26 from the REAL.FR (REseau sur la maladie d'ALzheimer FRançais) cohort were studied and followed up during 4 years. Patients were classified in 2 groups according to weight loss defined by a loss of 4% or more during the first year of follow-up. RCD was defined as the loss of 3 points or more in MMSE over 6 months. The incidence of RCD was determined among both groups over the last 3 years of follow-up. MMSE, Katz's Activity of Daily Living scale, Mini-Nutritional Assessment scale, co-morbidities, behavioral and psychological symptoms of dementia, medication, level of education, living arrangement, and caregiver's burden were assessed every 6 months. Eighty-seven patients (21.0%) lost 4% or more of their initial weight during the first year. The incidence of RCD for all patients was 57.6 (95% confidence interval (CI) = 51.6-64.8) per 100 person-year (median follow-up of 15.1 months). In Cox proportional hazards models, after controlling for potential confounders, weight loss was a significant predictor factor of RCD (adjusted hazard ratio (HR) = 1.50, 95% CI = 1.04-2.17). In conclusion, weight loss predicted RCD in this cohort. Whether the prevention of weight loss (by improving nutritional status) impacts cognitive decline remains an open question.

  2. Obstructive Sleep Apnea in Obese Community-Dwelling Children: The NANOS Study

    PubMed Central

    Alonso-Álvarez, María Luz; Cordero-Guevara, José Aurelio; Terán-Santos, Joaquin; Gonzalez-Martinez, Mónica; Jurado-Luque, María José; Corral-Peñafiel, Jaime; Duran-Cantolla, Joaquin; Kheirandish-Gozal, Leila; Gozal, David

    2014-01-01

    Introduction: Obesity in children is assumed to serve as a major risk factor in pediatric obstructive sleep apnea syndrome (OSAS). However, the prevalence of OSAS in otherwise healthy obese children from the community is unknown. Aim: To determine the prevalence of OSAS in obese children identified and recruited from primary care centers. Methods: A cross-sectional, prospective, multicenter study. Spanish children ages 3–14 y with a body mass index (BMI) greater than or equal to the 95th percentile for age and sex were randomly selected, and underwent medical history, snoring, and Pediatric Sleep Questionnaire (PSQ) assessments, as well as physical examination, nasopharyngoscopy, and nocturnal polysomnography (NPSG) recordings. Results: Two hundred forty-eight children (54.4% males) with mean age of 10.8 ± 2.6 y were studied with a BMI of 28.0 ± 4.7 kg/m2 corresponding to 96.8 ± 0.6 percentile when adjusted for age and sex. The mean respiratory disturbance index (RDI), obstructive RDI (ORDI), and obstructive apnea-hypopnea index (OAHI) were 5.58 ± 9.90, 5.06 ± 9.57, and 3.39 ± 8.78/h total sleep time (TST), respectively. Using ≥ 3/h TST as the cutoff for the presence of OSAS, the prevalence of OSAS ranged from 21.5% to 39.5% depending on whether OAHI, ORDI, or RDI were used. Conclusions: The prevalence of obstructive sleep apnea syndrome (OSAS) in obese children from the general population is high. Obese children should be screened for the presence of OSAS. ClinicalTrials.gov Identifier: NCT01322763. Citation: Alonso-Álvarez ML, Cordero-Guevara JA, Terán-Santos J, Gonzalez-Martinez M, Jurado-Luque MJ, Corral-Peñafiel J, Duran-Cantolla J, Kheirandish-Gozal L, Gozal D, for the Spanish Sleep Network. Obstructive sleep apnea in obese community-dwelling children: the NANOS study. SLEEP 2014;37(5):943-949. PMID:24790273

  3. Depressive Symptoms and Subjective And Objective Sleep In Community-Dwelling Older Women

    PubMed Central

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

    2012-01-01

    Objectives To examine the relationship between depressive symptoms and subjective and objective sleep in older women. Design Cross-sectional. Setting Four US clinical centers. Participants 3045 community-dwelling women ≥70 years. Measurements Depressive symptoms were assessed with the Geriatric Depression Scale categorizing participants as “normal” (0–2, referent), “some depressive symptoms” (3–5), or “depressed” (≥6). Subjective sleep quality and daytime sleepiness were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Objective sleep measures were assessed with wrist actigraphy. Results In multivariable-adjusted models, there were graded associations between increased level of depressive symptoms and both worse subjective sleep quality and more subjective daytime sleepiness (p-trends <0.001). Women with some depressive symptoms (OR 1.82, CI 1.48–2.24) and depressed (OR 2.84, CI 2.08–3.86) women had greater odds of reporting poor sleep (PSQI>5). Women with some depressive symptoms (OR 1.97, CI 1.47–2.64) and depressed women (OR 1.70, CI 1.12–2.58) had greater odds of reporting excessive daytime sleepiness (ESS>10). There were also graded associations between increased level of depressive symptoms and objectively measured wake after sleep onset (WASO) (p-trend = 0.030) and long wake episodes >5 minutes (p-trend 0.006). Depressed women had modestly increased odds of WASO ≥1 hour (OR 1.37, CI 1.03–1.83). Women with some depressive symptoms (OR 1.49, CI 1.19–1.86) and depressed women (OR 2.04, CI 1.52–2.74) had greater odds of being in the highest quartile for number of nap episodes >5 minutes. No associations between depressive symptom level and prolonged sleep latency, reduced sleep efficiency, or reduced or increased total sleep time were found. Conclusion Greater depressive symptom levels were associated with more subjective sleep disturbance and objective evidence of sleep

  4. Fall-Related Psychological Concerns and Anxiety among Community-Dwelling Older Adults: Systematic Review and Meta-Analysis

    PubMed Central

    Payette, Marie-Christine; Bélanger, Claude; Léveillé, Vanessa; Grenier, Sébastien

    2016-01-01

    Fear of falling and other fall-related psychological concerns (FRPCs), such as falls-efficacy and balance confidence, are highly prevalent among community-dwelling older adults. Anxiety and FRPCs have frequently, but inconsistently, been found to be associated in the literature. The purpose of this study is to clarify those inconsistencies with a systematic review and meta-analysis and to evaluate if the strength of this relationship varies based on the different FRPC constructs used (e.g., fear of falling, falls-efficacy or balance confidence). A systematic review was conducted through multiple databases (e.g., MEDLINE, PsycINFO) to include all articles published before June 10th 2015 that measured anxiety and FRPCs in community-dwelling older adults. Active researchers in the field were also contacted in an effort to include unpublished studies. The systematic review led to the inclusion of twenty relevant articles (n = 4738). A random-effect meta-analysis revealed that the mean effect size for fear of falling and anxiety is r = 0.32 (95% CI: 0.22–0.40), Z = 6.49, p < 0.001 and the mean effect size for falls-efficacy or balance confidence and anxiety is r = 0.31 (95% CI: 0.23–0.40), Z = 6.72, p < 0.001. A Q-test for heterogeneity revealed that the two effect sizes are not significantly different (Q(19) = 0.13, p = n.s.). This study is the first meta-analysis on the relationship between anxiety and FRPCs among community-dwelling older adults. It demonstrates the importance of considering anxiety when treating older adults with FRPCs. PMID:27043139

  5. Feasibility of repeated self-measurements of maximum step length and gait speed by community-dwelling older persons

    PubMed Central

    Bongers, Kim T J; Schoon, Yvonne; Olde Rikkert, Marcel G M

    2016-01-01

    Objectives Self-management of mobility and fall risk can be important in fall prevention; however, it remains unstudied. Therefore, the current study assessed whether community-dwelling older persons were able to repeatedly self-assess maximum step length (MSL) and gait speed (GS) in their own home for a 6-month period, how these tests changed during this period and if these changes were related to falling. Design This is a prospective study. Setting This study was conducted at home. Participants A total of 56 community-dwelling older adults (24 women (43%), mean age 76.2 (SD 3.9) years) entered the study; of which, 45 completed the study. Methods Participants performed MSL and GS once a week in their own home during a 6-month period. Primary and secondary outcomes Repeated MSL and GS measurements were the primary outcomes. Falls, self-management and mobility were the secondary outcomes. Results Self-assessment of MSL and GS by older persons is feasible. Compliance of repeatedly self-measuring MSL and GS was good; the median number of weekly measurements was 23.0 (88%) and 21.0 (81%) for MSL and GS, respectively. Drop-outs showed less self-management abilities compared to the participants who completed the study (p=0.049). Linear mixed models showed a small significant improvement in MSL and GS over time (p<0.001), without an influence on falling. Conclusions Most community-dwelling older persons are able and willing to repeatedly assess their MSL and GS. Self-managing mobility and fall risk did not increase fall occurrence. The fact that older persons can be actively involved in their own healthcare is clinically relevant. Further studies are needed to examine the (cost-)effectiveness of self-management in fall prevention interventions. PMID:27496235

  6. Effects of substituting a portion of standard physiotherapy time with virtual reality games among community-dwelling stroke survivors

    PubMed Central

    2013-01-01

    Background Evidence indicates that the continuation of therapy among community-dwelling stroke survivors improves physical function. Community rehabilitation programmes often face limitations in terms of resources. It is imperative to include new motivational interventions to encourage some level of non-clinician management. The aim of this study was to determine whether there were any changes in physical function and activities of daily living when substituting a portion of the standard physiotherapy time with virtual reality games among community-dwelling stroke survivors. Methods In this controlled trial, the experimental group received 30 minutes of virtual reality balance games in addition to 90 minutes of standard physiotherapy. The control group continued with their two hours of routine standard physiotherapy. Both groups received 12 therapy sessions: two-hour sessions twice per week for six continuous weeks. Changes in physical function, activities of daily living and balance ability were assessed using the Timed Up and Go test, 30-second Sit to Stand test, Timed Ten-Metre Walk test, Six-Minute Walk test and the Barthel Index, and static balance was assessed using a probalance board. Results Twenty-eight participants completed post-intervention assessments. The results showed a significant within-subject effect on the Timed Up and Go test: F (1, 26) = 5.83, p = 0.02; and the 30-second Sit to Stand test; F (1, 26) = 13.50, p = 0.001. The between-subject effect was not significant (p > 0.05) for any of the outcome measurements. Conclusion Substituting a portion of the standard physiotherapy time with virtual reality games was equally effective in maintaining physical function outcomes and activities of daily living among community-dwelling stroke survivors. Trial Registration Australia and New Zealand Clinical Trials Register, ACTRN12613000478718 PMID:24330250

  7. Exercise and social support are associated with psychological distress outcomes in a population of community-dwelling older adults.

    PubMed

    McHugh, Joanna E; Lawlor, Brian A

    2012-09-01

    Exercise reduces the likelihood of psychological distress, but this may be due to incidental socializing. We gathered information on exercise, social support and three aspects of psychological distress from 583 community-dwelling older adults. Exercise and social support from friends were both associated with lower scores of depression, anxiety and perceived stress. For infrequent exercisers, having a low level of social support indicated higher levels of depression, whereas for frequent exercisers, having a low level of social support did not affect depression levels. Both exercise and social support have roles in regulating psychological well-being in older populations and exercisers are less susceptible to effects of low social support on depression.

  8. Learning Needs and Activity Limitations of Elderly Japanese with Physical Disabilities.

    ERIC Educational Resources Information Center

    Hori, Shigeo; Fujiwara, Mizuho

    2003-01-01

    A survey of 364 Japanese adults over 60 with physical disabilities found that 87% have learning needs in the areas of health care, communication, and leisure activities. Instrumental/social learning ranked higher among those with serious activity limitations. Expressive/communicative learning was more important for those with moderate limitations.…

  9. [Longitudinal change in independence in the elderly--Kahoku Longitudinal Aging Study (KLAS)].

    PubMed

    Matsubayashi, K; Okumiya, K; Kawamoto, A; Kimura, S; Wada, T; Fujisawa, M; Doi, Y; Shimada, K; Ozawa, T

    1994-10-01

    A community based study named Kahoku Longitudinal Aging Study (KLAS) was conducted since 1990 for the purpose of evaluating the comprehensive geriatric functional assessment (CGA) and preventing a decline in CGA in the community-dwelling elderly population. It was carried out in a Japanese rural town, in which 32% of the population was over 65 years of age. This study included a questionnaire about activity of daily living (ADL), information-related physical function, mental (cognitive and affective) and social functional domains. In addition to subjective informative instruments, various types of objective assessment such as quantitative neuro-behavioral function tests and medical examinations were performed. Subjects were all the eligible elderly aged over 65 years in the community. Although the ratio of subjects who were independent in ADL decreased with advancing age in both 1991 and 1993, the ratio of the independent elderly in ADL became significant higher (74%) in 1993 than in 1991 (71%). Scores on 2 kinds of neurobehavioral function tests in the 159 subjects aged over 75 years who attended the examination every year showed a significant and slight decrease during two years. However, some test indices significantly improved during the 2 years. These results suggested that age-related dependency in ADL and some kind of neurobehavioral functions might be prevented, in part, by health promoting education and improvement of life style. PMID:7853739

  10. Comparisons of social interaction and activities of daily living between long-term care facility and community-dwelling stroke patients.

    PubMed

    Yoon, Jeong-Ae; Park, Se-Gwan; Roh, Hyo-Lyun

    2015-10-01

    [Purpose] This study was conducted to compare the correlation between social interaction and activities of daily living (ADL) between community-dwelling and long-term care facility stroke patients. [Subjects and Methods] The Subjects were 65 chronic stroke patients (32 facility-residing, 33 community-dwelling). The Evaluation Social Interaction (ESI) tool was used to evaluate social interaction and the Assessment of Motor and Process Skills (AMPS) measure was used to evaluate ADL. [Results] Both social interaction and ADL were higher in community-dwelling than facility-residing stroke patients. There was a correlation between ESI and ADL for both motor and process skills among facility-residing patients, while only ADL process skills and ESI correlated among community-dwelling patients. In a partial correlation analysis using ADL motor and process skills as control variables, only process skills correlated with ESI. [Conclusion] For rehabilitation of stroke patients, an extended treatment process that combines ADL and social activities is likely to be required. Furthermore, treatment programs and institutional systems that can improve social interaction and promote health maintenance for community-dwelling and facility-residing chronic stroke patients are needed throughout the rehabilitation process.

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  12. Factors associated with the 6-minute walk test in nursing home residents and community-dwelling older adults

    PubMed Central

    Caballer, Vicent-Benavent; Lisón, Juan Francisco; Rosado-Calatayud, Pedro; Amer-Cuenca, Juan José; Segura-Orti, Eva

    2015-01-01

    [Purpose] The main objective of this study was to determine the contributions and extent to which certain physical measurements explain performance in the 6-minute walk test in healthy older adults living in a geriatric nursing home and for older adults dwelling in the community. [Subjects] The subjects were 122 adults aged 65 and older with no cognitive impairment who were independent in their daily activities. [Methods] The 6-minute walk test, age, body mass index, walking speed, chair stand test, Berg Balance Scale, Timed Up-and-Go test, rectus femoris cross-sectional area, Short Physical Performance Battery, and hand-grip strength were examined. [Results] Strong significant associations were found between mobility, lower-limb function, balance, and the 6-minute walk test. A stepwise multiple regression on the entire sample showed that lower-limb function was a significant and independent predictor for the 6-minute walk test. Additionally, lower-limb function was a strong predictor for the 6-minute walk test in our nursing home group, whereas mobility was found to be the best predictor in our community-dwelling group. [Conclusion] Better lower-limb function, balance, and mobility result in a higher distance covered by healthy older adults. Lower-limb function and mobility appeared to best determine walking performance in the nursing home and community-dwelling groups, respectively. PMID:26696740

  13. Long-term use of benzodiazepines and related drugs among community-dwelling individuals with and without Alzheimer's disease.

    PubMed

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

    2015-07-01

    The aim of this study was to investigate the prevalence of benzodiazepine and related drug (BZDR) use, especially long-term use, and associated factors among community-dwelling individuals with and without Alzheimer's disease (AD). We utilized data from the MEDALZ-2005 cohort, which includes all community-dwelling individuals diagnosed with AD in Finland at the end of 2005 and matched comparison individuals without AD. Register-based data included prescription drug purchases, comorbidities, and hospital discharge diagnoses. In this study, 24,966 individuals with AD and 24,985 individuals without AD were included. During the 4-year follow-up, we found that 45% (N = 11,312) of individuals with AD and 38% (N = 9534) of individuals without AD used BZDRs. The prevalence of long-term (≥ 180 days) BZDR use was more common among individuals with AD (30%) than individuals without AD (26%). The median durations of the first long-term use periods of BZDRs were 1.5 and 2 years for individuals with and without AD, respectively. Factors associated with long-term BZDR use included female sex, AD, schizophrenia, bipolar disorder, depression, coronary artery disease, and asthma/chronic obstructive pulmonary disease. The high prevalence of long-term BZDR use among individuals with AD is especially a cause for concern because long-term use may further impair cognition and may be associated with serious adverse events. PMID:26011780

  14. About Cats and Dogs...Reconsidering the Relationship between Pet Ownership and Health Related Outcomes in Community-Dwelling Elderly

    ERIC Educational Resources Information Center

    Rijken, Mieke; van Beek, Sandra

    2011-01-01

    Having a pet has been claimed to have beneficial health effects, but methodologically sound empirical studies are scarce. Small sample sizes and a lack of information about the specific type of pets involved make it difficult to draw unambiguous conclusions. We aimed to shed light on the relationship between pet ownership and several health…

  15. Relationships among hearing loss, cognition and balance ability in community-dwelling older adults

    PubMed Central

    Koh, Da Hyun; Lee, Jong Dae; Lee, Hee Joong

    2015-01-01

    [Purpose] The purpose of this study was to determine the relationships among hearing loss, cognition, and balance ability in elderly individuals. [Subjects and Methods] In total, 46 elderly individuals over 65 years of age who were attending senior welfare centers participated in this study. Through a hearing test, the speech frequency pure tone average in the better ear was checked. We set a criterion of hearing loss if the better ear hearing level (BEHL) value was 25 dB or more. Cognition ability was evaluated using the Korean mini-mental state examination (K-MMSE). Dynamic balance ability was evaluated by the timed up and go (TUG) test, and static balance ability was tested using a one-leg stance test (OLST). [Results] The ages of the subjects were all related to BEHL, TUG, K-MMSE, and OLST. BEHL had a negative correlation with OLST, whereas it had no correlation with K-MMSE or TUG. The hearing loss group had a significantly shorter OLST time than the normal hearing group. [Conclusion] As elderly individuals get older, their hearing and cognition, as well as their balance abilities deteriorate. The results of this study indicate there is a significant correlation between hearing loss and static balance. PMID:26157259

  16. Seasonal variation in the acute effects of ozone on premature mortality among elderly Japanese.

    PubMed

    Ng, Chris Fook Sheng; Ueda, Kayo; Nitta, Hiroshi; Takeuchi, Ayano

    2013-10-01

    We conducted a multicity time-series study using monitoring data to assess seasonal patterns of short-term ozone-mortality association among elderly aged 65 years and over in Japan. Daily exposure to ambient ozone was computed using hourly measurements of photochemical oxidants available at multiple monitoring stations in each city. Effects of ozone on daily all-cause non-accidental, cardiovascular, and respiratory mortality were estimated using distributed lag linear models, controlling for confounding by temporal, day of the week, temperature, and flu epidemics. City-level effect estimates were combined using inverse variance meta-analysis. In spring and autumn, a 10-ppbv increase of daily maximum 8-h average ozone concentration in the previous 3 days was associated with 0.69 % (95 % confidence interval (CI): 0.27-1.10), 1.07 % (0.34-1.82), and 1.77 % (0.78-2.77) increases in daily all-cause, cardiovascular, and respiratory mortality, respectively. Forward displacement of respiratory mortality was large during the cold season despite lower ozone concentration. Results were generally independent of fine particulate matter and nitrogen dioxide. Findings suggest significant mortality effects of short-term ozone exposure among the elderly during the moderate season. Those with underlying respiratory diseases were susceptible, even during winter.

  17. Comparison of consumer derived evidence with an omaha system evidence-based practice guideline for community dwelling older adults.

    PubMed

    Pruinelli, Lisiane; Fu, Helen; Monsen, Karen A; Westra, Bonnie L

    2014-01-01

    Consumer involvement in healthcare is critical to support continuity of care for consumers to manage their health while transitioning from one care setting to another. Validation of evidence-based practice (EBP) guideline by consumers is essential to achieving consumer health goals over time that is consistent with their needs and preferences. The purpose of this study was to compare an Omaha System EBP guideline for community dwelling older adults with consumer-derived evidence of their ongoing needs, resources, and strategies after home care discharge. All identified problems were relevant for all patients except for Neglect and Substance use. Ten additional problems were identified from the interviews, five of which affected at least 10% of the participants. Consumer derived evidence both validated and expanded EBP guidelines; thus further emphasizing the importance of consumer involvement in the delivery of home healthcare.

  18. Contribution of Head Position, Standing Surface, and Vision to Postural Control in Community-Dwelling Older Adults.

    PubMed

    Pociask, Fredrick D; DiZazzo-Miller, Rosanne; Goldberg, Allon; Adamo, Diane E

    2016-01-01

    Postural control requires the integration of sensorimotor information to maintain balance and to properly position and orient the body in response to external stimuli. Age-related declines in peripheral and central sensory and motor function contribute to postural instability and falls. This study investigated the contribution of head position, standing surface, and vision on postural sway in 26 community-dwelling older adults. Participants were asked to maintain a stable posture under conditions that varied standing surface, head position, and the availability of visual information. Significant main and interaction effects were found for all three factors. Findings from this study suggest that postural sway responses require the integration of available sources of sensory information. These results have important implications for fall risks in older adults and suggest that when standing with the head extended and eyes closed, older adults may place themselves at risk for postural disequilibrium and loss of balance. PMID:26709429

  19. Contribution of Head Position, Standing Surface, and Vision to Postural Control in Community-Dwelling Older Adults.

    PubMed

    Pociask, Fredrick D; DiZazzo-Miller, Rosanne; Goldberg, Allon; Adamo, Diane E

    2016-01-01

    Postural control requires the integration of sensorimotor information to maintain balance and to properly position and orient the body in response to external stimuli. Age-related declines in peripheral and central sensory and motor function contribute to postural instability and falls. This study investigated the contribution of head position, standing surface, and vision on postural sway in 26 community-dwelling older adults. Participants were asked to maintain a stable posture under conditions that varied standing surface, head position, and the availability of visual information. Significant main and interaction effects were found for all three factors. Findings from this study suggest that postural sway responses require the integration of available sources of sensory information. These results have important implications for fall risks in older adults and suggest that when standing with the head extended and eyes closed, older adults may place themselves at risk for postural disequilibrium and loss of balance.

  20. Vision and agility training in community dwelling older adults: incorporating visual training into programs for fall prevention.

    PubMed

    Reed-Jones, Rebecca J; Dorgo, Sandor; Hitchings, Maija K; Bader, Julia O

    2012-04-01

    This study aimed to examine the effect of visual training on obstacle course performance of independent community dwelling older adults. Agility is the ability to rapidly alter ongoing motor patterns, an important aspect of mobility which is required in obstacle avoidance. However, visual information is also a critical factor in successful obstacle avoidance. We compared obstacle course performance of a group that trained in visually driven body movements and agility drills, to a group that trained only in agility drills. We also included a control group that followed the American College of Sports Medicine exercise recommendations for older adults. Significant gains in fitness, mobility and power were observed across all training groups. Obstacle course performance results revealed that visual training had the greatest improvement on obstacle course performance (22%) following a 12 week training program. These results suggest that visual training may be an important consideration for fall prevention programs.

  1. Mild Clinical Course of Severe Fever with Thrombocytopenia Syndrome Virus Infection in an Elderly Japanese Patient

    PubMed Central

    Ohagi, Yuko; Nakamoto, Chiaki; Nakamoto, Hiromichi; Saijo, Masayuki; Shimojima, Masayuki; Nakano, Yoshio; Fujimoto, Tokuzo

    2014-01-01

    Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious and hemorrhagic disease recently described in China and western Japan. A 71-year-old healthy Japanese woman noticed a tick biting her after harvesting in an orchard and removed it herself. She developed diarrhea, anorexia, and chills eight days later. Because these symptoms continued, she visited a primary care physician 6 days after the onset. Laboratory data revealed thrombocytopenia, leukocytopenia, and elevated liver enzymes. She was then referred to our hospital. Although not completely fulfilling the diagnostic criteria used in a retrospective study in Japan, SFTS was suspected, and we detected SFTS virus in the patient's blood using RT-PCR. However, she recovered without intensive treatment and severe complications 13 days after the onset. In this report, we present a mild clinical course of SFTS virus infection in Japan in detail. PMID:25574405

  2. Associations Between Observed In-Home Behaviors and Self-Reported Low Mood in Community-Dwelling Older Adults

    PubMed Central

    Thielke, Stephen M.; Mattek, Nora C.; Hayes, Tamara L.; Dodge, Hiroko H.; Quiñones, Ana R.; Austin, Daniel; Petersen, Johanna; Kaye, Jeffrey A.

    2014-01-01

    Objective Using novel monitoring technologies, we sought to ascertain the association between self-report of low mood and unobtrusively measured behaviors (walking speed, time out of residence, frequency of room transitions, and computer use) in community-dwelling older adults. Design Longitudinal cohort study of older adults whose homes were outfitted with activity sensors. The participants completed internet-based weekly health questionnaires with questions about mood. Setting Apartments and homes of older adults living in the Portland, Oregon metropolitan area. Participants 157 adults, average age 84, followed for an average of 3.7 years. Measurements Mood was assessed by self-report each week. Walking speed, time spent out of residence, and room transitions were estimated using data from sensors; computer use was measured by timing actual use. We ascertained the association between global or weekly low mood and the four behavior measures, adjusting for baseline characteristics. Results 18,960 weekly observations of mood were analyzed; 2.6% involved low mood. Individuals who reported low mood more often showed no average differences in any behavior parameters compared to those who reported low mood less often. During weeks when they reported low mood, participants spent significantly less time out of residence and on the computer, but showed no change in walking speed or room transitions. Conclusion Low mood in these community-dwelling older adults involved going out of the house less and using the computer less, but no consistent changes in movements. Technologies to monitor in-home behavior may have potential for research and clinical care. PMID:24635020

  3. Factors Associated with Fear of Falling among Community-Dwelling Older Adults in the Shih-Pai Study in Taiwan

    PubMed Central

    Chang, Hsiao-Ting; Chen, Hsi-Chung; Chou, Pesus

    2016-01-01

    Background Fear of falling is an important risk indicator for adverse health related outcomes in older adults. However, factors associated with fear of falling among community-dwelling older adults are not well-explored. Objectives To explore the quality of life and associated factors in fear of falling among older people in the Shih-Pai area in Taiwan. Methods This community-based survey recruited three thousand eight hundred and twenty-four older adults aged ≥ 65 years. The measurements included a structured questionnaire, including quality of life by using Short-Form 36, and information of fear of falling, fall history, demographics, medical conditions, insomnia, sleep quality, depression and subjective health through face-to-face interviews. Results A total of 53.4% of participants reported a fear of falling. The rate of fear of falling was higher in female subjects. Subjects with fear of falling had lower Short Form-36 scores both for men and women. Falls in the previous year, older age, insomnia, depression and worse subjective health were correlates of fear of falling for both sexes. Male-specific associations with fear of falling were the accessibility of medical help in an emergency, diabetes mellitus and stroke. In parallel, cardiovascular diseases were a female-specific correlate for fear of falling. Conclusions Fear of falling is prevalent among community-dwelling older adults. It is seems that there are gender differences in fear of falling with respect to the prevalence and associated factors in older adults. Gender differences should be considered when planning prevention and intervention strategies for fear of falling among older people. PMID:26933882

  4. Associations between vitamin K status and hemostatic and inflammatory biomarkers in community-dwelling adults: The multi-ethnic study of atherosclerosis

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Vitamin K is integral to hemostatic function, and in vitro and animal experiments suggest that vitamin K can suppress production of inflammatory cytokines. To test the hypothesis that higher vitamin K status is associated with lower hemostasic activation and inflammation in community-dwelling adults...

  5. The Longitudinal Elderly Person Shadowing Program: Outcomes from an Interprofessional Senior Partner Mentoring Program

    ERIC Educational Resources Information Center

    Basran, Jenny F. S.; Dal Bello-Haas, Vanina; Walker, Doreen; MacLeod, Peggy; Allen, Bev; D'Eon, Marcel; McKague, Meredith; Chopin, Nicola S.; Trinder, Krista

    2012-01-01

    The University of Saskatchewan's Longitudinal Elderly Person Shadowing (LEPS) is an interprofessional senior mentors program (SMP) where teams of undergraduate students in their first year of medicine, pharmacy, and physiotherapy; 2nd year of nutrition; 3rd year nursing; and 4th year social work partner with community-dwelling older adults.…

  6. Predictors and Sequelae of Fractures in the Elderly: The Canadian Study of Health and Aging (CSHA)

    ERIC Educational Resources Information Center

    Ostbye, Truls; Walton, Ruth E.; Steenhuis, Runa; Hodsman, Anthony B.

    2004-01-01

    The objective of this study was to describe the incidence, type, risk factors, and sequelae of fractures experienced by community-dwelling elderly Canadians. Data are from the Canadian Study of Health and Aging (CSHA), a longitudinal cohort study, collected in three waves: baseline (1991), wave 2 (1996), and wave 3 (2001). In CSHA-2 (1996),…

  7. Health-Seeking Behaviors of Elderly Chinese Americans: Shifts in Expectations

    ERIC Educational Resources Information Center

    Pang, Elaine C.; Jordan-Marsh, Maryalice; Silverstein, Merril; Cody, Michael

    2003-01-01

    Purpose: This study reported a qualitative analysis of health-seeking behaviors of community-dwelling elderly Chinese Americans on the influences of family network, cultural values, and immigrant experience in their use of health resources. Barriers to health care, pathway of health care, and adaptation of health care by use of self-treatment and…

  8. Elder Disability as an Explanation for Racial Differences in Informal Home Care

    ERIC Educational Resources Information Center

    Li, Lydia W.; Fries, Brant E.

    2005-01-01

    Purpose: Adjusting for sociodemographic characteristics and disability levels, this study examines whether differences exist in the structure and function of community-dwelling Black and White frail elders' informal care networks. Design and Methods: Data from in-person assessments of Michigan's Home and Community-Based Medicaid Waiver applicants…

  9. IMPACT OF A SERIOUS GAME FOR HEALTH ON CHRONIC DISEASE SELF-MANAGEMENT: PRELIMINARY EFFICACY AMONG COMMUNITY DWELLING ADULTS WITH HYPERTENSION.

    PubMed

    Hickman, Ronald L; Clochesy, John M; Pinto, Melissa D; Burant, Christopher; Pignatiello, Grant

    2015-01-01

    Most Americans will acquire a chronic disease during their lifetime. One of the most prevalent chronic diseases that affect Americans is hypertension (HTN). Despite the known comorbidities and increased mortality rate associated with uncontrolled HTN, most community dwelling adults with HTN do not have sufficient blood pressure control Therefore, the aim of this article is to report the preliminary efficacy of a serious game for health to enhance blood pressure control among community dwelling adults with HTN. A nonprobability sample of 116 community dwelling adults with HTN participated in this nonblinded, randomized controlled trial. Participants were randomly assigned to: (1) an intervention arm that consisted of four exposures to a serious game for health known as eSMART-HD; or (2) an attentional control arm that compromised of four exposures to screen-based HTN education. The primary outcome measure for this trial was blood pressure reduction over a four month observational period. In this study, baseline characteristics and blood pressure measurements were similar between participants in each study arm. There was no significant between-group difference in blood pressure reduction over time. However, there were significant within-group reductions in systolic and diastolic blood pressures across time among favoring participants exposed to eSMART-HD. This study establishes the preliminary efficacy of eSMART-HD that can be easily administered to community dwelling adults and facilitate clinically significant reductions in systolic and diastolic blood pressures. Future studies should assess the influential components of this promising serious game for health (eSMART-HD) combined with medication management in larger and more diverse samples of community dwelling adults with HTN. PMID:26442364

  10. IMPACT OF A SERIOUS GAME FOR HEALTH ON CHRONIC DISEASE SELF-MANAGEMENT: PRELIMINARY EFFICACY AMONG COMMUNITY DWELLING ADULTS WITH HYPERTENSION.

    PubMed

    Hickman, Ronald L; Clochesy, John M; Pinto, Melissa D; Burant, Christopher; Pignatiello, Grant

    2015-01-01

    Most Americans will acquire a chronic disease during their lifetime. One of the most prevalent chronic diseases that affect Americans is hypertension (HTN). Despite the known comorbidities and increased mortality rate associated with uncontrolled HTN, most community dwelling adults with HTN do not have sufficient blood pressure control Therefore, the aim of this article is to report the preliminary efficacy of a serious game for health to enhance blood pressure control among community dwelling adults with HTN. A nonprobability sample of 116 community dwelling adults with HTN participated in this nonblinded, randomized controlled trial. Participants were randomly assigned to: (1) an intervention arm that consisted of four exposures to a serious game for health known as eSMART-HD; or (2) an attentional control arm that compromised of four exposures to screen-based HTN education. The primary outcome measure for this trial was blood pressure reduction over a four month observational period. In this study, baseline characteristics and blood pressure measurements were similar between participants in each study arm. There was no significant between-group difference in blood pressure reduction over time. However, there were significant within-group reductions in systolic and diastolic blood pressures across time among favoring participants exposed to eSMART-HD. This study establishes the preliminary efficacy of eSMART-HD that can be easily administered to community dwelling adults and facilitate clinically significant reductions in systolic and diastolic blood pressures. Future studies should assess the influential components of this promising serious game for health (eSMART-HD) combined with medication management in larger and more diverse samples of community dwelling adults with HTN.

  11. Comparing GFR Estimating Equations Using Cystatin C and Creatinine in Elderly Individuals

    PubMed Central

    Fan, Li; Levey, Andrew S.; Gudnason, Vilmundur; Eiriksdottir, Gudny; Andresdottir, Margret B.; Gudmundsdottir, Hrefna; Indridason, Olafur S.; Palsson, Runolfur; Mitchell, Gary

    2015-01-01

    Current guidelines recommend reporting eGFR using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations unless other equations are more accurate, and recommend the combination of creatinine and cystatin C (eGFRcr-cys) as more accurate than either eGFRcr or eGFRcys alone. However, preferred equations and filtration markers in elderly individuals are debated. In 805 adults enrolled in the community-based Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, we measured GFR (mGFR) using plasma clearance of iohexol, standardized creatinine and cystatin C, and eGFR using the CKD-EPI, Japanese, Berlin Initiative Study (BIS), and Caucasian and Asian pediatric and adult subjects (CAPA) equations. We evaluated equation performance using bias, precision, and two measures of accuracy. We first compared the Japanese, BIS, and CAPA equations with the CKD-EPI equations to determine the preferred equations, and then compared eGFRcr and eGFRcys with eGFRcr-cys using the preferred equations. Mean (SD) age was 80.3 (4.0) years. Median (25th, 75th) mGFR was 64 (52, 73) ml/min per 1.73 m2, and the prevalence of decreased GFR was 39% (95% confidence interval, 35.8 to 42.5). Among 24 comparisons with the other equations, CKD-EPI equations performed better in 9, similar in 13, and worse in 2. Using the CKD-EPI equations, eGFRcr-cys performed better than eGFRcr in four metrics, better than eGFRcys in two metrics, and similar to eGFRcys in two metrics. In conclusion, neither the Japanese, BIS, nor CAPA equations were superior to the CKD-EPI equations in this cohort of community-dwelling elderly individuals. Using the CKD-EPI equations, eGFRcr-cys performed better than eGFRcr or eGFRcys. PMID:25527647

  12. Body mass index and the risk of incident functional disability in elderly Japanese: The OHSAKI Cohort 2006 Study.

    PubMed

    Zhang, Shu; Tomata, Yasutake; Sugiyama, Kemmyo; Kaiho, Yu; Honkura, Kenji; Watanabe, Takashi; Tanji, Fumiya; Sugawara, Yumi; Tsuji, Ichiro

    2016-08-01

    The relationship between the body mass index (BMI) and the incidence of cause-specific disability remains unclear.We conducted a prospective cohort study of 12,376 Japanese individuals aged ≥65 years who were followed up for 5.7 years. Information on BMI and other lifestyle factors was collected via a questionnaire in 2006. Functional disability data were retrieved from the public Long-term Care Insurance database. BMI was divided into 6 groups (<21, 21-<23, 23-<25, 25-<27[reference], 27-<29 and ≥29). Hazard ratios and 95% confidence intervals for cause-specific disability were estimated using Cox proportional hazards regression models.A U-shaped relationship between BMI and functional disability was observed, with a nadir at 26. The nadir BMI values with the lowest disability risk were 28 for dementia, 25 for stroke, and 23 for joint disease. A low BMI (<23) was a risk factor for disability due to dementia, the HR values (95% CI) being 2.48 (1.70-3.63) for BMI <21 and 2.25 (1.54-3.27) for BMI 21 to <23; a high BMI (≥29) was a risk factor for disability due to joint disease, the HR value (95% CI) being 2.17 (1.40-3.35). There was no significant relationship between BMI and disability due to stroke.The BMI nadirs for cause-specific disability differed: a low BMI (<23) was a risk factor for disability due to dementia, and a high BMI (≥29) was a risk factor for disability due to joint disease. Because BMI values of 23 to <29 did not pose a significantly higher risk for each cause of disability, this range should be regarded as the optimal one for the elderly population. PMID:27495075

  13. Self-Reported Hindering Health Complaints of Community-Dwelling Older Persons: A Cross-Sectional Study

    PubMed Central

    van Blijswijk, Sophie C. E.; Chan, On Ying A.; van Houwelingen, Anne H.; Gussekloo, Jacobijn; den Elzen, Wendy P. J.; Blom, Jeanet W.

    2015-01-01

    Purpose Proactive care for community-dwelling older persons targeting self-reported hindering health complaints might prevent a decline in function. We investigated the spectrum of self-reported hindering complaints of community-dwelling older persons, the association with functional outcomes, and help-seeking behavior for these complaints. Methods Within the ISCOPE trial, participants (aged ≥75 years) received the ISCOPE screening questionnaire, including the open-ended question “At the moment, which health complaints limit you the most in your day-to-day life?”. After coding the answers with the ICPC-1-NL, we examined the prevalence and the association between the number and type of complaints and functional outcomes (Groningen Activities Restriction Scale, quality of life measured on Cantril’s Ladder, Mini-Mental State Examination, Geriatric Depression Scale-15, and De Jong Gierveld Loneliness Scale). Electronic patient registers were searched for the most reported complaints. Results 7285 participants (median age: 81.0 years [IQR 77.8–85.3], 38.6% males) reported 13,524 hindering complaints (median 1, range 0–18); 32.7% reported no complaints. Participants mostly reported problems with walking/standing (22.1%), pain (20.8%) or weakness/tiredness (8.5%). These complaints were mentioned in the electronic patient registers in 28.3%, 91.3% and 55.5%, respectively. Higher numbers of hindering complaints were related to poorer scores on the number of domains with problems, Cantril’s Ladder for quality of life, Groningen Activities Restriction Scale, Geriatric Depression Scale, and De Jong Gierveld Loneliness Scale. Self-reported weakness, problems with walking/standing, visual limitations, cognitive problems, dyspnea and back complaints were associated with poorer scores on the number of domains with problems, Groningen Activities Restriction Scale, MMSE or Geriatric Depression Scale. Conclusion One third of the participants reported no hindering

  14. Vitamin D and Actigraphic Sleep Outcomes in Older Community-Dwelling Men: The MrOS Sleep Study

    PubMed Central

    Massa, Jennifer; Stone, Katie L.; Wei, Esther K.; Harrison, Stephanie L.; Barrett-Connor, Elizabeth; Lane, Nancy E.; Paudel, Misti; Redline, Susan; Ancoli-Israel, Sonia; Orwoll, Eric; Schernhammer, Eva

    2015-01-01

    Study Objectives: Maintaining adequate serum levels of vitamin D may be important for sleep duration and quality; however, these associations are not well understood. We examined whether levels of serum 25(OH)D are associated with objective measures of sleep in older men. Setting and Participants: Cross-sectional study within a large cohort of community-dwelling older men, the MrOS study. Interventions: Among 3,048 men age 68 years or older, we measured total serum vitamin D. Objective estimates of nightly total sleep time, sleep efficiency, and wake time after sleep onset (WASO) were obtained using wrist actigraphy worn for an average of 5 consecutive 24-h periods. Results: 16.4% of this study population had low levels of vitamin D (< 20.3 ng/mL 25(OH)D). Lower serum vitamin D levels were associated with a higher odds of short (< 5 h) sleep duration, (odds ratio [OR] for the highest (≥ 40.06 ng/mL) versus lowest (< 20.3 ng/mL) quartile of 25(OH)D, 2.15; 95 % confidence interval (CI), 1.21–3.79; Ptrend = 0.004) as well as increased odds of actigraphy-measured sleep efficiency of less than 70% (OR, 1.45; 95% CI, 0.97–2.18; Ptrend = 0.004), after controlling for age, clinic, season, comorbidities, body mass index, and physical and cognitive function. Lower vitamin D levels were also associated with increased WASO in age-adjusted, but not multivariable adjusted models Conclusions: Among older men, low levels of total serum 25(OH)D are associated with poorer sleep including short sleep duration and lower sleep efficiency. These findings, if confirmed by others, suggest a potential role for vitamin D in maintaining healthy sleep. Citation: Massa J, Stone KL, Wei EK, Harrison SL, Barrett-Connor E, Lane NE, Paudel M, Redline S, Ancoli-Israel S, Orwoll E, Schernhammer E. Vitamin D and actigraphic sleep outcomes in older community-dwelling men: the MrOS Sleep Study. SLEEP 2015;38(2):251–257. PMID:25581929

  15. Effect of meal size reduction and protein enrichment on intake and satiety in vital community-dwelling older adults.

    PubMed

    Ziylan, Canan; Kremer, Stefanie; Eerens, Jessie; Haveman-Nies, Annemien; de Groot, Lisette C P G M

    2016-10-01

    Undernutrition risk among community-dwelling older adults is partly caused by inadequate protein intake. Enriching readymade meals with protein could be beneficial in increasing protein intake. Moreover, reduced-size meals could suit older adults with diminished appetite. In this single-blind randomized crossover study with 120 participants (age: 70.5 ± 4.5 y, BMI: 27.2 ± 4.4 kg/m(2)), 60 participants consumed four beef meals and another 60 consumed four chicken meals on four different days, once per week. These meals were produced according to a 2 × 2 factorial design: the protein content was either ∼25 g (lower) or ∼30 g (enriched), and the portion size was either 450 g (normal) or of 400 g (reduced). Palatability evaluation, meal intake, and subsequent satiety ratings after 120 min were measured. No significant differences in palatability among meals were found. While absolute intake (g) of the normal-size meals was significantly higher than that of the reduced-size meals, the relative intake (%) of the served meals did not differ between the four meals. Both protein and energy intakes were significantly higher for the enriched meals, regardless of portion size. Protein intakes were 5.4 g and 5.1 g higher in the normal-size and reduced-size enriched beef meals, respectively, and 6.1 g and 7.1 g higher in the enriched chicken meals, respectively. The normal-size enriched beef meal and reduced-size enriched chicken meal led to slightly but significantly higher ratings of satiety than the non-enriched meals. Due to these mixed satiety findings, separate effects of meal-size reduction and protein enrichment could not be distinguished in this study. The intake findings show that palatable protein-enriched meals support higher protein and energy intakes in vital community-dwelling older adults during a single meal.

  16. Advanced glycation end products and their circulating receptors predict cardiovascular disease mortality in older community-dwelling women

    PubMed Central

    Semba, Richard D.; Ferrucci, Luigi; Sun, Kai; Beck, Justine; Dalal, Mansi; Varadhan, Ravi; Walston, Jeremy; Guralnik, Jack M.; Fried, Linda P.

    2008-01-01

    Objective To characterize the relationship between advanced glycation end products (AGEs) and circulating receptors for AGEs (RAGE) with cardiovascular disease mortality. Methods The relationships between serum AGEs, total RAGE (sRAGE), and endogenous secretory RAGE (esRAGE), and mortality were characterized in 559 community-dwelling women, ≥65 years, in Baltimore, Maryland. Results During 4.5 years of follow-up, 123 (22%) women died, of whom 54 died with cardiovascular disease. The measure of serum AGEs was carboxymethyl-lysine (CML), a dominant AGE. Serum CML predicted cardiovascular disease mortality (Hazards Ratio [H.R.] for highest versus lower three quartiles 1.94, 95% Confidence Interval [C.I.] 1.08-3.48, P = 0.026), after adjusting for age, race, body mass index, and renal insufficiency. Serum sRAGE (ng/mL) and esRAGE (ng/mL) predicted cardiovascular disease mortality (H.R. per 1 Standard Deviation [S.D.] 1.27, 95% C.I. 0.98-1.65, P = 0.07; H.R. 1.28, 95% C.I. 1.02-1.63, P = 0.03), after adjusting for the same covariates. Among non-diabetic women, serum CML, sRAGE, and esRAGE, respectively, predicted cardiovascular disease mortality (H.R. for highest versus lower three quartiles, 2.29, 95% C.I. 1.21-4.34, P = 0.01; H.R. per 1 S.D., 1.24, 95% C.I. 0.92-1.65, P = 0.16; H.R. per 1 S.D. 1.45, 95% C.I. 1.08-1.93, P = 0.01), after adjusting for the same covariates. Conclusions High circulating AGEs and RAGE predict cardiovascular disease mortality among older community-dwelling women. AGEs are a potential target for interventions, as serum AGEs can be lowered by change in dietary pattern and pharmacological treatment. PMID:19448391

  17. Lean mass, muscle strength and gene expression in community dwelling older men: findings from the Hertfordshire Sarcopenia Study (HSS).

    PubMed

    Patel, Harnish P; Al-Shanti, Nasser; Davies, Lucy C; Barton, Sheila J; Grounds, Miranda D; Tellam, Ross L; Stewart, Claire E; Cooper, Cyrus; Sayer, Avan Aihie

    2014-10-01

    Sarcopenia is associated with adverse health outcomes. This study investigated whether skeletal muscle gene expression was associated with lean mass and grip strength in community-dwelling older men. Utilising a cross-sectional study design, lean muscle mass and grip strength were measured in 88 men aged 68-76 years. Expression profiles of 44 genes implicated in the cellular regulation of skeletal muscle were determined. Serum was analysed for circulating cytokines TNF (tumour necrosis factor), IL-6 (interleukin 6, IFNG (interferon gamma), IL1R1 (interleukin-1 receptor-1). Relationships between skeletal muscle gene expression, circulating cytokines, lean mass and grip strength were examined. Participant groups with higher and lower values of lean muscle mass (n = 18) and strength (n = 20) were used in the analysis of gene expression fold change. Expression of VDR (vitamin D receptor) [fold change (FC) 0.52, standard error for fold change (SE) ± 0.08, p = 0.01] and IFNG mRNA (FC 0.31; SE ± 0.19, p = 0.01) were lower in those with higher lean mass. Expression of IL-6 (FC 0.43; SE ± 0.13, p = 0.02), TNF (FC 0.52; SE ± 0.10, p = 0.02), IL1R1 (FC 0.63; SE ± 0.09, p = 0.04) and MSTN (myostatin) (FC 0.64; SE ± 0.11, p = 0.04) were lower in those with higher grip strength. No other significant changes were observed. Significant negative correlations between serum IL-6 (R = -0.29, p = 0.005), TNF (R = -0.24, p = 0.017) and grip strength were demonstrated. This novel skeletal muscle gene expression study carried out within a well-characterized epidemiological birth cohort has demonstrated that lower expression of VDR and IFNG is associated with higher lean mass, and lower expression of IL-6, TNF, IL1R1 and myostatin is associated with higher grip strength. These findings are consistent with a role of proinflammatory factors in mediating lower muscle strength in community-dwelling older men.

  18. Physical fitness and psychological benefits of strength training in community dwelling older adults.

    PubMed

    Tsutsumi, T; Don, B M; Zaichkowsky, L D; Delizonna, L L

    1997-11-01

    Previous studies concerning psychological benefits of exercise among the elderly has focused predominantly on the effects of aerobic exercise. In the present study, psychological and behavioral adaptations in response to 12-weeks of strength training were examined in medically healthy but sedentary 42 older adults (mean age = 68 years). The purpose of this study was to evaluate the effects of high and low intensity resistance training intensity on a) muscular fitness, b) psychological affect, and c) neurocognitive functioning. Subjects were randomly assigned to high intensity/low volume (EXH: 2 sets of 8 to 10 repetitions for 75 to 85% of 1 RM), low intensity/high volume (EXL: 2 sets of 14 to 16 repetitions for 55 to 65% of 1 RM), or no exercise control programs. Prior to and following the 12-week program, subjects underwent comprehensive physiological and psychological evaluations. Physiological assessment included measurements of blood pressure, heart rate, arm and leg muscle strength, body composition, and oxygen consumption (VO2max). Psychological measures included evaluations of mood, anxiety, and physical self-efficacy as well as cognitive functioning. The results of this study indicated that both high and low intensity strength programs were associated with marked improvements in physiological fitness and psychological functioning. Specifically, subjects in the strength training programs increased overall muscle strength by 38.6% and reduced percent body fat by 3.0%. Favorable psychological changes in the strength-trained subjects included improvements in positive and negative mood, trait anxiety, and perceived confidence for physical capability. The treatment effects of neurocognitive functioning were not significant. In summary, this study demonstrated that participation in 12-weeks of high or low intensity strength training can improve overall physical fitness, mood, and physical self-efficacy in older adults while cognitive functioning remains constant.

  19. Health Care Service Needs and Correlates of Quality of Life: A Case Study of Elderly Chinese Immigrants in Canada

    ERIC Educational Resources Information Center

    Chow, Henry P. H.

    2012-01-01

    This study explored the health care service needs and the major correlates of quality of life among 127 community-dwelling elderly Chinese immigrants in a western Canadian city. Participants were interviewed in their homes by trained, bilingual interviewers employing a structured questionnaire that covered a wide range of topics including health…

  20. Falls and risk factors for falls in community-dwelling adults with dementia (NutriAlz trial).

    PubMed

    Salvà, Antoni; Roqué, Marta; Rojano, Xavier; Inzitari, Marco; Andrieu, Sandrine; Schiffrin, Eduardo J; Guigoz, Yves; Vellas, Bruno

    2012-01-01

    To estimate the number of fallers and risk factors for falls in a cohort with dementia, we did a secondary analysis of a cluster-randomized controlled trial (NutriAlz) in 11 outpatient and day care centers in Catalonia (Spain) including 626 community-dwelling patients with dementia, followed for 12 months. Participants' characteristics were assessed at baseline, at 6 and 12 months [fall in the earlier 6 mo, anthropometric data, comorbidities, Mini-Mental State Examination, Clinical Dementia Rating, Basic Activities of Daily Living (BADL), Instrumental Activities of Daily Living, Neuropsychiatric Inventory Questionnaire, Zarit Caregiver Burden Interview and Mini-Nutritional Assessment]. Multivariate logistic regression models and generalized linear models were used to explore risk factors for falls and changes in health and function. Two hundred twenty-three participants fell during the 12 months follow-up (35.62%). Risk factors identified for falls were age (odds ratio (OR)=1.03, 95% confidence interval (CI), 1.00-1.05), BADL (OR=1.18, 95% CI, 1.05-1.32), and earlier fall (OR=2.30, 95% CI, 1.57-3.35). Fallers had worse health than nonfallers, and their dependence increased significantly more in BADL during the study, compared with nonfallers. Dependence in BADL is a risk factor and a consequence of falls; interventions aimed at preventing falls in dementia patients could promote autonomy in BADL and slow its decline.

  1. Development of TUA-WELLNESS screening tool for screening risk of mild cognitive impairment among community-dwelling older adults

    PubMed Central

    Vanoh, Divya; Shahar, Suzana; Rosdinom, Razali; Din, Normah Che; Yahya, Hanis Mastura; Omar, Azahadi

    2016-01-01

    Background and aim Focus on screening for cognitive impairment has to be given particular importance because of the rising older adult population. Thus, this study aimed to develop and assess a brief screening tool consisting of ten items that can be self-administered by community dwelling older adults (TUA-WELLNESS). Methodology A total of 1,993 noninstitutionalized respondents aged 60 years and above were selected for this study. The dependent variable was mild cognitive impairment (MCI) assessed using neuropsychological test batteries. The items for the screening tool comprised a wide range of factors that were chosen mainly from the analysis of ordinal logistic regression (OLR) and based on past literature. A suitable cut-off point was developed using receiver operating characteristic analysis. Results A total of ten items were included in the screening tool. From the ten items, eight were found to be significant by ordinal logistic regression and the remaining two items were part of the tool because they showed strong association with cognitive impairment in previous studies. The area under curve (AUC), sensitivity, and specificity for cut-off 11 were 0.84%, 83.3%, and 73.4%, respectively. Conclusion TUA-WELLNESS screening tool has been used to screen for major risk factors of MCI among Malaysian older adults. This tool is only suitable for basic MCI risk screening purpose and should not be used for diagnostic purpose. PMID:27274208

  2. Factors influencing administration of hepatitis B vaccine to community-dwelling teenagers aged 12-18 with an intellectual disability.

    PubMed

    Yen, Chia-Feng; Lin, Jin-Ding

    2011-01-01

    The study aims to determine hepatitis B vaccination coverage rates among community-dwelling teenagers with an intellectual disability in Taiwan and to identify the possible influencing factors of their vaccination. The present paper was part of the results of the "2007 National Survey on Healthy Behaviors and Preventive Health Utilizations of People with Intellectual Disabilities in Taiwan," which was a cross-sectional survey of 1111 intellectually disabled (ID) teenagers ranging from 12 to 18 years of age. The results showed that the completed hepatitis B vaccination rate was 72.9%, a rate lower than that in the general population of Taiwan considering the same age group. There was no gender difference between each age group in the vaccination rate in this population. Multilevel logistic regression analyses revealed that those ID individuals whose primary caregivers were parents or siblings (OR = 2.45, 95% CI = 1.29-4.64), whose household monthly income was 20,000-59,999 NTD vs. less than 20,000 NTD (OR = 2.47, 95% CI = 1.00-6.12), and who had ever undergone an oral health exam (OR = 2.29, 95% CI = 1.24-4.01) were more likely to receive a complete hepatitis B vaccination than their counterparts. The study highlighted that most teenagers had received complete hepatitis B vaccination. Nonetheless, better public health strategies may be needed to deliver the hepatitis B vaccine to those who do not comply with the vaccination schedule in the community.

  3. The effect of therapeutic horseback riding on balance in community-dwelling older adults: a pilot study.

    PubMed

    Homnick, Tamara D; Henning, Kim M; Swain, Charlene V; Homnick, Douglas N

    2015-02-01

    Equine assisted activities (hippotherapy and therapeutic riding) improve balance in patients with disabilities such as cerebral palsy, but have not been systematically studied in older adults, at risk of falls due to balance deficits. We conducted a 10-week, single blind, controlled trial of the effect of a therapeutic horseback riding course on measures of balance in community-dwelling adults 65 years and older. Nine riders and six controls completed the trial. Controls were age matched to riders and all participants were recruited from the local community. Both groups showed improvements in balance during the trial, but did not reach statistical significance. Sample size was small, participants had relatively high initial balance scores, and controls tended to increase their physical activities, likely influencing outcomes. No adverse events occurred and the supervised therapeutic riding program appeared to be a safe and effective form of exercise to improve balance in older adults. A power analysis was performed to estimate numbers of participants needed for a larger study.

  4. Evaluation of a Community Reintegration Outpatient Program Service for Community-Dwelling Persons with Spinal Cord Injury

    PubMed Central

    Bain, Patricia; Hébert, Debbie; Hitzig, Sander L.

    2014-01-01

    Objective. To evaluate the effectiveness of a community reintegration outpatient (CROP) service for promoting well-being and community participation following spinal cord injury (SCI). Participants. Community-dwelling adults (N = 14) with traumatic and nontraumatic SCI. Interventions. The CROP service is a 12-week (1 × week; 120 minutes) interprofessional closed therapeutic education service. Main Outcome Measure(s). Moorong Self-Efficacy Scale (MSES); Impact on Participation and Autonomy (IPA); Positive Affect and Negative Affect Scale (PANAS); Coping Inventory of Stressful Situations (CISS); World Health Organization Quality of Life (WHOQOL-BREF); semistructured qualitative interviews. Methods. Twenty-one participants were recruited from two subsequent CROP services, with only 14 persons completing all data assessments. Data were collected at baseline (week 0), at exit (week 12), and at a three-month follow-up. Semistructured interviews were conducted at exit. Results. Self-efficacy (MSES) and positive affect (PANAS) improved from baseline to exit (P < .05), but the changes were not maintained at follow-up. Qualitative analysis identified four major themes related to therapeutic benefits: (1) role of self; (2) knowledge acquisition; (3) skill application; and (4) group processes. Conclusions. Participation in a therapeutic education service has the potential to improve well-being in persons with SCI, but there is a need to identify strategies to maintain long-term gains. PMID:25574397

  5. The effect of therapeutic horseback riding on balance in community-dwelling older adults: a pilot study.

    PubMed

    Homnick, Tamara D; Henning, Kim M; Swain, Charlene V; Homnick, Douglas N

    2015-02-01

    Equine assisted activities (hippotherapy and therapeutic riding) improve balance in patients with disabilities such as cerebral palsy, but have not been systematically studied in older adults, at risk of falls due to balance deficits. We conducted a 10-week, single blind, controlled trial of the effect of a therapeutic horseback riding course on measures of balance in community-dwelling adults 65 years and older. Nine riders and six controls completed the trial. Controls were age matched to riders and all participants were recruited from the local community. Both groups showed improvements in balance during the trial, but did not reach statistical significance. Sample size was small, participants had relatively high initial balance scores, and controls tended to increase their physical activities, likely influencing outcomes. No adverse events occurred and the supervised therapeutic riding program appeared to be a safe and effective form of exercise to improve balance in older adults. A power analysis was performed to estimate numbers of participants needed for a larger study. PMID:25548091

  6. Feasibility and effectiveness of a walking program for community-dwelling older adults with mild cognitive impairment.

    PubMed

    van Uffelen, Jannique G Z; Chinapaw, Marijke J M; Hopman-Rock, Marijke; van Mechelen, Willem

    2009-10-01

    This study examined the feasibility and effect on aerobic fitness of a 1-yr, twice-weekly, group-based moderate-intensity walking program (MI-WP, n = 77) compared with a low-intensity activity program (LI-AP, n = 75) for community-dwelling older adults with mild cognitive impairment (MCI). Thirty participants did not start a program; median attendance in the other 122 participants was 71%. Small but significant associations were observed between attendance and memory in the MI-WP and general cognition in the LI-AP. Associations were no longer significant when both groups were analyzed together. Intensity, assessed using percentage of heart-rate reserve and the Borg scale, equaled intended intensity for both programs. Aerobic fitness improved significantly in participants in the MI-WP. In conclusion, cognition was not clearly associated with attendance in the 62 participants starting the MI-WP, and average attendance was good. The intensity was feasible for participants who continued the MI-WP. The findings support the proposal that regular moderate-intensity walking improves aerobic fitness in adults with MCI.

  7. Using a memory handbook to improve everyday memory in community-dwelling older adults with memory complaints.

    PubMed

    Andrewes, D G; Kinsella, G; Murphy, M

    1996-01-01

    Community-dwelling, nondemented older people (60-70 years) with reported memory complaints were randomly assigned to either a memory-handbook (MHB) group (n = 20) or a placebo group (n = 20). The MHB group members were given a self-contained memory handbook and were individually trained on two of the handbook's sections that related to (a) remembering a person's name and (b) prospective memory, for approximately 30 minutes each. The placebo group was given an instructional pamphlet with a description of three list-learning mnemonics as a placebo treatment. Subjects were tested before and after the intervention. When compared with the placebo group, the MHB group members significantly improved their performance on a face-naming task and a strategies knowledge questionnaire, but not on the prospective memory measures, when compared with the placebo group. In addition, the MHB group showed a significant advantage on an everyday memory diary that was filled out by all subjects following the intervention. Following the study, the placebo group was also given the memory handbook, and both groups were then assessed on their knowledge and use of strategies by questionnaire at a 4-month follow-up. At this time the MHB group appeared to maintain most of its original gains, while the placebo group made some improvement.

  8. Nutritional status and clinical outcomes among institutionalized elderly Chinese in Taiwan.

    PubMed

    Chen, Liang-Kung; Lin, Ming-Hsien; Hwang, Shinn-Jang; Wang, Pein; Chwang, Leh-Chii

    2007-01-01

    Nutrition is an important issue in institutional care, and is related to clinical outcomes in many aspects. Although Taiwan is marching to an aged society, related studies were lacking. Elderly residents in two long-term care facilities (LTCF) were enrolled for study. Nutritional status including anthropometric measurements and laboratory examinations was assessed every 3 months for 12 months. Age, sex-matched community-dwelling elderly participating in the annual health check-up was randomly selected as the control subjects. In total, 66 subjects in LTCF and 870 age, sex-matched community-dwelling elderly were enrolled. Body mass index, serum levels of albumin, and total cholesterol were significantly poorer in LTCF residents than the community-dwelling elderly. Triceps skinfold thickness, hemoglobin, serum albumin, and total cholesterol were progressively deteriorated among the institutionalized elderly during the 6-month follow-up. Thirteen subjects of the study group had been hospitalized during the follow-up. Body mass index, triceps skinfold thickness, mid-arm circumference, serum albumin at screening were significantly poorer and unintentional weight loss within 6 months was significantly greater in subjects who had been hospitalized. By using multivariate logistic regression model, only weight loss >5% within 6-month follow-up was the significant independent predictive factors to hospitalization. In conclusion, nutritional status of institutionalized elderly Chinese was significantly poorer than the community-dwelling elderly. Nutritional markers were progressively deteriorated in LTCF residents during the follow-up period. Unintentional weight loss >5% within 6 months was the only significantly independent predictive factor for hospitalization among the institutionalized elderly Chinese.

  9. [Elder].

    PubMed

    Arroyo, Pedro; Gutiérrez-Robledo, Luis Miguel

    2016-09-01

    The aim of this review is to present scientific evidence on the biological, dietary, cultural and economic advantages of cow´s milk and dairy products intake in adults, with emphasis on the elderly. The role of milk and dairy products as part of the regular diet, as well as their contribution to a healthy diet for the aged population is described. The updated scientific references on the importance of milk and dairy products on the dietary management of the most prevalent diseases of the eldery -among these energy-protein malnutrition, sarcopenia, obesity, sarcopenic obesity, osteoporosis, diabetes and cardiovascular diseases- are presented. PMID:27603886

  10. The Association between Sleep Problems, Sleep Medication Use, and Falls in Community-Dwelling Older Adults: Results from the Health and Retirement Study 2010

    PubMed Central

    2016-01-01

    Background. Very few studies have assessed the impact of poor sleep and sleep medication use on the risk of falls among community-dwelling older adults. The objective of this study was to evaluate the association between sleep problems, sleep medication use, and falls in community-dwelling older adults. Methods. The study population comprised a nationally representative sample of noninstitutionalized older adults participating in the 2010 Health and Retirement Study. Proportion of adults reporting sleep problems, sleep medication use, and fall was calculated. Multiple logistic regression models were constructed to examine the impact of sleep problems and sleep medication use on the risk of falls after controlling for covariates. Results. Among 9,843 community-dwelling older adults, 35.8% had reported a fall and 40.8% had reported sleep problems in the past two years. Sleep medication use was reported by 20.9% of the participants. Older adults who do have sleep problems and take sleep medications had a significant high risk of falls, compared to older adults who do not have sleep problems and do not take sleep medications. The other two groups also had significantly greater risk for falls. Conclusion. Sleep problems added to sleep medication use increase the risk of falls. Further prospective studies are needed to confirm these observed findings. PMID:27547452

  11. Task-specific balance training improves self-assessed function in community-dwelling older adults with balance deficits and fear of falling: a randomized controlled trial

    PubMed Central

    Halvarsson, Alexandra; Sahlström, Theres; Ståhle, Agneta

    2014-01-01

    Objective: To evaluate the effects of a 12-week balance training programme on self-assessed function and disability in healthy community-dwelling older adults with self-perceived balance deficits and fear of falling. Design: A prospective, randomized controlled trial. Setting: Stockholm County, Sweden. Participants: A total of 59 community-dwelling older adults (42 women and 17 men) aged 67–93 were randomized to either an intervention group (n = 38) or to serve as controls (n = 21) after baseline testing. Intervention: The intervention was a 12-week, three times per week, progressive, specific and individually adjusted group balance-training programme. Main measures: Self-perceived function and disability measured with Late Life Function and Disability Instrument. Results: The intervention group reported improvement in overall function (p = 0.016), as well as in basic (p = 0.044) and advanced lower extremity function (p = 0.025) compared with the control group. The study showed no improvement in overall disability or upper extremity function. Conclusion: This group balance training programme improves self-assessed function in community-dwelling older adults with balance deficits and fear of falling. PMID:24895381

  12. Effects of a Behavioral Program on Exercise Adherence and Exercise Self-Efficacy in Community-Dwelling Older Persons

    PubMed Central

    Azizan, Azliyana; Kuan, Chua Siew

    2013-01-01

    Background. This study determines the effects of a behavioral program on exercise adherence (step counts) and level of exercise self-efficacy (ESE) in community-dwelling older persons. Methods. Sixty-three participants (age = 63.8 ± 4.5 years) were enrolled in this controlled quasi-experimental study. They were divided into 3 groups: (1) EBG performed a 6-week exercise intervention followed by a 5-week behavioral program, (2) EG performed exercise intervention similar to EBG, and (3) control group (CG) did not receive any interventions. Step counts were measured based on the scores recorded by a pedometer while ESE was measured by a self-reported ESE scale. Results. Data analysis showed significant differences due to time effect (F(1,2) = 39.884, P < 0.01, and η = .399); time and group interactions (F(2,60) = 112.683, P < 0.01, and η = .790); and between-group effect (F(2,60) = 12.524, P < 0.01, and η = .295) for step counts. As for ESE, significant differences were also found for time effect (F(2,4) = 66.628, P < 0.05, and η = .526); time and group interactions (F(2,60) = 4.562, P = 0.014, and η = .132); and between-group effect (F(2,60) = 13.632, P < 0.05, and η = .312). EBG presented with significantly higher mean changes for both step counts and ESE compared to other groups (all P < 0.05). Conclusion. This study suggests that the addition of a behavioral program is superior as compared to exercising alone on increasing exercise adherence and level of self-efficacy in older persons. PMID:24489539

  13. Patterns of comorbidity in community-dwelling older people hospitalised for fall-related injury: A cluster analysis

    PubMed Central

    2011-01-01

    Background Community-dwelling older people aged 65+ years sustain falls frequently; these can result in physical injuries necessitating medical attention including emergency department care and hospitalisation. Certain health conditions and impairments have been shown to contribute independently to the risk of falling or experiencing a fall injury, suggesting that individuals with these conditions or impairments should be the focus of falls prevention. Since older people commonly have multiple conditions/impairments, knowledge about which conditions/impairments coexist in at-risk individuals would be valuable in the implementation of a targeted prevention approach. The objective of this study was therefore to examine the prevalence and patterns of comorbidity in this population group. Methods We analysed hospitalisation data from Victoria, Australia's second most populous state, to estimate the prevalence of comorbidity in patients hospitalised at least once between 2005-6 and 2007-8 for treatment of acute fall-related injuries. In patients with two or more comorbid conditions (multicomorbidity) we used an agglomerative hierarchical clustering method to cluster comorbidity variables and identify constellations of conditions. Results More than one in four patients had at least one comorbid condition and among patients with comorbidity one in three had multicomorbidity (range 2-7). The prevalence of comorbidity varied by gender, age group, ethnicity and injury type; it was also associated with a significant increase in the average cumulative length of stay per patient. The cluster analysis identified five distinct, biologically plausible clusters of comorbidity: cardiopulmonary/metabolic, neurological, sensory, stroke and cancer. The cardiopulmonary/metabolic cluster was the largest cluster among the clusters identified. Conclusions The consequences of comorbidity clustering in terms of falls and/or injury outcomes of hospitalised patients should be investigated by

  14. High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults.

    PubMed

    Wu, Chen-Yi; Hu, Hsiao-Yun; Chou, Yiing-Jenq; Huang, Nicole; Chou, Yi-Chang; Li, Chung-Pin

    2015-11-01

    Although hypertension is common among older adults, the optimal blood pressure (BP) for survival in older adults remains unclear. We attempt to use a large cohort to assess the relationship between BP and mortality and to gain insight into what level of BP is required for optimal survival in older adults.A total of 77,389 community-dwelling adults, aged ≥65 years, were followed between 2006 and 2010. Mortality was determined using matching cohort identifications with national death files. Cox proportional hazards regression models were used to evaluate the relationship of BP with all-cause, cardiovascular disease (CVD), and expanded-CVD mortalities.The mortality risks of the stage 2-3 hypertension group were substantial (all-cause mortality: hazard ratio [HR]: 1.23; 95% confidence interval [CI]: 1.10-1.37; CVDs mortality: HR: 1.31; 95% CI: 1.05-1.64; expanded-CVDs mortality: HR: 1.40; 95% CI: 1.15-1.71). The cardiovascular and expanded-cardiovascular mortality risks were lowest when systolic blood pressures were 120 to 129 mm Hg, and increased significantly when systolic blood pressures (SBPs) were ≥160 mm Hg or diastolic BPs were ≥90 mm Hg. A J-curve phenomenon for SBP on CVD and expanded-CVD mortality was observed. The impacts of stage 2-3 hypertension on mortality risks were significantly increased among women. The mortality risks of hypertension were not attenuated with older age.This study provides insight for identifying the optimal BP for survival in older adults, and extends the knowledge of the impacts of hypertension on mortality risks among women and the older adults.

  15. Longitudinal Trends in Fall Accidents in Community Dwelling Korean Adults: The 2008–2013 Korean Community Health Survey

    PubMed Central

    Logan, Sarah

    2016-01-01

    Objective To describe the longitudinal characteristics of unintentional fall accidents using a representative population-based sample of Korean adults. Methods We examined data from the Korean Community Health Survey from 2008 to 2013. Univariate analysis and multivariable logistic regression were used to identify the characteristics of fall accidents in adults. Results Between 2008 and 2013, the incidence rate of fall accidents requiring medical treatment increased from 1,248 to 3,423 per 100,000 people (p<0.001), while the proportion of indoor fall accidents decreased from 38.12% to 23.16% (p<0.001). Females had more annual fall accidents than males (p<0.001). The major reason for fall accidents was slippery floors (33.7% in 2011 and 36.3% in 2013). Between 2008 and 2010, variables associated with higher fall accident risk included specific months (August and September), old age, female gender, current drinker, current smoker, diabetes, osteoarthritis, osteoporosis, and depression. A high level of education and living with a partner were negatively associated with fall accident risk. In 2013, people experiencing more than 1 fall accident felt more fear of falling than those having no fall accidents (odds ratio [OR] for 1 fall, 2.12; 95% confidence interval [CI], 2.04–2.12; OR for more than 2 falls, 2.97; 95% CI, 2.83–3.10). Conclusion The occurrence of fall accidents has consistently increased in Korea from 2008 to 2013. Future intervention studies are needed to reduce the increasing incidence rates of fall accidents in community dwelling adults. PMID:27606272

  16. Effectiveness of interdisciplinary primary care approach to reduce disability in community dwelling frail older people: cluster randomised controlled trial

    PubMed Central

    van Rossum, Erik; de Witte, Luc P; Ambergen, Antonius W; Hobma, Sjoerd O; Sipers, Walther; Kempen, Gertrudis I J M

    2013-01-01

    Objective To evaluate whether an interdisciplinary primary care approach for community dwelling frail older people is more effective than usual care in reducing disability and preventing (further) functional decline. Design Cluster randomised controlled trial. Setting 12 general practices in the south of the Netherlands Participants 346 frail older people (score ≥5 on Groningen Frailty Indicator) were included; 270 (78%) completed the study. Interventions General practices were randomised to the intervention or control group. Practices in the control group delivered care as usual. Practices in the intervention group implemented the “Prevention of Care” (PoC) approach, in which frail older people received a multidimensional assessment and interdisciplinary care based on a tailor made treatment plan and regular evaluation and follow-up. Main outcome measures The primary outcome was disability, assessed at 24 months by means of the Groningen Activity Restriction Scale. Secondary outcomes were depressive symptomatology, social support interactions, fear of falling, and social participation. Outcomes were measured at baseline and at 6, 12, and 24 months’ follow-up. Results 193 older people in the intervention group (six practices) received the PoC approach; 153 older people in the control group (six practices) received care as usual. Follow-up rates for patients were 91% (n=316) at six months, 86% (n=298) at 12 months, and 78% (n=270) at 24 months. Mixed model multilevel analyses showed no significant differences between the two groups with regard to disability (primary outcome) and secondary outcomes. Pre-planned subgroup analyses confirmed these results. Conclusions This study found no evidence for the effectiveness of the PoC approach. The study contributes to the emerging body of evidence that community based care in frail older people is a challenging task. More research in this field is needed. Trial registration Current Controlled Trials ISRCTN31954692

  17. Use of the Dynamic Visual Acuity Test as a screener for community-dwelling older adults who fall.

    PubMed

    Honaker, Julie A; Shepard, Neil T

    2011-01-01

    Adequate function of the peripheral vestibular system, specifically the vestibulo-ocular reflex (VOR; a network of neural connections between the peripheral vestibular system and the extraocular muscles) is essential for maintaining stable vision during head movements. Decreased visual acuity resulting from an impaired peripheral vestibular system may impede balance and postural control and place an individual at risk of falling. Therefore, sensitive measures of the vestibular system are warranted to screen for the tendency to fall, alerting clinicians to recommend further risk of falling assessment and referral to a falling risk reduction program. Dynamic Visual Acuity (DVA) testing is a computerized VOR assessment method to evaluate the peripheral vestibular system during head movements; reduced visual acuity as documented with DVA testing may be sensitive to screen for falling risk. This study examined the sensitivity and specificity of the computerized DVA test with yaw plane head movements for identifying community-dwelling adults (58-78 years) who are prone to falling. A total of 16 older adults with a history of two or more unexplained falls in the previous twelve months and 16 age and gender matched controls without a history of falls in the previous twelve months participated. Computerized DVA with horizontal head movements at a fixed velocity of 120 deg/sec was measured and compared with the Dynamic Gait Index (DGI) a gold standard gait assessment measurement for identifying falling risk. Receiver operating characteristics (ROC) curve analysis and area under the ROC curve (AUC) were used to assess the sensitivity and specificity of the computerized DVA as a screening measure for falling risk as determined by the DGI. Results suggested a link between computerized DVA and the propensity to fall; DVA in the yaw plane was found to be a sensitive (92%) and accurate screening measure when using a cutoff logMAR value of >0.25.

  18. Circadian rest-activity rhythms predict future increases in depressive symptoms among community-dwelling older men

    PubMed Central

    Smagula, Stephen F.; Ancoli-Israel, Sonia; Blackwell, Terri; Boudreau, Robert; Stefanick, Marcia L.; Paudel, Misti L.; Stone, Katie L.; Cauley, Jane A.

    2014-01-01

    Objectives Circadian rest-activity rhythms (CARs) have been cross-sectionally associated with depressive symptoms, however no longitudinal research has examined whether CARs are a risk factor for developing depressive symptoms. Methods We examined associations of CARs (measured with actigraphy over a mean of 4.8 days) with depressive symptoms (measured with the Geriatric Depression Scale) among 2892 community-dwelling older men (mean age: 76.2 +/− 5.5) from the MrOS Sleep Study who were without cognitive impairment. Among 2124 men with minimal (0–2) symptoms at baseline, we assessed associations between CAR parameters and increases to mild (3–5) or clinically significant (≥6) symptoms after an average of 1.2 (+/− 0.32) years later. Results Cross-sectional associations between rhythm height parameters were independent of chronic diseases, lifestyle, sleep, and self-reported physical activity covariates. For example, men in the lowest mesor quartile had 2 times the adjusted odds (Adjusted Odds Ratio (AOR)=2.04, 95% CI 1.36–3.04, p=0.0005) of having prevalent clinically significant symptoms (compared to minimal). Longitudinally, low CAR robustness (being in the lowest quartile of the pseudo-F statistic) was independently associated with increasing odds of developing symptoms (i.e. AOR for having clinically significant depressive symptoms at follow-up=2.58, 95% CI 1.11–5.99, p=0.03). Conclusion CAR disturbances are indicative of depressive symptomology. Low CAR robustness may independently contribute to the risk of worsening depression symptomology. PMID:25066948

  19. Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons--a narrative review.

    PubMed

    Goisser, Sabine; Kemmler, Wolfgang; Porzel, Simone; Volkert, Dorothee; Sieber, Cornel Christian; Bollheimer, Leo Cornelius; Freiberger, Ellen

    2015-01-01

    One of the many threats to independent life is the age-related loss of muscle mass and muscle function commonly referred to as sarcopenia. Another important health risk in old age leading to functional decline is obesity. Obesity prevalence in older persons is increasing, and like sarcopenia, severe obesity has been consistently associated with several negative health outcomes, disabilities, falls, and mobility limitations. Both sarcopenia and obesity pose a health risk for older persons per se, but in combination, they synergistically increase the risk for negative health outcomes and an earlier onset of disability. This combination of sarcopenia and obesity is commonly referred to as sarcopenic obesity. The present narrative review reports the current knowledge on the effects of complex interventions containing nutrition and exercise interventions in community-dwelling older persons with sarcopenic obesity. To date, several complex interventions with different outcomes have been conducted and have shown promise in counteracting either sarcopenia or obesity, but only a few studies have addressed the complex syndrome of sarcopenic obesity. Strong evidence exists on exercise interventions in sarcopenia, especially on strength training, and for obese older persons, strength exercise in combination with a dietary weight loss intervention demonstrated positive effects on muscle function and body fat. The differences in study protocols and target populations make it impossible at the moment to extract data for a meta-analysis or give state-of-the-art recommendations based on reliable evidence. A conclusion that can be drawn from this narrative review is that more exercise programs containing strength and aerobic exercise in combination with dietary interventions including a supervised weight loss program and/or protein supplements should be conducted in order to investigate possible positive effects on sarcopenic obesity. PMID:26346071

  20. Longitudinal Trends in Fall Accidents in Community Dwelling Korean Adults: The 2008–2013 Korean Community Health Survey

    PubMed Central

    Logan, Sarah

    2016-01-01

    Objective To describe the longitudinal characteristics of unintentional fall accidents using a representative population-based sample of Korean adults. Methods We examined data from the Korean Community Health Survey from 2008 to 2013. Univariate analysis and multivariable logistic regression were used to identify the characteristics of fall accidents in adults. Results Between 2008 and 2013, the incidence rate of fall accidents requiring medical treatment increased from 1,248 to 3,423 per 100,000 people (p<0.001), while the proportion of indoor fall accidents decreased from 38.12% to 23.16% (p<0.001). Females had more annual fall accidents than males (p<0.001). The major reason for fall accidents was slippery floors (33.7% in 2011 and 36.3% in 2013). Between 2008 and 2010, variables associated with higher fall accident risk included specific months (August and September), old age, female gender, current drinker, current smoker, diabetes, osteoarthritis, osteoporosis, and depression. A high level of education and living with a partner were negatively associated with fall accident risk. In 2013, people experiencing more than 1 fall accident felt more fear of falling than those having no fall accidents (odds ratio [OR] for 1 fall, 2.12; 95% confidence interval [CI], 2.04–2.12; OR for more than 2 falls, 2.97; 95% CI, 2.83–3.10). Conclusion The occurrence of fall accidents has consistently increased in Korea from 2008 to 2013. Future intervention studies are needed to reduce the increasing incidence rates of fall accidents in community dwelling adults.

  1. Hearing impairment and incident disability and all-cause mortality in older British community-dwelling men

    PubMed Central

    Liljas, Ann E. M.; Wannamethee, S. Goya; Whincup, Peter H.; Papacosta, Olia; Walters, Kate; Iliffe, Steve; Lennon, Lucy T.; Carvalho, Livia A.; Ramsay, Sheena E.

    2016-01-01

    Background and objective: hearing impairment is common in older adults and has been implicated in the risk of disability and mortality. We examined the association between hearing impairment and risk of incident disability and all-cause mortality. Design and setting: prospective cohort of community-dwelling older men aged 63–85 followed up for disability over 2 years and for all-cause mortality for 10 years in the British Regional Heart Study. Methods: data were collected on self-reported hearing impairment including hearing aid use, and disability assessed as mobility limitations (problems walking/taking stairs), difficulties with activities of daily living (ADL) and instrumental ADL (IADL). Mortality data were obtained from the National Health Service register. Results: among 3,981 men, 1,074 (27%) reported hearing impairment. Compared with men with no hearing impairment, men who could hear and used a hearing aid, and men who could not hear despite a hearing aid had increased risks of IADL difficulties (age-adjusted OR 1.86, 95% CI 1.29–2.70; OR 2.74, 95% CI 1.53–4.93, respectively). The associations remained after further adjustment for covariates including social class, lifestyle factors, co-morbidities and social engagement. Associations of hearing impairment with incident mobility limitations, incident ADL difficulties and all-cause mortality were attenuated on adjustment for covariates. Conclusion: this study suggests that hearing problems in later life could increase the risk of having difficulties performing IADLs, which include more complex everyday tasks such as shopping and light housework. However, further studies are needed to determine the associations observed including the underlying pathways. PMID:27146303

  2. Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons – a narrative review

    PubMed Central

    Goisser, Sabine; Kemmler, Wolfgang; Porzel, Simone; Volkert, Dorothee; Sieber, Cornel Christian; Bollheimer, Leo Cornelius; Freiberger, Ellen

    2015-01-01

    One of the many threats to independent life is the age-related loss of muscle mass and muscle function commonly referred to as sarcopenia. Another important health risk in old age leading to functional decline is obesity. Obesity prevalence in older persons is increasing, and like sarcopenia, severe obesity has been consistently associated with several negative health outcomes, disabilities, falls, and mobility limitations. Both sarcopenia and obesity pose a health risk for older persons per se, but in combination, they synergistically increase the risk for negative health outcomes and an earlier onset of disability. This combination of sarcopenia and obesity is commonly referred to as sarcopenic obesity. The present narrative review reports the current knowledge on the effects of complex interventions containing nutrition and exercise interventions in community-dwelling older persons with sarcopenic obesity. To date, several complex interventions with different outcomes have been conducted and have shown promise in counteracting either sarcopenia or obesity, but only a few studies have addressed the complex syndrome of sarcopenic obesity. Strong evidence exists on exercise interventions in sarcopenia, especially on strength training, and for obese older persons, strength exercise in combination with a dietary weight loss intervention demonstrated positive effects on muscle function and body fat. The differences in study protocols and target populations make it impossible at the moment to extract data for a meta-analysis or give state-of-the-art recommendations based on reliable evidence. A conclusion that can be drawn from this narrative review is that more exercise programs containing strength and aerobic exercise in combination with dietary interventions including a supervised weight loss program and/or protein supplements should be conducted in order to investigate possible positive effects on sarcopenic obesity. PMID:26346071

  3. Apathy and cognitive and functional decline in community-dwelling older adults: Results from the Baltimore ECA longitudinal study

    PubMed Central

    Clarke, Diana E.; Ko, Jean Y.; Lyketsos, Constantine; Rebok, George W.; Eaton, William W.

    2010-01-01

    Background Apathy, a complex neuropsychiatric syndrome, commonly affects patients with Alzheimer’s disease. Prevalence estimates for apathy range widely and are based on cross-sectional data and / or clinic samples. This study examines the relationships between apathy and cognitive and functional declines in non-depressed community-based older adults. Methods Data on 1,136 community-dwelling adults age 50 and older from the Baltimore Epidemiologic Catchment Area (ECA) study, with 1 and 13 years of follow-up, were used. Apathy was assessed with a subscale of items from the General Health Questionnaire. Chi-square, t-tests, logistic regression, and Generalized Estimating Equations were used to accomplish the study’s objectives. Results The prevalence of apathy at Wave 1 was 23.7%. Compared to those without, individuals with apathy were on average older, more likely to be female, and have lower MMSE scores and impairments in basic and instrumental functioning at baseline. Apathy was significantly associated with cognitive decline (OR = 1.65, 95% CI = 1.06, 2.60) and declines in instrumental (OR = 4.42; 95% CI = 2.65, 7.38) and basic (OR=2.74; 95%CI= 1.35, 5.57) function at 1 year follow-up, even after adjustment for baseline age, level of education, race, and depression at follow-up. At 13 years of follow-up, apathetic individuals were not at greater risk for cognitive decline but were 2-fold more likely to have functional decline. Incidence of apathy at 1- year follow up and 13- year follow-up was respectively, 22.6% and 29.4%. Conclusions These results underline the public health importance of apathy and the need for further population-based studies in this area. PMID:20478091

  4. High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults

    PubMed Central

    Wu, Chen-Yi; Hu, Hsiao-Yun; Chou, Yiing-Jenq; Huang, Nicole; Chou, Yi-Chang; Li, Chung-Pin

    2015-01-01

    Abstract Although hypertension is common among older adults, the optimal blood pressure (BP) for survival in older adults remains unclear. We attempt to use a large cohort to assess the relationship between BP and mortality and to gain insight into what level of BP is required for optimal survival in older adults. A total of 77,389 community-dwelling adults, aged ≥65 years, were followed between 2006 and 2010. Mortality was determined using matching cohort identifications with national death files. Cox proportional hazards regression models were used to evaluate the relationship of BP with all-cause, cardiovascular disease (CVD), and expanded-CVD mortalities. The mortality risks of the stage 2–3 hypertension group were substantial (all-cause mortality: hazard ratio [HR]: 1.23; 95% confidence interval [CI]: 1.10–1.37; CVDs mortality: HR: 1.31; 95% CI: 1.05–1.64; expanded-CVDs mortality: HR: 1.40; 95% CI: 1.15–1.71). The cardiovascular and expanded-cardiovascular mortality risks were lowest when systolic blood pressures were 120 to 129 mm Hg, and increased significantly when systolic blood pressures (SBPs) were ≥160 mm Hg or diastolic BPs were ≥90 mm Hg. A J-curve phenomenon for SBP on CVD and expanded-CVD mortality was observed. The impacts of stage 2–3 hypertension on mortality risks were significantly increased among women. The mortality risks of hypertension were not attenuated with older age. This study provides insight for identifying the optimal BP for survival in older adults, and extends the knowledge of the impacts of hypertension on mortality risks among women and the older adults. PMID:26632749

  5. Cognitive Impairment and Disability in Older Japanese Adults

    PubMed Central

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

    2016-01-01

    The prevalence of disability is increasing due to an expanding aging population and an increasing incidence of chronic health problems. Cognitive impairment may predict the development of disability in older adults. Therefore, we examined the association of mild cognitive impairment (MCI) and/or general cognitive impairment (GCI, defined as a Mini Mental State Examination [MMSE] score of 20–23) with the development of disability in a cohort of Japanese community-dwelling older adults. A total of 4290 participants (aged ≥65 years) enrolled in the Obu Study of Health Promotion for the Elderly were classified according to the presence and degree of cognitive impairment as follows: cognitively healthy, GCI, MCI single domain (MCIs), MCIs with GCI, MCI multiple domain (MCIm), and MCIm with GCI. MMSE scores, risk factors for dementia, and incidences of new disability were recorded. After an average of 29.5 months, 205 participants (4.8%) experienced a new onset of disability. All subtypes of cognitive impairment showed significant relationships with disability except for GCI alone. The following hazard ratios (HRs) were determined: MCIs (HR, 2.04; 95% CI, 1.39–3.00), MCIs with GCI (HR, 2.10; 95% CI, 1.21–3.62), MCIm (HR, 2.32; 95% CI, 1.39–3.85), and MCIm with GCI (HR, 4.23; 95% CI, 2.73–6.57). These results indicate that cognitive impairment may be related to an increased risk for the development of disability. Healthcare providers should implement global cognitive assessments to identify MCI and GCI and consider preventive interventions for disability, especially in older persons. PMID:27415430

  6. An Educational Intervention for Police and Firefighters for Elders at Risk: Limits of Education Alone as a Strategy for Behavior Change

    ERIC Educational Resources Information Center

    Nusbaum, N. J.; Mistretta, M.; Wegner, J.

    2007-01-01

    As part of a research project aimed at the health care needs of the vulnerable community-dwelling elderly, an educational intervention was delivered to police and firefighters in worksite settings. A single educational intervention proved insufficient to produce lasting attitudinal and behavioral change as measured by follow-up surveys 3 and 6…

  7. Association of Fetuin-A With Incident Fractures in Community-Dwelling Older Adults: The Cardiovascular Health Study.

    PubMed

    Fink, Howard A; Bůžková, Petra; Garimella, Pranav S; Mukamal, Kenneth J; Cauley, Jane A; Kizer, Jorge R; Barzilay, Joshua I; Jalal, Diana I; Ix, Joachim H

    2015-08-01

    Fetuin-A, a serum protein that regulates calcium mineralization, has been associated with bone mineral density (BMD) in several cross-sectional human studies, suggesting a possible beneficial effect on clinically important measures of bone health. Fetuin-A and incidence of subsequent fracture was assessed in 4714 men and women ≥65 years of age. Proportional hazards models were used to estimate risk of incident hip (hospital discharge ICD-9 codes) and composite fracture (hip, pelvis, humerus, or proximal forearm; hospital discharge ICD-9 codes and Medicare claims data). A total of 576 participants had an incident hip fracture (median follow-up 11.2 years) and 768 had an incident composite fracture (median follow-up 6.9 years). In unadjusted analyses, there was no association between fetuin-A (per SD increase) and risk of hip fracture (hazard ratio [HR], 0.96; 95% CI, 0.88 to 1.05) or composite fracture (HR, 0.99; 95% CI, 0.92 to 1.06). Results were not significantly changed after adjustment for potential confounding variables. Analyses modeling fetuin-A in quartiles or within a subset with available BMD measures also showed no statistically significant association with risk of hip or composite fracture. Though fetuin-A was positively associated with areal BMD in partially adjusted models (total hip: β, 0.013 g/cm(2) ; 95% CI, 0.005 to 0.021; femoral neck: β, 0.011 g/cm(2) ; 95% CI, 0.004 to 0.018; and lumbar spine: β, 0.007 g/cm(2) ; 95% CI, 0.001 to 0.028), these associations were no longer significant after further adjustment for BMI and in final multivariate models. In this large sample of community-dwelling older adults, a small positive association between fetuin-A and areal BMD appeared attributable to confounding variables and we found no evidence of an association between fetuin-A and risk of clinical fracture. PMID:25656814

  8. Chronic low back pain is associated with reduced vertebral bone mineral measures in community-dwelling adults

    PubMed Central

    2012-01-01

    Background Chronic low back pain (CLBP) experienced in middle-age may have important implications for vertebral bone health, although this issue has not been investigated as a primary aim previously. This study investigated the associations between CLBP and dual energy X-ray absorptiometry (DXA)-derived vertebral bone mineral measures acquired from postero-anterior and lateral-projections, among community-dwelling, middle-aged adults. Methods Twenty-nine adults with CLBP (11 male, 18 female) and 42 adults with no history of LBP in the preceding year (17 male, 25 female) were evaluated. Self-reported demographic and clinical data were collected via questionnaires. Areal bone mineral density (aBMD) was measured in the lumbar spine by DXA. Apparent volumetric (ap.v) BMD in the lumbar spine was also calculated. Multiple linear regression models were used to examine associations between study group (CLBP and control) and vertebral DXA variables by gender, adjusting for height, mass and age. Results There was no difference between groups by gender in anthropometrics or clinical characteristics. In the CLBP group, the mean (SD) duration of CLBP was 13.3 (10.4) years in males and 11.6 (9.9) years in females, with Oswestry Disability Index scores of 16.2 (8.7)% and 15.4 (9.1)%, respectively. Males with CLBP had significantly lower adjusted lateral-projection aBMD and lateral-projection ap.vBMD than controls at L3 with mean differences (standard error) of 0.09 (0.04) g/cm2 (p = 0.03) and 0.02 (0.01) g/cm3 (p = 0.04). These multivariate models accounted for 55% and 53% of the variance in lateral-projection L3 aBMD and lateral-projection L3 ap.vBMD. Conclusions CLBP in males is associated with some lumbar vertebral BMD measures, raising important questions about the mechanism and potential clinical impact of this association. PMID:22458361

  9. Supervision of care networks for frail community dwelling adults aged 75 years and older: protocol of a mixed methods study

    PubMed Central

    Verver, Didi; Merten, Hanneke; Robben, Paul; Wagner, Cordula

    2015-01-01

    Introduction The Dutch healthcare inspectorate (IGZ) supervises the quality and safety of healthcare in the Netherlands. Owing to the growing population of (community dwelling) older adults and changes in the Dutch healthcare system, the IGZ is exploring new methods to effectively supervise care networks that exist around frail older adults. The composition of these networks, where formal and informal care takes place, and the lack of guidelines and quality and risk indicators make supervision complicated in the current situation. Methods and analysis This study consists of four phases. The first phase identifies risks for community dwelling frail older adults in the existing literature. In the second phase, a qualitative pilot study will be conducted to assess the needs and wishes of the frail older adults concerning care and well-being, perception of risks, and the composition of their networks, collaboration and coordination between care providers involved in the network. In the third phase, questionnaires based on the results of phase II will be sent to a larger group of frail older adults (n=200) and their care providers. The results will describe the composition of their care networks and prioritise risks concerning community dwelling older adults. Also, it will provide input for the development of a new supervision framework by the IGZ. During phase IV, a second questionnaire will be sent to the participants of phase III to establish changes of perception in risks and possible changes in the care networks. The framework will be tested by the IGZ in pilots, and the researchers will evaluate these pilots and provide feedback to the IGZ. Ethics and dissemination The study protocol was approved by the Scientific Committee of the EMGO+institute and the Medical Ethical review committee of the VU University Medical Centre. Results will be presented in scientific articles and reports and at meetings. PMID:26307619

  10. Non-invasive monitoring of core body temperature rhythms over 72 h in 10 bedridden elderly patients with disorders of consciousness in a Japanese hospital: a pilot study.

    PubMed

    Matsumoto, Masaru; Sugama, Junko; Okuwa, Mayumi; Dai, Misako; Matsuo, Junko; Sanada, Hiromi

    2013-01-01

    The purpose of this study was to elucidate the body core temperature rhythms of bedridden elderly patients with disorders of consciousness (DOC) in a Japanese hospital using a simple, non-invasive, deep-body thermometer. We measured body core temperature on the surface of abdomen in 10 bedridden elderly patients with DOC continuously over 72 h. A non-heated core body temperature thermometer was used. The cycle of the body core temperature rhythm was initially derived by using the least squares method. Then, based on that rhythm, the mean, amplitude, and times of day of the highest and lowest body temperatures during the optimum cycle were determined using the cosinor method. We found a 24-h cycle in seven of the 10 patients. One patient had a 6-h, one a 12-h, and one a 63-h cycle. The mean value of the cosine curve in the respective optimum cycles was 36.48 ± 0.34 °C, and the amplitude was 0.22 ± 0.09 °C. Of the seven subjects with 24-h cycles, the highest body temperature occurred between 12:58 and 14:44 h in four. In addition to 24-h cycles of core temperature rhythm, short cycles of 12 and 6-h and a long cycle of 63-h were seen. In order to understand the temperature rhythms of bedridden elderly patients with DOC, it is necessary to monitor their core body temperatures, ideally using a simple, non-invasive device. In the future, it will be important to investigate the relationship of the core temperature rhythm to nursing care and living environment.

  11. Antioxidant-rich food intakes and their association with blood total antioxidant status and vitamin C and E levels in community-dwelling seniors from the Quebec longitudinal study NuAge.

    PubMed

    Khalil, Abdelouahed; Gaudreau, Pierrette; Cherki, Mounia; Wagner, Richard; Tessier, Daniel M; Fulop, Tamas; Shatenstein, Bryna

    2011-06-01

    A cross-sectional study was designed to investigate the association between current consumption of a series of 26 common antioxidant-rich foods (ARF) with serum total antioxidant status (TAS) and plasma vitamin C and E levels in community-dwelling older adults. A convenience sample of the first 94 non-smoking Caucasian men (54%) and women (46%) enrolled in the Quebec Longitudinal Study NuAge were selected. The "Functional Foods Consumption Frequency Questionnaire" (FFCFQ) was administered at recruitment (T1) to ascertain patterns of consumption of ARF over the lifetime. The total Oxygen Radical Antioxidant Capacity (ORAC) of 25 ARF reported by subjects was estimated using published values. Serum TAS was determined based on the Trolox equivalent antioxidant capacity (TEAC) assay while plasma vitamins C and E (α- and γ-tocopherol) levels were analyzed by HPLC. The numbers of ARF eaten daily at T1, estimated from the FFCFQ and calculated from the diet recalls, were significantly correlated (r=0.51, P<0.0001) and each measure was associated with total ORAC content (r=0.34, P<0.001 and r=0.59, P<0.0001 for FFCFQ and recalls, respectively). No significant association was found between TAS and the total ORAC value of ARF determined from the quantitative 24-h diet recalls. However, daily ARF consumption at T1 obtained from the FFCFQ was significantly and positively correlated with TAS (r=0.26, P<0.05) and circulating levels of vitamin C (r=0.25, P<0.02) and α-tocopherol (r=0.22, p<0.05) and negatively correlated with plasma γ-tocopherol (r=-0.25, P<0.025). These results highlight associations between ARF consumption and circulating levels of antioxidants in the elderly and suggest benefits from antioxidant-rich foods during aging.

  12. Comparison between smartphone pedometer applications and traditional pedometers for improving physical activity and body mass index in community-dwelling older adults

    PubMed Central

    Fong, Shirley S.M.; Ng, Shamay S.M.; Cheng, Yoyo T.Y.; Zhang, Joni; Chung, Louisa M.Y.; Chow, Gary C.C.; Chak, Yvonne T.C.; Chan, Ivy K.Y.; Macfarlane, Duncan J.

    2016-01-01

    [Purpose] The effectiveness of a smartphone pedometer application was compared with that of a traditional pedometer for improving the physical activity and weight status of community-dwelling older adults. [Subjects and Methods] This study had a nonequivalent pretest-posttest control group design. Ninety-seven older adults (mean age ± SD, 60.1 ± 5.5 years) joined the smartphone pedometer group and underwent a 2-week walking intervention based on a smartphone pedometer application. Fifty-four older adults (mean age ± SD, 65.3 ± 8.7 years) joined the traditional pedometer group and underwent a 2-week walking intervention based on a traditional pedometer. The participants’ physical activity was evaluated using the International Physical Activity Questionnaire–Short Form, and their weight status was quantified by calculating the body mass index. The daily pedometer count was also documented. [Results] No significant time, group, or time-by-group interaction effects were found for any of the outcome variables. However, trends of improvement in physical activity and body mass index were seen only in the smartphone pedometer group. [Conclusion] A smartphone pedometer application might be more favorable than a traditional pedometer in improving physical activity and body mass index in community-dwelling older adults. However, further experimental studies are necessary to confirm the results. PMID:27313391

  13. Comparison between smartphone pedometer applications and traditional pedometers for improving physical activity and body mass index in community-dwelling older adults.

    PubMed

    Fong, Shirley S M; Ng, Shamay S M; Cheng, Yoyo T Y; Zhang, Joni; Chung, Louisa M Y; Chow, Gary C C; Chak, Yvonne T C; Chan, Ivy K Y; Macfarlane, Duncan J

    2016-05-01

    [Purpose] The effectiveness of a smartphone pedometer application was compared with that of a traditional pedometer for improving the physical activity and weight status of community-dwelling older adults. [Subjects and Methods] This study had a nonequivalent pretest-posttest control group design. Ninety-seven older adults (mean age ± SD, 60.1 ± 5.5 years) joined the smartphone pedometer group and underwent a 2-week walking intervention based on a smartphone pedometer application. Fifty-four older adults (mean age ± SD, 65.3 ± 8.7 years) joined the traditional pedometer group and underwent a 2-week walking intervention based on a traditional pedometer. The participants' physical activity was evaluated using the International Physical Activity Questionnaire-Short Form, and their weight status was quantified by calculating the body mass index. The daily pedometer count was also documented. [Results] No significant time, group, or time-by-group interaction effects were found for any of the outcome variables. However, trends of improvement in physical activity and body mass index were seen only in the smartphone pedometer group. [Conclusion] A smartphone pedometer application might be more favorable than a traditional pedometer in improving physical activity and body mass index in community-dwelling older adults. However, further experimental studies are necessary to confirm the results.

  14. What are the factors associated with physical activity (PA) participation in community dwelling adults with dementia? A systematic review of PA correlates.

    PubMed

    Stubbs, Brendon; Eggermont, Laura; Soundy, Andrew; Probst, Michel; Vandenbulcke, Mathieu; Vancampfort, Davy

    2014-01-01

    PA shows promise as a modifiable lifestyle intervention to benefit pathological symptoms of dementia. However, little is known about the factors associated with participation in PA in community dwelling adults with dementia. A systematic review was undertaken to identify PA correlates. Two independent reviewers searched major electronic databases and extracted data on studies reporting quantitative correlates of PA participation in community dwelling adults with dementia. PA correlates were analyzed using the summary code approach within the socio-ecological model. Out of a potential of 118 articles, 12 met the eligibility criteria encompassing 752 participants. We conducted secondary analysis on nine data sets. Increased energy intake, resting metabolic rate, fat free mass, gait speed, global motor function, overall health related quality of life (HRQOL), physical HRQOL, higher levels of social functioning and reduced apathy were positively associated with PA. Taking ≥ four medications, dizziness, lower activities of daily living (ADL) function, a history of falls, less waking hours in the day, more autonomic problems and delirium were negatively associated with PA. Increasing age and lower global cognition were not consistently associated with PA participation. It is surprising that increasing age and lower global cognition do not appear to influence PA participation. All significant correlates should be confirmed in prospective studies with particular focus on the relationship of PA and gait speed, ADL function, falls history and dietary intake and the progression of frailty and nursing home admission as a priority.

  15. Comparison between smartphone pedometer applications and traditional pedometers for improving physical activity and body mass index in community-dwelling older adults.

    PubMed

    Fong, Shirley S M; Ng, Shamay S M; Cheng, Yoyo T Y; Zhang, Joni; Chung, Louisa M Y; Chow, Gary C C; Chak, Yvonne T C; Chan, Ivy K Y; Macfarlane, Duncan J

    2016-05-01

    [Purpose] The effectiveness of a smartphone pedometer application was compared with that of a traditional pedometer for improving the physical activity and weight status of community-dwelling older adults. [Subjects and Methods] This study had a nonequivalent pretest-posttest control group design. Ninety-seven older adults (mean age ± SD, 60.1 ± 5.5 years) joined the smartphone pedometer group and underwent a 2-week walking intervention based on a smartphone pedometer application. Fifty-four older adults (mean age ± SD, 65.3 ± 8.7 years) joined the traditional pedometer group and underwent a 2-week walking intervention based on a traditional pedometer. The participants' physical activity was evaluated using the International Physical Activity Questionnaire-Short Form, and their weight status was quantified by calculating the body mass index. The daily pedometer count was also documented. [Results] No significant time, group, or time-by-group interaction effects were found for any of the outcome variables. However, trends of improvement in physical activity and body mass index were seen only in the smartphone pedometer group. [Conclusion] A smartphone pedometer application might be more favorable than a traditional pedometer in improving physical activity and body mass index in community-dwelling older adults. However, further experimental studies are necessary to confirm the results. PMID:27313391

  16. Improvement of gait ability with a short-term intensive gait rehabilitation program using body weight support treadmill training in community dwelling chronic poststroke survivors.

    PubMed

    Takao, Toshifumi; Tanaka, Naoki; Iizuka, Noboru; Saitou, Hideyuki; Tamaoka, Akira; Yanagi, Hisako

    2015-01-01

    [Purpose] Most previous studies have shown that body weight support treadmill training (BWSTT) can improve gait speed poststroke patients. The purpose of this study was to evaluate effectiveness of a short-term intensive program using BWSTT among community dwelling poststroke survivors. [Subjects] Eighteen subjects participated in this study. The treatment group was composed of 10 subjects (2 women; 8 men; mean age, 59.1 ± 12.5 years; time since stroke onset, 35.3 ± 33.2 months), whereas the control group was made up of 8 subjects (3 women; 5 men; mean age, 59.8 ± 6.3 years; time since stroke onset, 39.3 ± 27.3 months). [Methods] The treatment group received BWSTT 3 times a week for 4 weeks (a total of 12 times), with each session lasting 20 minutes. The main outcome measures were maximum gait speed on a flat floor, cadence, and step length. [Results] No differences were observed in the baseline clinical data between the 2 groups. The gait speed in the treatment group was significantly improved compared with that in the control by 2-way ANOVA, while the other parameters showed no significant interaction. [Conclusion] These results suggested that short-term intensive gait rehabilitation using BWSTT was useful for improving gait ability among community dwelling poststroke subjects.

  17. Improvement of gait ability with a short-term intensive gait rehabilitation program using body weight support treadmill training in community dwelling chronic poststroke survivors

    PubMed Central

    Takao, Toshifumi; Tanaka, Naoki; Iizuka, Noboru; Saitou, Hideyuki; Tamaoka, Akira; Yanagi, Hisako

    2015-01-01

    [Purpose] Most previous studies have shown that body weight support treadmill training (BWSTT) can improve gait speed poststroke patients. The purpose of this study was to evaluate effectiveness of a short-term intensive program using BWSTT among community dwelling poststroke survivors. [Subjects] Eighteen subjects participated in this study. The treatment group was composed of 10 subjects (2 women; 8 men; mean age, 59.1 ± 12.5 years; time since stroke onset, 35.3 ± 33.2 months), whereas the control group was made up of 8 subjects (3 women; 5 men; mean age, 59.8 ± 6.3 years; time since stroke onset, 39.3 ± 27.3 months). [Methods] The treatment group received BWSTT 3 times a week for 4 weeks (a total of 12 times), with each session lasting 20 minutes. The main outcome measures were maximum gait speed on a flat floor, cadence, and step length. [Results] No differences were observed in the baseline clinical data between the 2 groups. The gait speed in the treatment group was significantly improved compared with that in the control by 2-way ANOVA, while the other parameters showed no significant interaction. [Conclusion] These results suggested that short-term intensive gait rehabilitation using BWSTT was useful for improving gait ability among community dwelling poststroke subjects. PMID:25642063

  18. Reliability and validity of the personality inventory for DSM-5 (PID-5): predicting DSM-IV personality disorders and psychopathy in community-dwelling Italian adults.

    PubMed

    Fossati, Andrea; Krueger, Robert F; Markon, Kristian E; Borroni, Serena; Maffei, Cesare

    2013-12-01

    In order to assess the internal consistency, factor structure, and ability to recover DSM-IV personality disorders (PDs) of the Personality Inventory for DSM-5 (PID-5) scales, 710 Italian adult community dwelling volunteers were administered the Italian translation of the PID-5, as well as the Italian translation of the Personality Diagnostic Questionnaire-4+ (PDQ-4+). Cronbach's alpha values were >.70 for all PID-5 facet scales and greater than .90 for all PID-5 domain scales. Parallel analysis and confirmatory factor analysis supported the theoretical five-factor model of the PID-5 trait scales. Regression analyses showed that both PID-5 trait and domain scales explained a substantial amount of variance in the PDQ-4+ PD scales, with the exception of the Passive-Aggressive PD scale. When the PID-5 was administered to a second independent sample of 389 Italian adult community dwelling volunteers, the basic psychometric properties of the scale were replicated. In this second sample, the PID-5 trait and domain scales proved to be significant predictors of psychopathy measures. As a whole, the results of the present study support the hypothesis that the PID-5 is a reliable instrument which is able to recover DSM-IV PDs, as well as to capture personality pathology that is not included in the DSM-IV (namely, psychopathy).

  19. Telemonitoring and Protocolized Case Management for Hypertensive Community-Dwelling Seniors With Diabetes: Protocol of the TECHNOMED Randomized Controlled Trial

    PubMed Central

    McAlister, Finlay Aleck; Wood, Peter William; Boulanger, Pierre; Fradette, Miriam; Klarenbach, Scott; Edwards, Alun L; Holroyd-Leduc, Jayna M; Alagiakrishnan, Kannayiram; Rabi, Doreen; Majumdar, Sumit Ranjan

    2016-01-01

    Background Diabetes and hypertension are devastating, deadly, and costly conditions that are very common in seniors. Controlling hypertension in seniors with diabetes dramatically reduces hypertension-related complications. However, blood pressure (BP) must be lowered carefully because seniors are also susceptible to low BP and attendant harms. Achieving “optimal BP control” (ie, avoiding both undertreatment and overtreatment) is the ultimate therapeutic goal in such patients. Regular BP monitoring is required to achieve this goal. BP monitoring at home is cheap, convenient, widely used, and guideline endorsed. However, major barriers prevent proper use. These may be overcome through use of BP telemonitoring—the secure teletransmission of BP readings to a health portal, where BP data are summarized for provider and patient use, with or without protocolized case management. Objective To examine the incremental effectiveness, safety, cost-effectiveness, usability, and acceptability of home BP telemonitoring, used with or without protocolized case management, compared with “enhanced usual care” in community-dwelling seniors with diabetes and hypertension. Methods A 300-patient, 3-arm, pragmatic randomized controlled trial with blinded outcome ascertainment will be performed in seniors with diabetes and hypertension living independently in seniors’ residences in greater Edmonton. Consenting patients will be randomized to usual care, home BP telemonitoring alone, or home BP telemonitoring plus protocolized pharmacist case management. Usual care subjects will receive a home BP monitor but neither they nor their providers will have access to teletransmitted data. In both telemonitored arms, providers will receive telemonitored BP data summaries. In the case management arm, pharmacist case managers will be responsible for reviewing teletransmitted data and initiating guideline-concordant and protocolized changes in BP management. Results Outcomes will be

  20. Trends in ADL and IADL Disability in Community-Dwelling Older Adults in Shanghai, China, 1998–2008

    PubMed Central

    2013-01-01

    Objectives. We investigated trends in activities of daily living (ADL) and instrumental activities of daily living (IADL) disability from 1998 to 2008 among elder adults in Shanghai, China. Method. Our data came from 4 waves of the Shanghai Longitudinal Survey of Elderly Life and Opinion (1998, 2003, 2005, and 2008). ADL and IADL disabilities were recorded dichotomously (difficulty vs. no difficulty). The major independent variable was survey year. Covariates included demographics, socioeconomic conditions, family and social support, and other health conditions. Nested random-effect models were applied to estimate trends over time, referenced to 1998. Results. In comparison with the baseline year (1998), older adults in 2008 had lower odds of being ADL disabled, though the effect was no longer statistically significant when other health conditions were taken into account. Elders in 2003, 2005, and 2008 were 20%–26%, 17%–38%, and 53%–64% less likely to be IADL disabled than those in 1998, respectively, depending on the set of covariates included in the model. Discussion. Shanghai elders experienced substantial improvements in both ADL and IADL disability prevalence over the past decade. The trend toward improvement in IADL function is more consistent and substantial than that of ADL function. PMID:23525547

  1. Effect of the Medicinal Mushroom, Grifola gargal (Agaricomycetes), on Bone Turnover Markers and Serum Lipids in Middle-Aged and Elderly Japanese Women.

    PubMed

    Harada, Etsuko; Morizono, Toshihiro; Sumiya, Toshimitsu; Kawagishi, Hirokazu

    2016-01-01

    A clinical study was performed to examine the effect of the edible mushroom, Grifola gargal, on bone turnover markers and serum lipids in middle-aged and elderly Japanese women. Postmenopausal women aged 51-73 years (mean age, 61 years) received daily oral administration of 5 g G. gargal fruiting bodies (hot air-dried and powdered; G. gargal powder [GGP]). Serum levels of bone alkaline phosphatase (BAP) and lipids and urinary deoxypyridinoline (DPD) levels were measured before and 2 weeks after the start of GGP treatment. As a result, urinary DPD bone resorption marker levels in women treated with GGP decreased significantly. Serum levels of the BAP bone formation marker also tended to increase, but the difference was not significant. By contrast, the atherogenic index decreased and the high-density lipoprotein (HDL) ratio increased significantly. However, there were no statistically significant differences in serum lipids of total cholesterol, HDL cholesterol, and low-density lipoprotein cholesterol. In addition, this study demonstrated for the first time that G. gargal is safe for human consumption. PMID:27279439

  2. End-of-Life Preference Discussions between Elderly Japanese American Men and Their Families: The Honolulu-Asia Aging Study

    PubMed Central

    Okamoto, Lauren; Bell, Christina; Fong, Kaon; Masaki, Kamal

    2015-01-01

    Background: Challenging cases in geriatrics often involve lack of communication regarding end-of-life preferences and cultural issues. There have been no previous population-based studies on acculturation and end-of-life preference discussions among older Japanese-Americans. Methods: The Honolulu-Asia Aging Study is a continuation of the Honolulu Heart Program, a longitudinal cohort study in Japanese-American men in Hawai‘i that began in 1965. In the 2009–10 exam, participants identified a proxy informant who answered questions about their knowledge of the men's end-of-life preferences. We studied the relationship between end-of-life preference discussions and completion of a written advance directive and actual preferences for end-of-life care, as well as associations between discussions and demographic and cultural factors. The Cultural Assimilation Scale (CAS) consisted of 8 questions assessing degree of Japanese identity and lifestyle. Results: Among 350 participants aged 89–108 years, proxy informants were wives (29.4%), daughters (29.4%), sons (22.0%), other relatives (8.0%) and others (mostly paid caregivers, 11.1%). On proxy interview, 70.7% reported end-of-life preference discussions and 29.3% did not. Those who had end-of-life preference discussions were more likely to have completed a written advance directive compared to those without discussions (93.6% vs 61.5%, P < .0001). Even among those with discussions, many proxies were unsure about certain preferences, including tube feeding (27.4%), nursing home care (23.8%) and dementia care (20.2%). Factors associated with having end-of-life preference discussions included Christian religion (vs Buddhist/Shinto, OR = 1.85, 95% CI = 1.00−3.41, P < .05) and daughter as proxy informant (vs wife, OR = 2.34, 95% CI = 1.20−4.54, P = .01), but no associations with age, education, marital status or acculturation scores. Conclusion: Among this oldest-old population, there were almost 30% who did not have end

  3. Seeking safety: predictors of hurricane evacuation of community-dwelling families affected by Alzheimer's disease or a related disorder in South Florida.

    PubMed

    Christensen, Janelle J; Richey, Elizabeth Danforth; Castañeda, Heide

    2013-11-01

    This article explores how dyads of 186 community-dwelling individuals with a diagnosis of Alzheimer's disease or a related disorder (ADRD) and their caregivers (dyads) plan to respond to hurricane evacuation warnings in South Florida. Predictors of dyad evacuation for a category 1-3 storm include (1) a younger age of the person with an ADRD diagnosis, (2) the caregiver living in a different residence than the person with ADRD, (3) lack of hurricane shutters, and (4) lower income. A dyad is more likely to evacuate in a category 4 or 5 hurricane if there is (1) a younger age person with an ADRD diagnosis, (2) a more recent diagnosis of ADRD, (3) a residence in an evacuation zone, and if (4) they report needing a shelter. Emergency management teams, especially those who assist with special needs shelters or other outreach programs for people with cognitive disabilities, can use these guidelines to estimate service usage and needs.

  4. Demographic and Socioenvironmental Characteristics of Black and White Community-Dwelling Caregivers and Care Recipients' Behavioral and Psychological Symptoms of Dementia.

    PubMed

    Cothran, Fawn A; Farran, Carol J; Barnes, Lisa L; Whall, Ann L; Redman, Richard W; Struble, Laura M; Dunkle, Ruth E; Fogg, Louis

    2015-01-01

    The purpose of the current study was to compare the association between caregiver background characteristics and care recipients' behavioral and psychological symptoms of dementia (BPSD) in Black and White community-dwelling family caregivers. Using logistic regression models, caregiver/care recipient dyad data from the Aging Demographics and Memory Study were used to describe associations between caregiver background characteristics (i.e., demographic and socioenvironmental variables) and care recipients' BPSD (i.e., hallucinations, delusions, agitation, depression) (N = 755). Results showed that Black caregivers were more likely to be female, younger, an adult child, have less education, and live in the South (p ≤ 0.05); they were less likely to be married. Several caregiver background characteristics were associated with care recipients' depression and agitation, but not with other BPSD. Caregiver background characteristics may play a role in the recognition and reporting of BPSD and should be considered when working with families of individuals with dementia.

  5. Type 1 Diabetes Mellitus and Pernicious Anemia in an Elderly Japanese Patient: A Case Report and Literature Review.

    PubMed

    Ohara, Nobumasa; Kaneko, Masanori; Yano, Toshio; Sato, Naoko; Usuda, Hiroyuki; Miyakoshi, Masashi; Furukawa, Tatsuo; Koike, Tadashi; Kaneko, Kenzo; Kamoi, Kyuzi

    2015-01-01

    We herein report the case of a 66-year-old Japanese man with acute-onset type 1 diabetes mellitus (T1D) accompanied by pernicious anemia. After 2 weeks of polyuria, the patient developed insulin-deficient hyperglycemia with diabetic ketoacidosis in the absence of verifiable islet-related autoantibodies and began insulin therapy in 2001. Eight years later, he developed gastric autoantibody-positive pernicious anemia and began methylcobalamin treatment. Previous studies have reported cases of slowly progressive autoimmune T1D concomitant with pernicious anemia. The present case suggests that potential associations with organ-specific autoimmune disorders should be considered during the long-term follow-up of T1D patients, even though verifiable islet-related autoantibodies are undetectable. PMID:26370862

  6. Interventions to prevent or reduce the level of frailty in community-dwelling older adults: a protocol for a scoping review of the literature and international policies

    PubMed Central

    Puts, Martine T E; Toubasi, Samar; Atkinson, Esther; Ayala, Ana Patricia; Andrew, Melissa; Ashe, Maureen C; Bergman, Howard; Ploeg, Jenny; McGilton, Katherine S

    2016-01-01

    Introduction With ageing comes increased vulnerability such that older adults’ ability to recover from acute illnesses, fall-related injuries and other stresses related to the physical ageing processes declines. This increased vulnerability, also known as frailty, is common in older adults and associated with increased healthcare service use and adverse health outcomes. Currently, there is no overview of available interventions to prevent or reduce the level of frailty (as defined by study's authors) which will help healthcare providers in community settings caring for older adults. We will address this gap by reviewing interventions and international polices that are designed to prevent or reduce the level of frailty in community-dwelling older adults. Methods and analysis We will conduct a scoping review using the updated guidelines of Arksey and O'Malley to systematically search the peer-reviewed journal articles to identify interventions that aimed to prevent or reduce the level of frailty. We will search grey literature for international policies. The 6-stage scoping review model involves: (1) identifying the research question; (2) identifying relevant studies; (3) selecting studies; (4) charting the data; (5) collating, summarising and reporting the results and (6) consulting with key stakeholders. Ethics and dissemination Our scoping review will use robust methodology to search for available interventions focused on preventing or reducing the level of frailty in community-dwelling older adults. We will consult with stakeholders to find out whether they find the frailty interventions/policies useful and to identify the barriers and facilitators to their implementation in Canada. We will disseminate our findings to relevant stakeholders at local, national and international levels by presenting at relevant meetings and publishing the findings. Our review will identify gaps in research and provide healthcare providers and policymakers with an overview of

  7. Higher Lipoprotein (a) Levels Are Associated with Better Pulmonary Function in Community-Dwelling Older People – Data from the Berlin Aging Study II

    PubMed Central

    Buchmann, Nikolaus; Kassner, Ursula; Norman, Kristina; Goldeck, David; Eckardt, Rahel; Pawelec, Graham; Steinhagen-Thiessen, Elisabeth; Demuth, Ilja

    2015-01-01

    Reduced pulmonary function and elevated serum cholesterol levels are recognized risk factors for cardiovascular disease. Currently, there is some controversy concerning relationships between cholesterol, LDL-cholesterol, HDL-cholesterol, serum triglycerides and lung function. However, most previous studies compared patients suffering from chronic obstructive pulmonary disease (COPD) with healthy controls, and only a small number examined this relationship in population-based cohorts. Moreover, lipoprotein a [Lp(a)], another lipid parameter independently associated with cardiovascular diseases, appears not to have been addressed at all in studies of lung function at the population level. Here, we determined relationships between lung function and several lipid parameters including Lp(a) in 606 older community-dwelling participants (55.1% women, 68±4 years old) from the Berlin Aging Study II (BASE-II). We found a significantly lower forced expiration volume in 1 second (FEV1) in men with low Lp(a) concentrations (t-test). This finding was further substantiated by linear regression models adjusting for known covariates, showing that these associations are statistically significant in both men and women. According to the highest adjusted model, men and women with Lp(a) levels below the 20th percentile had 217.3ml and 124.2ml less FEV1 and 239.0ml and 135.2ml less FVC, respectively, compared to participants with higher Lp(a) levels. The adjusted models also suggest that the known strong correlation between pro-inflammatory parameters and lung function has only a marginal impact on the Lp(a)-pulmonary function association. Our results do not support the hypothesis that higher Lp(a) levels are responsible for the increased CVD risk in people with reduced lung function, at least not in the group of community-dwelling older people studied here. PMID:26421427

  8. Limitations in Activities of Daily Living in Community-Dwelling People Aged 75 and Over: A Systematic Literature Review of Risk and Protective Factors

    PubMed Central

    Zijlstra, G. A. Rixt; Witte, Nico De; Duppen, Daan; Stuck, Andreas E.; Kempen, Gertrudis I. J. M.; Schols, Jos M. G. A.

    2016-01-01

    Background Most older people wish to age in place, for which functional status or being able to perform activities of daily living (ADLs) is an important precondition. However, along with the substantial growth of the (oldest) old, the number of people who develop limitations in ADLs or have functional decline dramatically increases in this part of the population. Therefore, it is important to gain insight into factors that can contribute to developing intervention strategies at older ages. As a first step, this systematic review was conducted to identify risk and protective factors as predictors for developing limitations in ADLs in community-dwelling people aged 75 and over. Methods Four electronic databases (CINAHL (EBSCO), EMBASE, PsycINFO and PubMed) were searched systematically for potentially relevant studies published between January 1998 and March 2016. Results After a careful selection process, 6,910 studies were identified and 25 were included. By far most factors were examined in one study only, and most were considered risk factors. Several factors do not seem to be able to predict the development of limitations in ADLs in people aged 75 years and over, and for some factors ambiguous associations were found. The following risk factors were found in at least two studies: higher age, female gender, diabetes, hypertension, and stroke. A high level of physical activity and being married were protective in multiple studies. Notwithstanding the fact that research in people aged 65 years and over is more extensive, risk and protective factors seem to differ between the ‘younger’ and ‘older’ olds. Conclusion Only a few risk and protective factors in community-dwelling people aged 75 years and over have been analysed in multiple studies. However, the identified factors could serve both detection and prevention purposes, and implications for future research are given as well. PMID:27760234

  9. Management of Falls in Community-Dwelling Older Adults: Clinical Guidance Statement From the Academy of Geriatric Physical Therapy of the American Physical Therapy Association

    PubMed Central

    Avin, Keith G.; Hanke, Timothy A.; Kirk-Sanchez, Neva; McDonough, Christine M.; Shubert, Tiffany E.; Hartley, Greg

    2015-01-01

    Background Falls in older adults are a major public health concern due to high prevalence, impact on health outcomes and quality of life, and treatment costs. Physical therapists can play a major role in reducing fall risk for older adults; however, existing clinical practice guidelines (CPGs) related to fall prevention and management are not targeted to physical therapists. Objective The purpose of this clinical guidance statement (CGS) is to provide recommendations to physical therapists to help improve outcomes in the identification and management of fall risk in community-dwelling older adults. Design and Methods The Subcommittee on Evidence-Based Documents of the Practice Committee of the Academy of Geriatric Physical Therapy developed this CGS. Existing CPGs were identified by systematic search and critically appraised using the Appraisal of Guidelines, Research, and Evaluation in Europe II (AGREE II) tool. Through this process, 3 CPGs were recommended for inclusion in the CGS and were synthesized and summarized. Results Screening recommendations include asking all older adults in contact with a health care provider whether they have fallen in the previous year or have concerns about balance or walking. Follow-up should include screening for balance and mobility impairments. Older adults who screen positive should have a targeted multifactorial assessment and targeted intervention. The components of this assessment and intervention are reviewed in this CGS, and barriers and issues related to implementation are discussed. Limitations A gap analysis supports the need for the development of a physical therapy–specific CPG to provide more precise recommendations for screening and assessment measures, exercise parameters, and delivery models. Conclusion This CGS provides recommendations to assist physical therapists in the identification and management of fall risk in older community-dwelling adults. PMID:25573760

  10. APOE genotype influences functional status among elderly without dementia

    SciTech Connect

    Albert, S.M.; Jacobs, D.M.; Stern, Y.

    1995-12-18

    The presence of apolipoprotein-{epsilon}4 (APOE-{epsilon}4) significantly increases the risk of Alzheimer`s disease (AD). The association between APOE-{epsilon}4 status and functional abilities was explored further in a multicultural sample of community-dwelling, nondemented elders. The sample was limited to cognitively-intact, community-dwelling elders, who were free of stroke or other neurologic disability. In 218 elders who met research criteria, the presence of APOE-{epsilon}4 was associated with poorer functional status, apart from the effects of neuropsychological performance, gender, age, and education (OR = 2.5, 95% CI: 1.3, 4.9). In 158 subjects without an APOE-{epsilon}4 allele, 50% reported no functional limitation; in the 60 subjects with an {epsilon}4 allele, only 28% reported no functional limitation (P < .01). The relationship was not explained by the distribution of co-morbidities. The association between poorer function and the presence of an APOE-{epsilon}4 allele was evident in each ethnic group. In path analyses, the presence of an APOE-{epsilon}4 allele was associated with decreased functional ability in non-demented elders not simply through an association with poorer cognitive status, but also independently. These results suggest that the APOE-{epsilon}4 genotype is associated with functional deficit in people with normal neuropsychological profiles. 29 refs., 1 fig., 3 tabs.

  11. [Bright light therapy for elderly].

    PubMed

    Okawa, Masako

    2015-06-01

    Bright light therapy (BLT) holds considerable promise for sleep problems in the elderly. BLT for community-dwelling patients with Alzheimer's disease showed significant improvement in sleep parameters. In the institutional setting, BLT was effective in reducing daytime nap duration. Morning BLT was found to advance the peak circadian rhythm and increase activity level in daytime and melatonin level at night. Light therapy could be used in combination with other nonpharmacological methods such as social activities, outside walking, physical exercises, which showed greater effects than independent BLT on sleep and cognitive function. BLT treatment strategy was proposed in the present paper. We should pay more attentions to BLT in community setting for mental and physical well-being. PMID:26065132

  12. Association of Holter-Based Measures Including T-wave Alternans with Risk of Sudden Cardiac Death in the Community-Dwelling Elderly: The Cardiovascular Health Study

    PubMed Central

    Stein, Phyllis K.; Sanghavi, Devang; Sotoodehnia, Nona; Siscovick, David S; Gottdiener, John

    2010-01-01

    Background Sudden cardiac death (SCD) can be the first manifestation of cardiovascular disease. Development of screening methods for higher / lower risk is critical. Methods The Cardiovascular Healthy Study (CHS) is a population-based study of risk factors for coronary heart disease and stroke those ≥65 years. N=49 (of 1649) with usable Holters and in normal sinus rhythm, suffered SCD during follow up and were matched with 2 controls, alive at the time of death of the case and not suffering SCD on follow up. Univariate and multivariate conditional logistic regression determined the association of Holter-based information and SCD. Results In univariate models, the upper half of VPC counts, abnormal heart rate turbulence, decreased normalized low frequency power, increased T-wave alternans (TWA) and decreased DFA1 (short-term fractal scaling exponent) were associated with SCD, but time domain HRV was not. In multivariate models, the upper half of VPC counts (OR=6.6) and having TWA ≥37µV on Ch2 (OR=4.8) were independently associated with SCD. Also, the upper half of VPC counts (OR=6.9) and having DFA1 <1.05 (OR=5.0) were independently associated with SCD. When additive effects were explored: having both higher VPCs and higher TWA was associated with an OR of 8.2 for SCD compared to 2.6 for having either. Also, having both higher VPCs and lower DFA1 was associated with an OR of 9.6 for SCD compared to 3.1 for having either. Conclusions Results support a potential role for 24-hour Holter recordings to identify older adults at increased or lower risk of SCD. PMID:20096853

  13. Effects of Third Age Learning Programs on the Life Satisfaction, Self-Esteem, and Depression Level among a Select Group of Community Dwelling Filipino Elderly

    ERIC Educational Resources Information Center

    Escolar Chua, Rowena L.; de Guzman, Allan B.

    2014-01-01

    With the growing number of older adults becoming a global concern, many countries have focused on education as a means of promoting successful aging. Although third age learning is gaining substantial ground in other countries, it is not well-established in the Philippines. The overall intent of this experimental study was to assess the…

  14. Psychiatric Illness in Relation to Frailty in Community-Dwelling Elderly People without Dementia: A Report from the Canadian Study of Health and Aging

    ERIC Educational Resources Information Center

    Andrew, Melissa K.; Rockwood, Kenneth

    2007-01-01

    We investigated whether frailty, defined as the accumulation of multiple, interacting illnesses, impairments and disabilities, is associated with psychiatric illness in older adults. Five-thousand-six-hundred-and-seventy-six community dwellers without dementia were identified within the Canadian Study of Health and Aging, and self-reported…

  15. The interaction of physical, psychological, socioeconomic and sociodemographic variables on the Body Mass Index (MINDEX) of the community-dwelling elderly.

    PubMed

    Donkin, A J; Johnson, A E; Morgan, K; Neale, R J; Lilley, J M

    1998-01-01

    Two cohorts of older people 65-74, and 75 or more years of age living at home in Nottingham or in a nearby rural area in the UK were interviewed and anthropometric measurements were taken (n=1037). Bivariate analyses showed significant relationships between mindex and variables previously associated with food choice. Those with a mindex above the 95th percentile were more likely to live in a rural area, and were less likely to smoke than those between the 5th and 95th percentiles. Those with a low mindex, below the 5th percentile, were more likely to smoke than those between the 5th and 95th percentiles (45% compared to 17%), and were also more likely to live in an urban area, to have difficulty carrying shopping bags, not to use a car for shopping, to have a poorer appetite, and to live alone. Those overweight and underweight had lower levels of social engagement and were more likely to be of a lower social class. In multivariate analysis, socioeconomic variables and psychosocial variables were not significantly associated with mindex, when controlling for physical and sociodemographic variables. Advancing age, female gender, smoking and decreased appetite were significantly associated with decreased mindex (Adjusted R2 = .168).

  16. A Chinese Chan-based mind–body intervention improves psychological well-being and physical health of community-dwelling elderly: a pilot study

    PubMed Central

    Yu, Ruby; Woo, Jean; Chan, Agnes S; Sze, Sophia L

    2014-01-01

    Background The aim of this study was to explore the potential benefits of the Dejian mind–body intervention (DMBI) for psychological and physical health in older Chinese adults. Methods After confirmation of eligibility, the subjects were invited to receive DMBI once a week for 12 weeks. The intervention involved components of learning self-awareness and self-control, practicing mind–body exercises, and adopting a special vegetarian diet. Intervention-related changes were measured using the Perceived Stress Scale, Geriatric Depression Scale, Pittsburgh Sleep Quality Index, Chinese Constipation Questionnaire, and self-report ratings of health. Indicators of metabolic syndrome and walking speed were also measured. Results Of the 44 subjects recruited, 42 (54.8% men) completed the study, giving an adherence rate of 95%. There was a significant reduction in perceived stress (P<0.05). A significant improvement was also found in systolic blood pressure among those who had abnormally high blood pressure at baseline (P<0.05). Physical fitness as reflected by walking speed was also significantly increased after the intervention (P<0.05). Sleep disturbances were reduced (P<0.01). Self-rated health was significantly enhanced, with the percentage rating very good health increasing from 14.3% at baseline to 42.8% after the intervention (P<0.001). No intervention effect was found for waist circumference, lipids and fasting blood glucose levels, Pittsburgh Sleep Quality Index global score, and constipation measures. Conclusion The DMBI was feasible and acceptable, and subjects showed some improvements in psychological and physical health. A larger controlled trial is needed to confirm these promising preliminary results. PMID:24790425

  17. Elder Abuse: Systematic Review and Implications for Practice.

    PubMed

    Dong, Xin Qi

    2015-06-01

    This article is based on the lecture for the 2014 American Geriatrics Society Outstanding Scientific Achievement for Clinical Investigation Award. Elder abuse is a global public health and human rights problem. Evidence suggests that elder abuse is prevalent, predictable, costly, and sometimes fatal. This review will highlight the global epidemiology of elder abuse in terms of its prevalence, risk factors, and consequences in community populations. The global literature in PubMed, MEDLINE, PsycINFO, BIOSIS, Science Direct, and Cochrane Central was searched. Search terms included elder abuse, elder mistreatment, elder maltreatment, prevalence, incidence, risk factors, protective factors, outcomes, and consequences. Studies that existed only as abstracts, case series, or case reports or recruited individuals younger than 60; qualitative studies; and non-English publications were excluded. Tables and figures were created to highlight the findings: the most-detailed analyses to date of the prevalence of elder abuse according to continent, risk and protective factors, graphic presentation of odds ratios and confidence intervals for major risk factors, consequences, and practical suggestions for health professionals in addressing elder abuse. Elder abuse is common in community-dwelling older adults, especially minority older adults. This review identifies important knowledge gaps, such as a lack of consistency in definitions of elder abuse; insufficient research with regard to screening; and etiological, intervention, and prevention research. Concerted efforts from researchers, community organizations, healthcare and legal professionals, social service providers, and policy-makers should be promoted to address the global problem of elder abuse. PMID:26096395

  18. Periodontal disease among New England elders.

    PubMed

    Fox, C H; Jette, A M; McGuire, S M; Feldman, H A; Douglass, C W

    1994-07-01

    Much of the existing oral epidemiologic literature is limited by having inadequate numbers of the oldest-old in their sample, having used rudimentary periodontal measures, or not having examined probability samples of community-dwelling elders. The New England Elders Dental Study (NEEDS) is the first study that documents the periodontal disease status of a probability sample of 554 adults aged 70 to 96 living within an entire U.S. Public Health Service region. The NEEDS study revealed substantially higher estimates of periodontal destruction among older adults than previous national studies would suggest. These results are consistent with several papers in the literature that suggest that periodontal disease rates are on the increase in older adults. In the coming decades dentistry should be prepared to meet the increasing need and demand for periodontal services in the growing older population. PMID:7608844

  19. A vitamin/nutriceutical formulation improves memory and cognitive performance in community-dwelling adults without dementia.

    PubMed

    Chan, A; Remington, R; Kotyla, E; Lepore, A; Zemianek, J; Shea, T B

    2010-03-01

    Adults of both genders without dementia consumed a nutriceutical formulation ("NF," consisting of folic acid, B12, Vitamin E, S-adenosylmethionine, N-acetyl cysteine and Acetyl-L-carnitine), previously shown to improve cognitive performance in Alzheimer's disease, or placebo. Participants receiving NF but not placebo improved statistically and clinically in the California Verbal Learning Test II and the Trail-Making Test. Both groups improved further during a 3-month open-label extension. Additional individuals displayed identical improvement during a separate 6-month open-label trial. Performance declined to baseline following withdrawal of NF, and statistically improved when participants resumed taking NF. Additional participants receiving NF but not placebo demonstrated improvement within 2 weeks in Trail-making and Digit-Memory tests; both groups improved in a 2-week open-label extension. An increased percentage of participants > or = 74 years of age did not show improvement with NF, which may relate to age-related difficulties in adsorption and/or basal nutritional deficiencies, or age-related cognitive decline during the course of this study. These findings support the benefit of nutritional supplements for cognitive performance and suggest that additional supplementation may be required for the elderly. PMID:20191258

  20. A vitamin/nutriceutical formulation improves memory and cognitive performance in community-dwelling adults without dementia.

    PubMed

    Chan, A; Remington, R; Kotyla, E; Lepore, A; Zemianek, J; Shea, T B

    2010-03-01

    Adults of both genders without dementia consumed a nutriceutical formulation ("NF," consisting of folic acid, B12, Vitamin E, S-adenosylmethionine, N-acetyl cysteine and Acetyl-L-carnitine), previously shown to improve cognitive performance in Alzheimer's disease, or placebo. Participants receiving NF but not placebo improved statistically and clinically in the California Verbal Learning Test II and the Trail-Making Test. Both groups improved further during a 3-month open-label extension. Additional individuals displayed identical improvement during a separate 6-month open-label trial. Performance declined to baseline following withdrawal of NF, and statistically improved when participants resumed taking NF. Additional participants receiving NF but not placebo demonstrated improvement within 2 weeks in Trail-making and Digit-Memory tests; both groups improved in a 2-week open-label extension. An increased percentage of participants > or = 74 years of age did not show improvement with NF, which may relate to age-related difficulties in adsorption and/or basal nutritional deficiencies, or age-related cognitive decline during the course of this study. These findings support the benefit of nutritional supplements for cognitive performance and suggest that additional supplementation may be required for the elderly.

  1. A protocol for a systematic review of research on managing behavioural and psychological symptoms in dementia for community-dwelling older people: evidence mapping and syntheses

    PubMed Central

    2013-01-01

    Background Non-cognitive behavioural and psychological symptoms of dementia affect up to 90% of people with dementia during the disease course and result in distress, increased carer burden, high service utilization and unwanted moves to care homes. Research has focused on long-term settings and has not considered people with dementia living at home and at different stages of the disease trajectory. Our aim is to review systematically the evidence concerning non-pharmacological strategies to minimise behavioural and psychological symptoms in community-dwelling older people with dementia. Methods/Design Our approach is a two-stage co-design: a systematic mapping of the broad evidence around behavioural and psychological symptoms followed by an in-depth systematic review of studies of non-pharmacological interventions for behavioural and psychological symptoms from the perspective of their impact on community-dwelling older people with dementia and their carers. The review will include published literature involving a wide range of electronic databases using sensitive and comprehensive searches and lateral searching including checking citations. We will produce a descriptive map of the studies by design and by the focus of interventions and apply further inclusion criteria, developed in conjunction with lay experts, to select studies for an in-depth systematic review that will include independent quality assessment and detailed data extraction by two reviewers. The review process will be integrated with stakeholder meetings and a multidisciplinary expert advisory group to guide the review parameters and shape the research questions on the management of behavioural and psychological symptoms in people with dementia. Because studies are likely to be diverse in methodology and interventions, we will conduct a narrative synthesis of the in-depth systematic review. If appropriate, we will pool studies in a meta-analysis. We will explore review findings at both stages

  2. Understanding the Experiences of Rural Community-Dwelling Older Adults in Using a New DVD-Delivered Otago Exercise Program: A Qualitative Study

    PubMed Central

    Agha, Arun; Liu-Ambrose, Teresa Y L; Backman, Catherine L; Leese, Jennifer

    2015-01-01

    Background The home-based Otago Exercise Program (OEP) has been shown to reduce the occurrence of falls in community-dwelling seniors. A new OEP DVD was recently developed for people living in rural communities to be used with minimal coaching by a physical therapist. Objective This study aimed to understand older adults’ experiences using the DVD-delivered OEP and explore barriers and facilitators to implementing the DVD-delivered OEP from the participants’ perspectives. Methods Rural community-dwelling older adults (75 years and older) who participated in a six-month DVD-delivered OEP study were invited to participate in this qualitative study. Two small group interviews were initially conducted to explore the breadth of participants’ experiences with the program. These were followed by semi-structured individual interviews to gain an in-depth understanding of these experiences. An inductive constant comparison analysis of the transcripts was performed. To ensure methodological rigor, field notes, journaling, and an audit trail were maintained, supplemented by peer-review. Results Of 32 eligible participants, five participated in group interviews and 16 in individual interviews. Three themes emerged. Theme 1, The OEP DVD—useful training tool but in need of more pep, represented participants’ experiences that the DVD provided important guidance at program onset, but was too slow and low-energy for longer-term use. Theme 2, Gaining control over one’s exercise regimen, but sometimes life gets in the way of staying active, described participants’ appreciation of the program’s flexibility, but personal health concerns and everyday lives posed challenges to adhering to the program. Theme 3, Social creatures—wanting greater human connection during exercise, described how some participants desired further social interactions for enhancing motivation and receiving guidance. Conclusions Individuals should be encouraged to refer to the OEP user manual or

  3. Prospective association of the SHARE-operationalized frailty phenotype with adverse health outcomes: evidence from 60+ community-dwelling Europeans living in 11 countries

    PubMed Central

    2013-01-01

    Background Among the many definitions of frailty, the frailty phenotype defined by Fried et al. is one of few constructs that has been repeatedly validated: first in the Cardiovascular Health Study (CHS) and subsequently in other large cohorts in the North America. In Europe, the Survey of Health, Aging and Retirement in Europe (SHARE) is a gold mine of individual, economic and health information that can provide insight into better understanding of frailty across diverse population settings. A recent adaptation of the original five CHS-frailty criteria was proposed to make use of SHARE data and measure frailty in the European population. To test the validity of the SHARE operationalized frailty phenotype, this study aims to evaluate its prospective association with adverse health outcomes. Methods Data are from 11,015 community-dwelling men and women aged 60+ participating in wave 1 and 2 of the Survey of Health, Aging and Retirement in Europe, a population-based survey. Multivariate logistic regression analyses were used to assess the 2-year follow up effect of SHARE-operationalized frailty phenotype on the incidence of disability (disability-free at baseline) and on worsening disability and morbidity, adjusting for age, sex, income and baseline morbidity and disability. Results At 2-year follow up, frail individuals were at increased risk for: developing mobility (OR 3.07, 95% CI, 1.02-9.36), IADL (OR 5.52, 95% CI, 3.76-8.10) and BADL (OR 5.13, 95% CI, 3.53-7.44) disability; worsening mobility (OR 2.94, 95% CI, 2.19- 3.93) IADL (OR 4.43, 95% CI, 3.19-6.15) and BADL disability (OR 4.53, 95% CI, 3.14-6.54); and worsening morbidity (OR 1.77, 95% CI, 1.35-2.32). These associations were significant even among the prefrail, but with a lower magnitude of effect. Conclusions The SHARE-operationalized frailty phenotype is significantly associated with all tested health outcomes independent of baseline morbidity and disability in community-dwelling men and women aged 60

  4. Effectiveness of a multifactorial falls prevention program in community-dwelling older people when compared to usual care: study protocol for a randomised controlled trial (Prevquedas Brazil)

    PubMed Central

    2013-01-01

    Background Falling in older age is a major public health concern due to its costly and disabling consequences. However very few randomised controlled trials (RCTs) have been conducted in developing countries, in which population ageing is expected to be particularly substantial in coming years. This article describes the design of an RCT to evaluate the effectiveness of a multifactorial falls prevention program in reducing the rate of falls in community-dwelling older people. Methods/design Multicentre parallel-group RCT involving 612 community-dwelling men and women aged 60 years and over, who have fallen at least once in the previous year. Participants will be recruited in multiple settings in Sao Paulo, Brazil and will be randomly allocated to a control group or an intervention group. The usual care control group will undergo a fall risk factor assessment and be referred to their clinicians with the risk assessment report so that individual modifiable risk factors can be managed without any specific guidance. The intervention group will receive a 12-week Multifactorial Falls Prevention Program consisting of: an individualised medical management of modifiable risk factors, a group-based, supervised balance training exercise program plus an unsupervised home-based exercise program, an educational/behavioral intervention. Both groups will receive a leaflet containing general information about fall prevention strategies. Primary outcome measures will be the rate of falls and the proportion of fallers recorded by monthly falls diaries and telephone calls over a 12 month period. Secondary outcomes measures will include risk of falling, fall-related self-efficacy score, measures of balance, mobility and strength, fall-related health services use and independence with daily tasks. Data will be analysed using the intention-to-treat principle.The incidence of falls in the intervention and control groups will be calculated and compared using negative binomial regression

  5. Gait speed correlates in a multiracial population of community-dwelling older adults living in Brazil: a cross-sectional population-based study

    PubMed Central

    2013-01-01

    Background Gait speed is a strong predictor of a wide range of adverse health outcomes in older adults. Mean values for gait speed in community-dwelling older adults vary substantially depending on population characteristics, suggesting that social, biological, or health factors might explain why certain groups tend to self-select their gait speed in different patterns. The vast majority of studies reported in the literature present data from North American and European populations. There are few population-based studies from other regions with a different ethnicity and/or social and health conditions. To address this, the present study identified the mean usual and fast gait speeds in a representative multiracial population of community-dwelling older adults living in a developing country, and explored their association with sociodemographic, mental and physical health characteristics. Methods This was a cross-sectional population-based study of a sample of 137 men and 248 women, aged 65 years and over. Usual gait speed and fast gait speed were measured on a 4.6 m path. Participants were classified into slow, intermediate, and faster groups by cluster analysis. Logistic regression analysis was used to estimate the independent effect of each factor on the odds of presenting with a slower usual and slower fast gait speeds. Results Participants had a mean (SD) usual gait speed of 1.11 (0.27) m/s and a mean fast gait speed of 1.39 (0.34) m/s. We did not observe an independent association between gait speed and race/ethnicity, educational level, or income. The main contributors to present a slower usual gait speed were low physical activity level, stroke, diabetes, urinary incontinence, high concern about falling, and old age. A slower fast gait speed was associated with old age, low physical activity, urinary incontinence and high concern about falling. Conclusion A multiracial population of older adults living in a developing country showed a similar mean gait speed

  6. Vitamin D Status and the Risk of Anemia in Community-Dwelling Adults: Results from the National Health and Nutrition Examination Survey 2001-2006.

    PubMed

    Monlezun, Dominique J; Camargo, Carlos A; Mullen, John T; Quraishi, Sadeq A

    2015-12-01

    Low vitamin D status has been implicated in several chronic medical conditions and unfavorable health outcomes. Our goal was to investigate whether serum 25-hydroxyvitamin D (25OHD) levels are a potentially modifiable risk factor for anemia in a nationally representative cohort of community-dwelling individuals in the United States. We performed a cross-sectional study of 5456 individuals (≥17 years) from the National Health and Nutrition Examination Survey from 2001 to 2006. Locally weighted scatterplot smoothing (LOWESS) was used to graphically depict the relationship between serum 25OHD levels and the cumulative frequency of anemia. Multivariable logistic regression models were then used to assess the independent association of 25OHD levels with anemia, while controlling for age, sex, race, body mass index, chronic kidney disease, as well as serum levels of C-reactive protein, ferritin, iron, vitamin B12, and folic acid. The mean (standard error) 25OHD and hemoglobin levels in the analytic group were 23.5 (0.4) ng/mL and 14.4 (0.1) g/dL, respectively. Prevalence of anemia was 3.9%. Locally weighted scatterplot smoothing analysis demonstrated a near-linear relationship between vitamin D status and cumulative frequency of anemia up to 25OHD levels of approximately 20  ng/mL. With increasing 25OHD levels, the curve flattened out progressively. Multivariable regression analysis demonstrated an inverse association of 25OHD levels with the risk of anemia (adjusted odds ratio 0.97; 95% confidence interval 0.95-0.99 per 1  ng/mL change in 25OHD). Compared to individuals with ≥20  ng/mL, individuals with 25OHD levels <20  ng/mL were more likely to be anemic (adjusted odds ratio 1.64; 95% confidence interval 1.08-2.49). In a nationally representative sample of community-dwelling individuals in the United States, low 25OHD levels were associated with increased risk of anemia. Randomized controlled trials are needed to determine whether optimizing vitamin D

  7. Home care assistants’ perspectives on detecting mental health problems and promoting mental health among community-dwelling seniors with multimorbidity

    PubMed Central

    Grundberg, Åke; Hansson, Anna; Religa, Dorota; Hillerås, Pernilla

    2016-01-01

    Introduction Elderly people with multiple chronic conditions, or multimorbidity, are at risk of developing poor mental health. These seniors often remain in their homes with support from home care assistants (HCAs). Mental health promotion by HCAs needs to be studied further because they may be among the first to observe changes in clients’ mental health status. Aim To describe HCAs’ perspectives on detecting mental health problems and promoting mental health among homebound seniors with multimorbidity. Methods We applied a descriptive qualitative study design using semi-structured interviews. Content analyses were performed on five focus group interviews conducted in 2014 with 26 HCAs. Results Most HCAs stated that they were experienced in caring for clients with mental health problems such as anxiety, depression, sleep problems, and high alcohol consumption. The HCAs mentioned as causes, or risk factors, multiple chronic conditions, feelings of loneliness, and social isolation. The findings reveal that continuity of care and seniors’ own thoughts and perceptions were essential to detecting mental health problems. Observation, collaboration, and social support emerged as important means of detecting mental health problems and promoting mental health. Conclusion The HCAs had knowledge of risk factors, but they seemed insecure about which health professionals had the primary responsibility for mental health. They also seemed to have detected early signs of mental health problems, even though good personal knowledge of the client and continuity in home visits were crucial to do so. When it came to mental health promotion, the suggestions related to the aim of ending social isolation, decreasing feelings of loneliness, and increasing physical activity. The results indicate that the HCAs seemed dependent on supervision by district nurses and on care managers’ decisions to support the needed care, to schedule assignments related to the detection of mental health

  8. Relationships between personal, depression and social network factors and sleep quality in community-dwelling older adults.

    PubMed

    Yao, Ke-Wu; Yu, Shu; Cheng, Shun-Ping; Chen, I-Ju

    2008-06-01

    Improving sleep quality is key to increasing life quality for the elderly. Clarifying the nature of sleep conditions and the factors that influence such is necessary to enrich the base of knowledge available to the clinical nursing profession and encourage effective nursing interventions in older populations. Purposes of this study were to describe sleep quality and identify the personal, depression and social network determinants of sleep quality among older people living independently. A cross-sectional research design was used, and 187 persons 65 years of age or older were recruited using two-stage random sampling from communities in Taipei City, Taiwan. All subjects were informed by the researchers and were asked to provide personal (demographic data, lifestyle behavior), depression, social network (perceived the relationships with and support from family, relatives/friends), and sleep quality (Chinese version of the Pittsburgh Sleep Quality Index, C-PSQI) information. Findings revealed that 25.7% of subjects were "poor sleepers" (attaining C-PSQI global scores > 5). The study identified significant relationships between three personal variables (alcohol consumption, educational level, and depressive tendencies), one social variable (relationships with relatives/friends) and sleep quality. Depression tendency, relationships with relatives/friends, college and above educational level, and habitual alcohol consumption accounted for 46.1% of sleep quality variance. Findings enrich the knowledge base by highlighting specific personal, depression and social network factors that could help nurses to assess sleep conditions more comprehensively. Nurses caring for older people should consider depression and social network factors (particularly the relationships with relatives/friends may play a discriminating role) as important determinants of sleep quality.

  9. Domestic Environmental Risk Factors Associated with Falling in Elderly

    PubMed Central

    LÖK, Neslihan; AKIN, Belgin

    2013-01-01

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

  10. Impact of drug-drug and drug-disease interactions on gait speed in community-dwelling older adults

    PubMed Central

    Naples, Jennifer G.; Marcum, Zachary A.; Perera, Subashan; Newman, Anne B.; Greenspan, Susan L.; Gray, Shelly L.; Bauer, Douglas C.; Simonsick, Eleanor M.; Shorr, Ronald I.; Hanlon, Joseph T.

    2016-01-01

    should focus on frail elders with less physiological reserve who may be more susceptible to the harms associated with potentially inappropriate medications. PMID:27138955

  11. Factors affecting the benefits of a six-month supervised exercise program on community-dwelling older adults: interactions among age, gender, and participation

    PubMed Central

    Hulya, Tuna Donat; Sevi, Yeşilyaprak Subasi Sevgi; Serap, Acar; Ayse, Ozcan Edeer

    2015-01-01

    [Purpose] This study determined the effects of age, gender, and participation on the benefits of a 6-month supervised exercise program on older adults. [Subjects and Methods] Eighty-five (37 women, 48 men) community-dwelling older adults participated. The chair sit-and-reach test, the 8-foot up-and-go test, the 6-minute walk test, the Berg Balance Scale, lower-body flexibility, dynamic balance, aerobic endurance, balance, metabolic rate, muscle strength, and position sense were evaluated. Repeated-measures of analysis of variance was performed including dependent variables of age, gender, and participation in the exercise program as dependent inter-subject factors and time of assessment as an intra-subject factor. [Results] Mean exercise participation was 29.88 ± 1.29 sessions. Flexibility, balance, position sense, and strength showed a significant main effect of time. There was a significant gender interaction for right shoulder flexion strength and knee extension strength, a significant gender-participation interaction for pre-/post-intervention measures of functional mobility, and a significant age-participation interaction for flexibility. [Conclusion] Exercise training improved outcomes after 6 months of supervised exercise, but the changes were similar regardless of participation level. Changes in strength were more pronounced in men than women. PMID:26157233

  12. Older adults' quality of life - Exploring the role of the built environment and social cohesion in community-dwelling seniors on low income.

    PubMed

    Engel, L; Chudyk, A M; Ashe, M C; McKay, H A; Whitehurst, D G T; Bryan, S

    2016-09-01

    The built environment and social cohesion are increasingly recognized as being associated with older adults' quality of life (QoL). However, limited research in this area still exists and the relationship has remained unexplored in the area of Metro Vancouver, Canada. This study examined the association between the built environment and social cohesion with QoL of 160 community-dwelling older adults (aged ≥ 65 years) on low income from Metro Vancouver. Cross-sectional data acquired from the Walk the Talk (WTT) study were used. Health-related QoL (HRQoL) and capability wellbeing were assessed using the EQ-5D-5L and the ICECAP-O, respectively. Measures of the environment comprised the NEWS-A (perceived built environment measure), the Street Smart Walk Score (objective built environment measure), and the SC-5PT (a measure of social cohesion). The primary analysis consists of Tobit regression models to explore the associations between environmental features and HRQoL as well as capability wellbeing. Key findings indicate that after adjusting for covariates, older adults' capability wellbeing was associated with street connectivity and social cohesion, while no statistically significant associations were found between environmental factors and HRQoL. Our results should be considered as hypothesis-generating and need confirmation in a larger longitudinal study.

  13. The Association between Different Levels of Alcohol Use and Gait under Single and Dual Task in Community-Dwelling Older Persons Aged 65 to 70 Years

    PubMed Central

    Büla, Christophe; Santos-Eggimann, Brigitte

    2016-01-01

    Objectives. This study aimed to describe the cross-sectional and longitudinal association between alcohol intake and gait parameters in older persons. Methods. Community-dwelling persons aged 65–70 years (N = 807). Information on health, functional status, and alcohol use was self-reported at baseline and at 3-year follow-up, whereas gait speed and stride-to-stride variability were measured while walking only (single task) and under dual tasking (counting backwards). Results. Compared to light-to-moderate drinking, heavy drinking was associated with slower gait speed in single task (adj. coeff.: −.040, 95% CI: −.0.78 to −.002, p = .035). No significant association was observed between heavy drinking and gait speed variability. Nondrinkers walked significantly slower than light-to-moderate drinkers in dual task and had significantly higher gait speed variability in both single and dual task, but these associations disappeared after adjustment for comorbidity. At follow-up, 35.2% and 34.1% of the participants walked significantly slower in single and dual task, respectively. This proportion varied a little across drinking categories. Conclusion. At baseline, heavy alcohol consumption was significantly associated with slower gait speed in single task. Selective survival of the fittest heavy drinkers probably explains why this association faded in longitudinal analyses. The trend of poorer gait performance in nondrinkers disappeared after adjustment for comorbidity, suggesting confounding by a worse health status. PMID:27516773

  14. Akathisia: prevalence and risk factors in a community-dwelling sample of patients with schizophrenia. Results from the FACE-SZ dataset.

    PubMed

    Berna, F; Misdrahi, D; Boyer, L; Aouizerate, B; Brunel, L; Capdevielle, D; Chereau, I; Danion, J M; Dorey, J M; Dubertret, C; Dubreucq, J; Faget, C; Gabayet, F; Lancon, C; Mallet, J; Rey, R; Passerieux, C; Schandrin, A; Schurhoff, F; Tronche, A M; Urbach, M; Vidailhet, P; Llorca, P M; Fond, G

    2015-12-01

    The main objective of this study was to determine the prevalence of akathisia in a community-dwelling sample of patients with schizophrenia, and to determine the effects of treatments and the clinical variables associated with akathisia. 372 patients with schizophrenia or schizoaffective disorder were systematically included in the network of FondaMental Expert Center for Schizophrenia and assessed with validated scales. Akathisia was measured with the Barnes Akathisia Scale (BAS). Ongoing psychotropic treatment was recorded. The global prevalence of akathisia (as defined by a score of 2 or more on the global akathisia subscale of the BAS) in our sample was 18.5%. Patients who received antipsychotic polytherapy were at higher risk of akathisia and this result remained significant (adjusted odd ratio=2.04, p=.025) after controlling the influence of age, gender, level of education, level of psychotic symptoms, substance use comorbidities, current administration of antidepressant, anticholinergic drugs, benzodiazepines, and daily-administered antipsychotic dose. The combination of second-generation antipsychotics was associated with a 3-fold risk of akathisia compared to second-generation antipsychotics used in monotherapy. Our results indicate that antipsychotic polytherapy should be at best avoided and suggest that monotherapy should be recommended in cases of akathisia. Long-term administration of benzodiazepines or anticholinergic drugs does not seem to be advisable in cases of akathisia, given the potential side effects of these medications.

  15. Partnering With Community-Dwelling Individuals With Diabetes for Health Behavior Change Using Action Plans: An Innovation in Health Professionals Education and Practice.

    PubMed

    Barry Hultquist, Teresa; Brown, Sara Goomis; Geske, Jenenne; Kaiser, Katherine Laux; Waibel-Rycek, Denise

    2015-11-01

    Health care practitioners support or hinder an individual's attempts to self-manage health behavior. Practitioners must understand an individual's health needs and goals to effectively partner for behavior change. Self-management support (SMS) promote efforts toward positive health behavior change. Practitioners need training to provide effective SMS, beginning with their formal education. The purpose of this educational practice project was to integrate an evidence-based intervention (SMS using action plans) into a nursing curriculum. Three sequential steps included (1) providing foundational SMS education, (2) SMS application with students' personal action plans, and (3) implementing SMS with community-dwelling individuals with diabetes. Students (n = 130) partnered with participants (n = 85), developing short- (n = 240) and long-term (n = 99) action plans during home visits. The average baseline Diabetes Empowerment Scale score measuring participant's perceived psychosocial diabetes management self-efficacy was 4.3 (1-5 scale, SD = 0.51, n = 83). Most common short-term actions related to physical activity (n = 100, 42%) and healthy eating (n = 61, 25%). Average participant confidence level was 7.7 (SD = 1.9, 0-10 scale). Short-term goal evaluation (n = 209) revealed 66% (n = 137) were met more than 50% of the time. Both participants (99%) and students (99%) expressed satisfaction with home visit and action plan experiences. This teaching-learning experience is replicable and applicable to any professional health care student. PMID:26220279

  16. Association between Lifetime Physical Activity and Cognitive Functioning in Middle-Aged and Older Community Dwelling Adults: Results from the Brain in Motion Study.

    PubMed

    Gill, Stephanie J; Friedenreich, Christine M; Sajobi, Tolulope T; Longman, R Stewart; Drogos, Lauren L; Davenport, Margie H; Tyndall, Amanda V; Eskes, Gail A; Hogan, David B; Hill, Michael D; Parboosingh, Jillian S; Wilson, Ben J; Poulin, Marc J

    2015-11-01

    To determine if total lifetime physical activity (PA) is associated with better cognitive functioning with aging and if cerebrovascular function mediates this association. A sample of 226 (52.2% female) community dwelling middle-aged and older adults (66.5 ± 6.4 years) in the Brain in Motion Study, completed the Lifetime Total Physical Activity Questionnaire and underwent neuropsychological and cerebrovascular blood flow testing. Multiple robust linear regressions were used to model the associations between lifetime PA and global cognition after adjusting for age, sex, North American Adult Reading Test results (i.e., an estimate of premorbid intellectual ability), maximal aerobic capacity, body mass index and interactions between age, sex, and lifetime PA. Mediation analysis assessed the effect of cerebrovascular measures on the association between lifetime PA and global cognition. Post hoc analyses assessed past year PA and current fitness levels relation to global cognition and cerebrovascular measures. Better global cognitive performance was associated with higher lifetime PA (p=.045), recreational PA (p=.021), and vigorous intensity PA (p=.004), PA between the ages of 0 and 20 years (p=.036), and between the ages of 21 and 35 years (p.5), but partially mediated the relation between current fitness and global cognition. This study revealed significant associations between higher levels of PA (i.e., total lifetime, recreational, vigorous PA, and past year) and better cognitive function in later life. Current fitness levels relation to cognitive function may be partially mediated through current cerebrovascular function. PMID:26581793

  17. Longitudinal comparison of a physiotherapist-led, home-based and group-based program for increasing physical activity in community-dwelling middle-aged adults.

    PubMed

    Freene, Nicole; Waddington, Gordon; Davey, Rachel; Cochrane, Tom

    2015-01-01

    Few studies have compared the longer-term effects of physical activity interventions. Here we compare a 6-month physiotherapist-led, home-based physical activity program to a community group exercise program over 2 years. Healthy, sedentary community-dwelling 50-65 year olds were recruited to a non-randomised community group exercise program (G, n = 93) or a physiotherapist-led, home-based physical activity program (HB, n = 65). Outcomes included 'sufficient' physical activity (Active Australia Survey), minutes of moderate-vigorous physical activity (ActiGraph GT1M), aerobic capacity (2-min step-test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio and body mass index. Outcome measures were collected at baseline, 6, 12, 18 and 24 months. Using intention-to-treat analysis, both interventions resulted in significant and sustainable increases in the number of participants achieving 'sufficient' physical activity (HB 22 v. 41%, G 22 v. 47%, P ≤ 0.001) and decreases in waist circumference (HB 90 v. 89 cm, G 93 v. 91 cm, P < 0.001) over 2 years. The home-based program was less costly (HB A$47 v. G $84 per participant) but less effective in achieving the benefits at 2 years. The physiotherapist-led, home-based physical activity program may be a low-cost alternative to increase physical activity levels for those not interested in, or unable to attend, a group exercise program.

  18. Partnering With Community-Dwelling Individuals With Diabetes for Health Behavior Change Using Action Plans: An Innovation in Health Professionals Education and Practice.

    PubMed

    Barry Hultquist, Teresa; Brown, Sara Goomis; Geske, Jenenne; Kaiser, Katherine Laux; Waibel-Rycek, Denise

    2015-11-01

    Health care practitioners support or hinder an individual's attempts to self-manage health behavior. Practitioners must understand an individual's health needs and goals to effectively partner for behavior change. Self-management support (SMS) promote efforts toward positive health behavior change. Practitioners need training to provide effective SMS, beginning with their formal education. The purpose of this educational practice project was to integrate an evidence-based intervention (SMS using action plans) into a nursing curriculum. Three sequential steps included (1) providing foundational SMS education, (2) SMS application with students' personal action plans, and (3) implementing SMS with community-dwelling individuals with diabetes. Students (n = 130) partnered with participants (n = 85), developing short- (n = 240) and long-term (n = 99) action plans during home visits. The average baseline Diabetes Empowerment Scale score measuring participant's perceived psychosocial diabetes management self-efficacy was 4.3 (1-5 scale, SD = 0.51, n = 83). Most common short-term actions related to physical activity (n = 100, 42%) and healthy eating (n = 61, 25%). Average participant confidence level was 7.7 (SD = 1.9, 0-10 scale). Short-term goal evaluation (n = 209) revealed 66% (n = 137) were met more than 50% of the time. Both participants (99%) and students (99%) expressed satisfaction with home visit and action plan experiences. This teaching-learning experience is replicable and applicable to any professional health care student.

  19. The Association between Different Levels of Alcohol Use and Gait under Single and Dual Task in Community-Dwelling Older Persons Aged 65 to 70 Years.

    PubMed

    Seematter-Bagnoud, Laurence; Büla, Christophe; Santos-Eggimann, Brigitte

    2016-01-01

    Objectives. This study aimed to describe the cross-sectional and longitudinal association between alcohol intake and gait parameters in older persons. Methods. Community-dwelling persons aged 65-70 years (N = 807). Information on health, functional status, and alcohol use was self-reported at baseline and at 3-year follow-up, whereas gait speed and stride-to-stride variability were measured while walking only (single task) and under dual tasking (counting backwards). Results. Compared to light-to-moderate drinking, heavy drinking was associated with slower gait speed in single task (adj. coeff.: -.040, 95% CI: -.0.78 to -.002, p = .035). No significant association was observed between heavy drinking and gait speed variability. Nondrinkers walked significantly slower than light-to-moderate drinkers in dual task and had significantly higher gait speed variability in both single and dual task, but these associations disappeared after adjustment for comorbidity. At follow-up, 35.2% and 34.1% of the participants walked significantly slower in single and dual task, respectively. This proportion varied a little across drinking categories. Conclusion. At baseline, heavy alcohol consumption was significantly associated with slower gait speed in single task. Selective survival of the fittest heavy drinkers probably explains why this association faded in longitudinal analyses. The trend of poorer gait performance in nondrinkers disappeared after adjustment for comorbidity, suggesting confounding by a worse health status. PMID:27516773

  20. Self-respect through ability to keep fear of frailty at a distance: Successful ageing from the perspective of community-dwelling older people

    PubMed Central

    Hörder, Helena M.; Frändin, Kerstin; Larsson, Maria E. H.

    2013-01-01

    With population ageing, there is an increased interest in how to promote a good old age. A predominant concept in these discussions is successful ageing, which is mainly based on researchers’ definitions. This article aims to explore successful ageing from the perspective of community-dwelling older people (24 persons aged 77–90 years). Individual open interviews were conducted and analysed according to qualitative content analysis. An overarching theme was formulated as “self-respect through ability to keep fear of frailty at a distance”. This embraced the content of four categories: “having sufficient bodily resources for security and opportunities”, “structures that promote security and opportunities”, “feeling valuable in relation to the outside world”, and “choosing gratitude instead of worries”. Ageing seems to be a dynamic process rather than a static structure and might therefore be susceptible to actions. Paying attention to attitudes and treating the older person with respect, particularly with regard to worries about increasing vulnerability, can lead to better ways of promoting successful ageing. PMID:23511089

  1. Longitudinal comparison of a physiotherapist-led, home-based and group-based program for increasing physical activity in community-dwelling middle-aged adults.

    PubMed

    Freene, Nicole; Waddington, Gordon; Davey, Rachel; Cochrane, Tom

    2015-01-01

    Few studies have compared the longer-term effects of physical activity interventions. Here we compare a 6-month physiotherapist-led, home-based physical activity program to a community group exercise program over 2 years. Healthy, sedentary community-dwelling 50-65 year olds were recruited to a non-randomised community group exercise program (G, n = 93) or a physiotherapist-led, home-based physical activity program (HB, n = 65). Outcomes included 'sufficient' physical activity (Active Australia Survey), minutes of moderate-vigorous physical activity (ActiGraph GT1M), aerobic capacity (2-min step-test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio and body mass index. Outcome measures were collected at baseline, 6, 12, 18 and 24 months. Using intention-to-treat analysis, both interventions resulted in significant and sustainable increases in the number of participants achieving 'sufficient' physical activity (HB 22 v. 41%, G 22 v. 47%, P ≤ 0.001) and decreases in waist circumference (HB 90 v. 89 cm, G 93 v. 91 cm, P < 0.001) over 2 years. The home-based program was less costly (HB A$47 v. G $84 per participant) but less effective in achieving the benefits at 2 years. The physiotherapist-led, home-based physical activity program may be a low-cost alternative to increase physical activity levels for those not interested in, or unable to attend, a group exercise program. PMID:26509205

  2. “Any Movement at All Is Exercise”: A Focused Ethnography of Rural Community-Dwelling Older Adults' Perceptions and Experiences of Exercise as Self-Care

    PubMed Central

    Connelly, Denise M.

    2013-01-01

    ABSTRACT Purpose: To understand rural community-dwelling older adult participants' shared values, beliefs, and behaviours related to exercise as self-care. Methods: We conducted a constructivist-focused ethnography involving semi-structured interviews and participant observation with 17 individuals 65 years and older. Interviews were transcribed and inductively coded to develop themes related to exercise, self-care, and exercise as self-care. Field notes were triangulated with follow-up interviews and dialogue between authors to enhance interpretation. Results: Participants described exercise broadly as movement and not as a central self-care behaviour. However, awareness of the importance and health-related benefits of exercise increased after a significant personal health-related event. Participants preferred exercise that was enjoyable and previously experienced. Conclusions: Prescribing exercise for older adults may be particularly effective if the focus is on enjoyable and previously experienced physical activity and if it incorporates interpretation of exercise guidelines and training principles in relation to chronic conditions and potential health benefits. PMID:24396160

  3. Lifestyle-Related Factors Contributing to Decline in Knee Extension Strength among Elderly Women: A Cross-Sectional and Longitudinal Cohort Study

    PubMed Central

    Kojima, Narumi; Kim, Miji; Saito, Kyoko; Yoshida, Hideyo; Yoshida, Yuko; Hirano, Hirohiko; Obuchi, Shuichi; Shimada, Hiroyuki; Suzuki, Takao; Kim, Hunkyung

    2015-01-01

    This cross-sectional and 4-year longitudinal cohort study aimed to clarify how various lifestyle-related variables affect knee extension strength in elderly Japanese women. The participants were community-dwelling women (n = 575) living in the Itabashi Ward of Tokyo, Japan aged 75–85 years at baseline (in 2008) who returned for a follow-up examination 4 years later (in 2012). Maximum isometric knee extension strength in the dominant leg was measured during comprehensive medical check-ups at baseline and follow-up. Interviews with participants included questions on their history of 11 diseases and lifestyle-related factors such as physical activity as well as dietary, smoking, and drinking habits. Cross-sectional and longitudinal analyses yielded inconsistent results regarding the associations between lifestyle-related factors and knee extension strength. While going out more frequently and regular physical exercise positively affected baseline knee extension strength, they did not affect knee extension strength in the longitudinal analysis. The longitudinal analysis revealed that more frequent intake of soy products or green and yellow vegetables at baseline decreased age-related knee extension strength decline. The inconsistent results from the cross-sectional and longitudinal analyses indicate that conducting both types of analyses is crucial for researching this type of subject. The present study demonstrates that the age-related decline in muscle strength is lower in those who frequently eat soy products or green and yellow vegetables. Thus, recommending higher intake of soy products, and green and yellow vegetables for the elderly might help maintain their muscle health. PMID:26177292

  4. Neuropsychological profiles of victims of financial elder exploitation at the los angeles county elder abuse forensic center.

    PubMed

    Wood, Stacey; Rakela, Benjamin; Liu, Pi-Ju; Navarro, Adria E; Bernatz, Susan; Wilber, Kathleen H; Allen, Robin; Homeier, Diana; Homier, Diana

    2014-01-01

    The current article examines neuropsychological correlates of financial elder exploitation in a sample of older adults who have been documented victims of financial elder exploitation. The purpose of this exploratory study was twofold. First, a subsample of the referrals at the Los Angeles County Elder Abuse Forensic Center (LACEAFC) was compared to community dwelling adults in terms of the specific cognitive domains linked to financial capacity including memory, calculation, and executive functioning. Next, the correlation between presence of neuropsychological data and the likelihood of filing a case with the LA County's District Attorney office was examined. Twenty-seven LACEAFC cases and 32 controls were assessed. Overall, the forensic center group performed worse than a community-based age-matched control group on the MMSE, calculation, and executive functioning (ps < .01). The presence of neuropsychological data was significantly correlated to an increased likelihood of a case being filed. PMID:24848863

  5. Neuropsychological profiles of victims of financial elder exploitation at the los angeles county elder abuse forensic center.

    PubMed

    Wood, Stacey; Rakela, Benjamin; Liu, Pi-Ju; Navarro, Adria E; Bernatz, Susan; Wilber, Kathleen H; Allen, Robin; Homeier, Diana; Homier, Diana

    2014-01-01

    The current article examines neuropsychological correlates of financial elder exploitation in a sample of older adults who have been documented victims of financial elder exploitation. The purpose of this exploratory study was twofold. First, a subsample of the referrals at the Los Angeles County Elder Abuse Forensic Center (LACEAFC) was compared to community dwelling adults in terms of the specific cognitive domains linked to financial capacity including memory, calculation, and executive functioning. Next, the correlation between presence of neuropsychological data and the likelihood of filing a case with the LA County's District Attorney office was examined. Twenty-seven LACEAFC cases and 32 controls were assessed. Overall, the forensic center group performed worse than a community-based age-matched control group on the MMSE, calculation, and executive functioning (ps < .01). The presence of neuropsychological data was significantly correlated to an increased likelihood of a case being filed.

  6. Japanese; Japanese Songs.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    This supplementary textbook for students of Japanese presents a collection of 43 songs--folk songs, nursery songs, lullabies, love songs, wedding songs, graduation songs, the national anthem, drinking songs, school songs, and Christmas carols. With the exception of the carols, the musical scores are presented with their Japanese lyrics. The…

  7. Gender Differences in Lay Knowledge of Type 2 Diabetes Symptoms Among Community-dwelling Caucasian, Latino, Filipino, and Korean Adults - DiLH Survey

    PubMed Central

    Fukuoka, Yoshimi; Bender, Melinda S.; Choi, JiWon; Gonzalez, Prisila; Arai, Shoshana

    2015-01-01

    Purpose The purpose of this study was to explore gender differences in lay knowledge of type 2 diabetes symptoms among community-dwelling Caucasian, Latino, Filipino, and Korean Americans. Design and Methods A cross-sectional survey was administered to a convenience sample of 904 adults (172 Caucasians, 248 Latinos, 234 Koreans, and 250 Filipinos) without diabetes at community events, community clinics, churches, and online in the San Francisco Bay Area and San Diego from August to December 2013. Participants were asked to describe in their own words signs and/or symptoms of diabetes. A multiple logistic regression analysis was performed to examine the association of lay symptom knowledge with gender after controlling for potential confounding factors. Results Overall, the average age of the sample populations was 44 (SD ±16.1) years, 36% were male, and 58% were married. Increased thirst/dry mouth following increased urinary frequency/color/odor and increased fatigue/lethargy/low energy were the most frequently reported signs and symptoms (19.8%, 15.4%, and 13.6%, respectively). After controlling for known confounding factors, women were 1.6 (95% confidence interval, 1.2-2.3, P = .004) times more likely than men to report at least 1 diabetes symptom. However, this gender difference in knowledge of diabetes signs and symptoms did not significantly differ across Caucasians, Latinos, Filipinos, and Korean Americans (P = .87). Conclusion The findings underscore the importance of improving public knowledge and awareness of signs and symptoms of diabetes, particularly in men. PMID:25227121

  8. Omega-3 Fatty Acid Supplementation for 12 Weeks Increases Resting and Exercise Metabolic Rate in Healthy Community-Dwelling Older Females.

    PubMed

    Logan, Samantha L; Spriet, Lawrence L

    2015-01-01

    Critical among the changes that occur with aging are decreases in muscle mass and metabolic rate and an increase in fat mass. These changes may predispose older adults to chronic disease and functional impairment; ultimately resulting in a decrease in the quality of life. Research has suggested that long chain omega-3 fatty acids, found predominantly in fatty fish, may assist in reducing these changes. The objective of this study was to evaluate the effect of fish oil (FO) supplementation in a cohort of healthy, community-dwelling older females on 1) metabolic rate and substrate oxidation at rest and during exercise; 2) resting blood pressure and resting and exercise heart rates; 3) body composition; 4) strength and physical function, and; 5) blood measures of insulin, glucose, c-reactive protein, and triglycerides. Twenty-four females (66 ± 1 yr) were recruited and randomly assigned to receive either 3g/d of EPA and DHA or a placebo (PL, olive oil) for 12 wk. Exercise measurements were taken before and after 12 wk of supplementation and resting metabolic measures were made before and at 6 and 12 wk of supplementation. The results demonstrated that FO supplementation significantly increased resting metabolic rate by 14%, energy expenditure during exercise by 10%, and the rate of fat oxidation during rest by 19% and during exercise by 27%. In addition, FO consumption lowered triglyceride levels by 29% and increased lean mass by 4% and functional capacity by 7%, while no changes occurred in the PL group. In conclusion, FO may be a strategy to improve age-related physical and metabolic changes in healthy older females. Trial registration: ClinicalTrials.gov NCT01734538.

  9. Antidementia drug use among community-dwelling individuals with Alzheimer’s disease in Finland: a nationwide register-based study

    PubMed Central

    Tanskanen, Antti; Koponen, Marjaana; Tolppanen, Anna-Maija; Tiihonen, Jari; Hartikainen, Sirpa

    2014-01-01

    The objective of this study was to investigate the prevalence of acetylcholinesterase inhibitor (AChEI) and memantine use, duration of treatment, concomitant use of these drugs, and factors associated with the discontinuation of AChEI therapy during 2006–2009. We utilized data from a nationwide sample of community-dwelling individuals with a clinically verified Alzheimer’s disease diagnosed during the year 2005 (n=6858) as a part of the MEDALZ-2005 study. During the 4-year follow-up, 84% used AChEI and 47% used memantine. Altogether, 22% of the sample used both drugs concomitantly. The median duration of the first AChEI use period was 860 (interquartile range 295–1458) days and 1103 (interquartile range 489–1487) days for the total duration of AChEI use. Although 20% of the AChEI users discontinued the use during the first year, over half of them restarted later. The risk of discontinuation was higher for rivastigmine [hazard ratio 1.34 (confidence interval 1.22–1.48)] and galantamine users [hazard ratio 1.23 (confidence interval 1.15–1.37)] compared with donepezil users in the adjusted model. In conclusion, median time for AChEI use was over 3 years and every fifth Alzheimer’s disease patient used AChEI and memantine concomitantly during the follow-up. The low rate of discontinuation is consistent with the Finnish Care Guideline but in contrast to the results reported from many other countries. PMID:24608822

  10. The Incidence and Recurrence of Getting Lost in Community-Dwelling People with Alzheimer’s Disease: A Two and a Half-Year Follow-Up

    PubMed Central

    2016-01-01

    Getting lost (GL) is a serious problem for people living with Alzheimer’s disease (PwAD), causing psychological distress in both PwAD and caregivers, and increasing the odds of being institutionalized. It is thus important to identify risk factors for the GL events in PwAD. Between April 2009 and March 2012, we invited 185 community-dwelling PwAD and their caregivers to participate in this study. At the baseline, 95 had experienced GL (Group B); the remaining 90 (Group A) had not. We focused on the incidence of GL events and the associated factors by way of demographic data, cognitive function assessed by the Cognitive Ability Screening Instrument (CASI), and spatial navigation abilities as assessed by the Questionnaire of Everyday Navigational Ability (QuENA). After a 2.5-year period, the incidence of GL in Group A was 33.3% and the recurrence of GL in Group B was 40%. Multiple logistic regression analysis revealed that the inattention item on the QuENA and orientation item on the CASI had independent effects on the GL incidence, while the absence of a safety range was associated with the risk of GL recurrence. During the 2.5 years, the PwAD with GL incidence deteriorated more in the mental manipulation item on the CASI than those without. We suggest that before the occurrence of GL, the caregivers of PwAD should refer to the results of cognitive assessment and navigation ability evaluation to enhance the orientation and attention of the PwAD. Once GL occurs, the caregivers must set a safety range to prevent GL recurrence, especially for younger people. PMID:27183297

  11. Measurement of the severity of disability in community-dwelling adults and older adults: interval-level measures for accurate comparisons in large survey data sets

    PubMed Central

    Buz, José; Cortés-Rodríguez, María

    2016-01-01

    Objectives To (1) create a single metric of disability using Rasch modelling to be used for comparing disability severity levels across groups and countries, (2) test whether the interval-level measures were invariant across countries, sociodemographic and health variables and (3) examine the gains in precision using interval-level measures relative to ordinal scores when discriminating between groups known to differ in disability. Design Cross-sectional, population-based study. Setting/participants Data were drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE), including comparable data across 16 countries and involving 58 489 community-dwelling adults aged 50+. Main outcome measures A single metric of disability composed of self-care and instrumental activities of daily living (IADLs) and functional limitations. We examined the construct validity through the fit to the Rasch model and the know-groups method. Reliability was examined using person separation reliability. Results The single metric fulfilled the requirements of a strong hierarchical scale; was able to separate persons with different levels of disability; demonstrated invariance of the item hierarchy across countries; and was unbiased by age, gender and different health conditions. However, we found a blurred hierarchy of ADL and IADL tasks. Rasch-based measures yielded gains in relative precision (11–116%) in discriminating between groups with different medical conditions. Conclusions Equal-interval measures, with person-invariance and item-invariance properties, provide epidemiologists and researchers with the opportunity to gain better insight into the hierarchical structure of functional disability, and yield more reliable and accurate estimates of disability across groups and countries. Interval-level measures of disability allow parametric statistical analysis to confidently examine the relationship between disability and continuous measures so frequent in health sciences

  12. Comparison of count-based multimorbidity measures in predicting emergency admission and functional decline in older community-dwelling adults: a prospective cohort study

    PubMed Central

    Wallace, Emma; McDowell, Ronald; Bennett, Kathleen; Fahey, Tom; Smith, Susan M

    2016-01-01

    Objectives Multimorbidity, defined as the presence of 2 or more chronic medical conditions in an individual, is associated with poorer health outcomes. Several multimorbidity measures exist, and the challenge is to decide which to use preferentially in predicting health outcomes. The study objective was to compare the performance of 5 count-based multimorbidity measures in predicting emergency hospital admission and functional decline in older community-dwelling adults attending primary care. Setting 15 general practices (GPs) in Ireland. Participants n=862, ≥70 years, community-dwellers followed-up for 2 years (2010–2012). Exposure at baseline: Five multimorbidity measures (disease counts, selected conditions counts, Charlson comorbidity index, RxRisk-V, medication counts) calculated using GP medical record and linked national pharmacy claims data. Primary outcomes (1) Emergency admission and ambulatory care sensitive (ACS) admission (GP medical record) and (2) functional decline (postal questionnaire). Statistical analysis Descriptive statistics and measure discrimination (c-statistic, 95% CIs), adjusted for confounders. Results Median age was 77 years and 53% were women. Prevalent rates ranged from 37% to 91% depending on which measure was used to define multimorbidity. All measures demonstrated poor discrimination for the outcome of emergency admission (c-statistic range: 0.62, 0.65), ACS admission (c-statistic range: 0.63, 0.68) and functional decline (c-statistic range: 0.55, 0.61). Medication-based measures were equivalent to diagnosis-based measures. Conclusions The choice of measure may have a significant impact on prevalent rates. Five multimorbidity measures demonstrated poor discrimination in predicting emergency admission and functional decline, with medication-based measures equivalent to diagnosis-based measures. Consideration of multimorbidity in isolation is insufficient for predicting these outcomes in community settings. PMID:27650770

  13. Effect of Exercise and Cognitive Activity on Self-Reported Sleep Quality in Community-Dwelling Older Adults with Cognitive Complaints: A Randomized Controlled Trial

    PubMed Central

    Pa, Judy; Goodson, William; Bloch, Andrew; King, Abby C.; Yaffe, Kristine; Barnes, Deborah E.

    2015-01-01

    Objectives To compare the effects of different types of physical and mental activity on self-reported sleep quality over 12 weeks in older adults with cognitive and sleep complaints. Design Randomized controlled trial. Setting General community. Participants Seventy-two inactive community-dwelling older adults with self-reported sleep and cognitive problems (mean age 73.3±6.1; 60% women). Intervention Random allocation to four arms using a two-by-two factorial design: aerobic+cognitive training, aerobic+educational DVD, stretching+cognitive training, and stretching+educational DVD arms (60 min/d, 3 d/wk for physical and mental activity for 12 weeks). Measurements Change in sleep quality using seven questions from the Sleep Disorders Questionnaire on the 2005–06 National Health and Nutrition Examination Survey (range 0–28, with higher scores reflecting worse sleep quality). Analyses used intention-to-treat methods. Results Sleep quality scores did not differ at baseline, but there was a significant difference between the study arms in change in sleep quality over time (p<.005). Mean sleep quality scores improved significantly more in the stretching+educational DVD arm (5.1 points) than in the stretching+cognitive training (1.2 points), aerobic+educational DVD (1.1 points), or aerobic+cognitive training (0.25 points) arm (all p<.05, corrected for multiple comparisons). Differences between arms were strongest for waking at night (p=.02) and taking sleep medications (p=.004). Conclusion Self-reported sleep quality improved significantly more with low-intensity physical and mental activities than with moderate- or high-intensity activities in older adults with self-reported cognitive and sleep difficulties. Future longer-term studies with objective sleep measures are needed to corroborate these results. PMID:25516028

  14. The Impact of a Participatory Care Model on Work Satisfaction of Care Workers and the Functionality, Connectedness, and Mental Health of Community-Dwelling Older People.

    PubMed

    Bernoth, Maree; Burmeister, Oliver K; Morrison, Mark; Islam, Md Zahidul; Onslow, Fiona; Cleary, Michelle

    2016-06-01

    This study describes and evaluates an innovative program designed to reduce functional decline among seniors, using a participatory care approach and integrated health teams. The evaluation provides older people and community support workers (CSWs) with the opportunity to share their experiences of being involved with an innovative program to reduce functional decline (mobility, skin integrity, nutrition, mental health, continence) of older, community dwelling adults implemented by a Nursing Service in a major capital city in Australia. As part of the program, CSWs were trained to provide care that aimed to reduce functional decline, and improve the quality of life for the care recipients. Data were collected through in-depth interviews with older people receiving care and a focus group (FG) was conducted with CSWs. Seven themes emerged during data analysis: 1) functionality/independence; 2) prevention; 3) confidence; 4) connection; 5) the approach; 6) care plans; and 7) the role of the CSWs. The relationship built between care giver and receiver and the mutual respect facilitated through adopting a participatory care approach was crucial. This relationship-focused care contributed to improved functionality and consequently quality of life for the older person, and for the CSW professional it contributed to their development, improved satisfaction with their role, and increased pride in the difference they make in the lives of their clients. Opportunities for improvement of the program included ensuring that participants understood the rationale for all aspects of the program, including regular reminders, as well as the use of regular reviews of individual outcomes. PMID:27070378

  15. The association between psychosis and severe pain in community-dwelling adults: Findings from 44 low- and middle-income countries.

    PubMed

    Koyanagi, Ai; Stickley, Andrew

    2015-10-01

    Previous studies examining the association between schizophrenia and pain have produced mixed results and data on sub-threshold psychosis or psychotic symptoms and pain are scarce. This study assessed the association between psychosis and severe pain among community-dwelling adults in 44 low- and middle-income countries (LMICs) where no data exists. Data on 235,370 adults aged ≥18 years from the World Health Survey (WHS) 2002-2004 were analyzed. The presence of past 12-month psychotic symptoms was established using four questions from the Composite International Diagnostic Interview. Participants were categorized into four mutually exclusive groups based on whether they had at least one psychotic symptom and/or a lifetime psychosis or schizophrenia diagnosis. Multivariable logistic regression was used to estimate the association between psychosis and past 30-day severe pain. The prevalence of severe pain among those with 0, 1, 2, ≥3 psychotic symptoms was 8.7%, 16.7%, 21.8%, 30.5% respectively. Compared to those with no psychotic symptoms or diagnosis, the ORs (95% CIs) were: at least one symptom without diagnosis [2.17 (1.99-2.38)]; no symptom with diagnosis [2.33 (1.71-3.17)]; at least one symptom and diagnosis [4.27 (3.20-5.71)]. Associations were partly mediated by chronic physical conditions, anxiety, and depression. Despite some limitations such as the use of a single-item question to assess pain, the results of this study suggest that individuals with psychotic symptoms or a psychosis diagnosis should be systematically assessed for pain, and if necessary, receive treatment for pain and its underlying conditions. Future research on the effect of pain management on psychosis outcome is warranted. PMID:26343590

  16. Fall Risk Awareness and Safety Precautions Taken by Older Community-Dwelling Women and Men—A Qualitative Study Using Focus Group Discussions

    PubMed Central

    Pohl, Petra; Sandlund, Marlene; Ahlgren, Christina; Bergvall-Kåreborn, Birgitta; Lundin-Olsson, Lillemor; Wikman, Anita Melander

    2015-01-01

    Introduction Daily life requires frequent estimations of the risk of falling and the ability to avoid a fall. The objective of this study was to explore older women’s and men’s understanding of fall risk and their experiences with safety precautions taken to prevent falls. Methods A qualitative study with focus group discussions was conducted. Eighteen community-dwelling people [10 women and 8 men] with and without a history of falls were purposively recruited. Participants were divided into two groups, and each group met four times. A participatory and appreciative action and reflection approach was used to guide the discussions. All discussions were audio recorded and transcribed verbatim. Data were analysed by qualitative content analysis, and categories were determined inductively. Findings Three categories describing the process of becoming aware of fall risks in everyday life were identified: 1] Facing various feelings, 2] Recognizing one’s fall risk, and 3] Taking precautions. Each category comprised several subcategories. The comprehensive theme derived from the categories was “Safety precautions through fall risk awareness”. Three strategies of ignoring [continuing a risky activity], gaining insight [realizing the danger in a certain situation], and anticipating [thinking ahead and acting in advance] were related to all choices of actions and could fluctuate in the same person in different contexts. Conclusions The fall risk awareness process might be initiated for various reasons and can involve different feelings and precautions as well as different strategies. This finding highlights that there are many possible channels to reach older people with information about fall risk and fall prevention, including the media and their peers. The findings offer a deeper understanding of older peoples’ conceptualizations about fall risk awareness and make an important contribution to the development and implementation of fall prevention programmes. PMID

  17. Family, religion, and depressive symptoms in caregivers of disabled elderly

    PubMed Central

    Zunzunegui, M. V.; Beland, F.; Llacer, A.; Keller, I.

    1999-01-01

    STUDY OBJECTIVE: To explain the variations in depressive symptomatology among primary caregivers of community dwelling activities of daily living disabled elderly and to evaluate the role of family and religiosity on the mental health consequences of caregiving in Spain. DESIGN: Cross sectional study. SETTING: City of Leganes in the metropolitan area of Madrid, Spain. PARTICIPANTS: All caregivers of a representative sample of community dwelling activities of daily living disabled persons, aged 65 and over were approached. The response rate was 85% (n = 194). Depression was assessed by the Center for Epidemiologic Studies Depression (CES-D) Scale. MAIN RESULTS: Controlling for caregivers' income, education, health status, and caregiving stress, religiosity was associated with more depressive symptoms among children caregivers while for spouses the association was negative. Emotional support was negatively associated with depression, but instrumental support was not significant. CONCLUSIONS: Depressive symptomatology is frequent among Spanish caregivers of disabled elderly. This study concludes that religiosity and family emotional support play an important part in the mental health of Spanish caregivers. The role of religiosity may be different according to kinship tie and needs further investigation.   PMID:10396484

  18. The reduction of disability in community-dwelling frail older people: design of a two-arm cluster randomized controlled trial

    PubMed Central

    2010-01-01

    Background Frailty among older people is related to an increased risk of adverse health outcomes such as acute and chronic diseases, disability and mortality. Although many intervention studies for frail older people have been reported, only a few have shown positive effects regarding disability prevention. This article presents the design of a two-arm cluster randomized controlled trial on the effectiveness, cost-effectiveness and feasibility of a primary care intervention that combines the most promising elements of disability prevention in community-dwelling frail older people. Methods/design In this study twelve general practitioner practices were randomly allocated to the intervention group (6 practices) or to the control group (6 practices). Three thousand four hundred ninety-eight screening questionnaires including the Groningen Frailty Indicator (GFI) were sent out to identify frail older people. Based on their GFI score (≥5), 360 participants will be included in the study. The intervention will receive an interdisciplinary primary care intervention. After a comprehensive assessment by a practice nurse and additional assessments by other professionals, if needed, an individual action plan will be defined. The action plan is related to a flexible toolbox of interventions, which will be conducted by an interdisciplinary team. Effects of the intervention, both for the frail older people and their informal caregivers, will be measured after 6, 12 and 24 months using postal questionnaires and telephone interviews. Data for the process evaluation and economic evaluation will be gathered continuously over a 24-month period. Discussion The proposed study will provide information about the usefulness of an interdisciplinary primary care intervention. The postal screening procedure was conducted in two cycles between December 2009 and April 2010 and turned out to be a feasible method. The response rate was 79.7%. According to GFI scores 29.3% of the respondents can

  19. Associations of Sarcopenic Obesity and Dynapenic Obesity with Bone Mineral Density and Incident Fractures Over 5-10 Years in Community-Dwelling Older Adults.

    PubMed

    Scott, David; Chandrasekara, Sahan D; Laslett, Laura L; Cicuttini, Flavia; Ebeling, Peter R; Jones, Graeme

    2016-07-01

    The purpose of this study is to determine whether low muscle mass (sarcopenia) or strength (dynapenia), in the presence of obesity, are associated with increased risk for osteoporosis and non-vertebral fracture over 5-10 years in community-dwelling older adults. N = 1089 volunteers (mean ± SD age 62 ± 7 years; 51 % female) participated at baseline and 761 attended follow-up clinics (mean 5.1 ± 0.5 years later). Total body, total hip and spine BMD, and appendicular lean and total fat mass were assessed by DXA. Sarcopenic obesity and dynapenic obesity were defined as the lowest sex-specific tertiles for appendicular lean mass or lower-limb strength, respectively, and the highest sex-specific tertile for total fat mass. Fractures were self-reported on three occasions over 10.7 ± 0.7 years in 563 participants. Obese alone participants had significantly higher BMD at all sites compared with non-sarcopenic non-obese. Sarcopenic obese and dynapenic obese men had lower spine and total body BMD, respectively, and sarcopenic obese women had lower total hip BMD, compared with obese alone (all P < 0.05). Sarcopenic obese men had higher non-vertebral fracture rates compared to non-sarcopenic non-obese (incidence rate ratio: 3.0; 95 % CI 1.7-5.5), and obese alone (3.6; 1.7-7.4). Sarcopenic obese women had higher fracture rates compared with obese alone (2.8; 1.4-5.6), but this was non-significant after adjustment for total hip BMD. Sarcopenic and dynapenic obese older adults may have increased risk of osteoporosis and non-vertebral fracture relative to obese alone counterparts. Sarcopenic and dynapenic obese individuals potentially represent a subset of the obese older adult population who require closer monitoring of bone health during ageing. PMID:26939775

  20. Risk factors for depressed mood amongst a community dwelling older age population in England: cross-sectional survey data from the PRO-AGE study

    PubMed Central

    2014-01-01

    Background The Quality and Outcomes Framework in the United Kingdom (UK) National Health Service previously highlighted case finding of depression amongst patients with diabetes or coronary heart disease. However, depression in older people remains under-recognized. Comprehensive data for analyses of the association of depression in older age with other health and functional measures, and demographic factors from community populations within England, are lacking. Methods Secondary analyses of cross-sectional baseline survey data from the England arm of a randomised controlled trial of health risk appraisal for older people in Europe; PRO-AGE study. Data from 1085 community-dwelling non-disabled people aged 65 years or more from three group practices in suburban London contributed to this study. Depressed mood was ascertained from the 5-item Mental Health Inventory Screening test. Exploratory multivariable logistic regression was used to identify the strongest associations of depressed mood with a previous diagnosis of a specified physical/mental health condition, health and functional measures, and demographic factors. Results Depressed mood occurred in 14% (155/1085) of participants. A previous diagnoses of depression (OR 3.39; P < 0.001) and poor vision as determined from a Visual Function Questionnaire (OR 2.37; P = 0.001) were amongst the strongest factors associated with depressed mood that were independent of functional impairment, other co-morbidities, and demographic factors. A subgroup analyses on those without a previous diagnosis of depression also indicated that within this group, poor vision (OR 2.51; P = 0.002) was amongst the strongest independent factors associated with depressed mood. Conclusions Previous case-finding strategies in primary care focussed on heart disease and diabetes but health-related conditions other than coronary heart disease and diabetes are also associated with an increased risk for depression. Complex issues of

  1. Physiotherapy to improve physical activity in community-dwelling older adults with mobility problems (Coach2Move): study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Older adults can benefit from physical activity in numerous ways. Physical activity is considered to be one of the few ways to influence the level of frailty. Standardized exercise programs do not necessarily lead to more physical activity in daily life, however, and a more personalized approach seems appropriate. The main objective of this study is to investigate whether a focused, problem-oriented coaching intervention (‘Coach2Move’) delivered by a physiotherapist specializing in geriatrics is more effective for improving physical activity, mobility and health status in community-dwelling older adults than usual physiotherapy care. In addition, cost-effectiveness will be determined. Methods/Design The design of this study is a single-blind randomized controlled trial in thirteen physiotherapy practices. Randomization will take place at the individual patient level. The study population consists of older adults, ≥70 years of age, with decreased physical functioning and mobility and/or a physically inactive lifestyle. The intervention group will receive geriatric physiotherapy according to the Coach2Move strategy. The control group will receive the usual physiotherapy care. Measurements will be performed by research assistants not aware of group assignment. The results will be evaluated on the amount of physical activity (LASA Physical Activity Questionnaire), mobility (modified ‘get up and go’ test, walking speed and six-minute walking test), quality of life (SF-36), degree of frailty (Evaluative Frailty Index for Physical Activity), fatigue (NRS-fatigue), perceived effect (Global Perceived Effect and Patient Specific Complaints questionnaire) and health care costs. Discussion Most studies on the effect of exercise or physical activity consist of standardized programs. In this study, a personalized approach is evaluated within a group of frail older adults, many of whom suffer from multiple and complex diseases and problems. A complicating

  2. A missense single nucleotide polymorphism, V114I of the Werner syndrome gene, is associated with risk of osteoporosis and femoral fracture in the Japanese population.

    PubMed

    Zhou, Heying; Mori, Seijiro; Tanaka, Masashi; Sawabe, Motoji; Arai, Tomio; Muramatsu, Masaaki; Mieno, Makiko Naka; Shinkai, Shoji; Yamada, Yoshiji; Miyachi, Motohiko; Murakami, Haruka; Sanada, Kiyoshi; Ito, Hideki

    2015-11-01

    Werner syndrome is a rare autosomal recessive disorder caused by mutations in the human WRN gene and characterized by the early onset of normal aging symptoms. Given that patients with this disease exhibit osteoporosis, the present study aimed to determine whether the WRN gene contributes to the etiology of osteoporosis. A genetic association study of eight non-synonymous polymorphisms in the WRN gene and the incidence of femoral fracture was undertaken in 1,632 consecutive Japanese autopsies in which 140 patients had experienced the fracture during their lifetime. The results were validated in 251 unrelated postmenopausal Japanese women with osteoporosis and 269 non-institutionalized, community-dwelling Japanese adults. A statistically significant association was observed between rs2230009 (c.340G > A)--which results in a Val to Ile substitution--and fracture risk; the incidence of femoral fracture increased dose-dependently with the number of A alleles (p = 0.0120). Femoral neck bone and whole bone densities were lower among postmenopausal women with osteoporosis and community-dwelling adults, respectively, if they were of the AG instead of the GG genotype. The results suggest that Japanese subjects bearing at least one A allele of rs2230009 of the WRN gene are at a significantly higher risk of femoral fracture, possibly due to decreased bone density.

  3. Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study.

    PubMed

    Fong, Shirley S M; Ng, Shamay S M; Cheng, Yoyo T Y; Wong, Janet Y H; Yu, Esther Y T; Chow, Gary C C; Chak, Yvonne T C; Chan, Ivy K Y; Zhang, Joni; Macfarlane, Duncan; Chung, Louisa M Y

    2016-01-01

    Objectives. To evaluate the effects of Ving Tsun (VT) martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5 ± 6.7 years) underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice), and 18 (mean age ± SD = 72.0 ± 6.7 years) received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P = 0.007) in the VT group and the time to reach peak force decreased (9.9%) differentially in the VT group compared to the control group (P = 0.033). For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P = 0.002). Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults. PMID:27525020

  4. Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study

    PubMed Central

    Ng, Shamay S. M.; Cheng, Yoyo T. Y.; Yu, Esther Y. T.; Chow, Gary C. C.; Chak, Yvonne T. C.; Chan, Ivy K. Y.; Zhang, Joni; Macfarlane, Duncan

    2016-01-01

    Objectives. To evaluate the effects of Ving Tsun (VT) martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5 ± 6.7 years) underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice), and 18 (mean age ± SD = 72.0 ± 6.7 years) received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P = 0.007) in the VT group and the time to reach peak force decreased (9.9%) differentially in the VT group compared to the control group (P = 0.033). For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P = 0.002). Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults. PMID:27525020

  5. Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study.

    PubMed

    Fong, Shirley S M; Ng, Shamay S M; Cheng, Yoyo T Y; Wong, Janet Y H; Yu, Esther Y T; Chow, Gary C C; Chak, Yvonne T C; Chan, Ivy K Y; Zhang, Joni; Macfarlane, Duncan; Chung, Louisa M Y

    2016-01-01

    Objectives. To evaluate the effects of Ving Tsun (VT) martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5 ± 6.7 years) underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice), and 18 (mean age ± SD = 72.0 ± 6.7 years) received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P = 0.007) in the VT group and the time to reach peak force decreased (9.9%) differentially in the VT group compared to the control group (P = 0.033). For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P = 0.002). Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults.

  6. Tying eHealth Tools to Patient Needs: Exploring the Use of eHealth for Community-Dwelling Patients With Complex Chronic Disease and Disability

    PubMed Central

    Miller, Daniel; Kuluski, Kerry; Cott, Cheryl

    2014-01-01

    Background Health policy makers have recently shifted attention towards examining high users of health care, in particular patients with complex chronic disease and disability (CCDD) characterized as having multimorbidities and care needs that require ongoing use of services. The adoption of eHealth technologies may be a key strategy in supporting and providing care for these patients; however, these technologies need to address the specific needs of patients with CCDD. This paper describes the first phase of a multiphased patient-centered research project aimed at developing eHealth technology for patients with CCDD. Objective As part of the development of new eHealth technologies to support patients with CCDD in primary care settings, we sought to determine the perceived needs of these patients with respect to (1) the kinds of health and health service issues that are important to them, (2) the information that should be collected and how it could be collected in order to help meet their needs, and (3) their views on the challenges/barriers to using eHealth mobile apps to collect the information. Methods Focus groups were conducted with community-dwelling patients with CCDD and caregivers. An interpretive description research design was used to identify the perceived needs of participants and the information sharing and eHealth technologies that could support those needs. Analysis was conducted concurrently with data collection. Coding of transcripts from four focus groups was conducted by 3 authors. QSR NVivo 10 software was used to manage coding. Results There were 14 total participants in the focus groups. The average age of participants was 64.4 years; 9 participants were female, and 11 were born in Canada. Participants identified a need for open two-way communication and dialogue between themselves and their providers, and better information sharing between providers in order to support continuity and coordination of care. Access issues were mainly around

  7. Effects of gait velocity and center of mass acceleration during turning gait in old-old elderly women

    PubMed Central

    Shin, Sun-Shil; Yoo, Won-Gyu

    2015-01-01

    [Purpose] This study investigated gait velocity and center of mass acceleration in three directions during square and semicircular turning gait tasks in old-old elderly women. [Subjects] Fifteen community-dwelling, old-old elderly women (≥75 years old) who could walk independently were recruited. [Methods] We measured gait velocity and center of mass acceleration in three directions using an accelerometer during two different turning gait tasks. [Results] The velocity during square turning was significantly slower than that during semicircular turning gait. There were no significant differences between gait tasks with respect to normalized antero-posterior, medo-lateral, or vertical center of mass acceleration. [Conclusion] Changing the direction of travel while walking regardless of turning angle is one of the greatest challenges for balance in old-old elderly people. Furthermore, gait velocity is a useful clinical marker for predicting falls in old-old elderly populations. PMID:26180319

  8. The prevalence and correlates of fear of falling in elderly persons living in the community.

    PubMed Central

    Arfken, C L; Lach, H W; Birge, S J; Miller, J P

    1994-01-01

    OBJECTIVES. Fear of falling has been recognized as a potentially debilitating consequence of falling in elderly persons. However, the prevalence and the correlates of this fear are unknown. METHODS. Prevalence of fear of falling was calculated from the 1-year follow-up of an age- and gender-stratified random sample of community-dwelling elderly persons. Cross-sectional associations of fear of falling with quality of life, frailty, and falling were assessed. RESULTS. The prevalence of fear increased with age and was greater in women. After adjustment for age and gender, being moderately fearful of falling was associated with decreased satisfaction with life, increased frailty and depressed mood, and recent experience with falls. Being very fearful of falling was associated with all of the above plus decreased mobility and social activities. CONCLUSIONS. Fear of falling is common in elderly persons and is associated with decreased quality of life, increased frailty, and recent experience with falls. PMID:8154557

  9. Intergenerational relations and elder care preferences of Asian Indians in North Carolina.

    PubMed

    Sudha, S

    2014-03-01

    The US older population is growing in ethnic diversity. Persistent ethnic disparities in service use among seniors are linked to structural barriers to access, and also to family processes such as cultural preferences and intergenerational relations. There is sparse information on the latter issue for immigrant ethnic minority seniors. Information on the Asian group (the fastest growing senior sub-population) is extremely scarce, due to this group's diversity in national, linguistic, and cultural origins. We conducted a qualitative study among community-dwelling Asian Indian families (including at least one member aged 60 years and older) in North Carolina to examine preferences of seniors and the midlife generation regarding elder care, and the role of intergenerational relations in desired care for elders, exploring the theoretical perspective of intergenerational relationship ambivalence. Our results suggest that cultural preferences, ambivalence in intergenerational relations, and regulations on health service eligibility among immigrant/transnational seniors and midlife adults influence preferences for elder care.

  10. Turning Japanese?

    ERIC Educational Resources Information Center

    Huwitz, Nina

    1990-01-01

    Relates observations of the Japanese educational system by a U.S. high school history teacher. Finds the Japanese system impressive but argues that such a centralized and authoritarian system would not work in the United States. Educators should learn from Japanese schools, not copy them. Recommends U.S. educators seek agreement on educational…

  11. Things Japanese.

    ERIC Educational Resources Information Center

    Shigeta, Jessie M.

    Presented in this booklet are brief descriptions of items and activities that are symbolic of Japanese culture. Some of the items and activities described include Japanese musical instruments and records, toys and crafts, traditional clothing and accessories, and food utensils. Several recipes for Japanese dishes are provided. Lists of pertinent…

  12. Japanese language and Japanese science

    NASA Astrophysics Data System (ADS)

    Tanikawa, Kiyotaka

    2003-08-01

    Japanese mathematical scientists including astronomers, physicists, and mathematicians obtain ideas in Japanese, discuss their problems in Japanese, and arrive at conclusions in Japanese, and yet they write their results in foreign languages such as English. This uncomfortable situation has continued for nearly one hundred years and has had serious effects on Japanese science. In this short report, the author discusses and analyses these effects. In order to put Japanese science on a sound basis, the author proposes to increase the number of articles, reviews and textbooks in Japanese, first by translation and second by the voluntary efforts of scientists themselves. As centers devoted to this activity, the author proposes to construct "Airborne Libraries" which are maintained and accumulate in an electronic form the scientific documents written in Japanese.

  13. Can a tailored exercise and home hazard reduction program reduce the rate of falls in community dwelling older people with cognitive impairment: protocol paper for the i-FOCIS randomised controlled trial

    PubMed Central

    2014-01-01

    Background The rate of falls in community dwelling older people with cognitive impairment (CI) is twice that of a cognitively intact population, with almost two thirds of people with CI falling annually. Studies indicate that exercise involving balance and/or a home hazard reduction program are effective in preventing falls in cognitively intact older people. However the potential benefit of these interventions in reducing falls in people with CI has not been established. This randomised controlled trial will determine whether a tailored exercise and home hazard reduction program can reduce the rate of falls in community dwelling older people with CI. We will determine whether the intervention has beneficial effects on a range of physical and psychological outcome measures as well as quality of life of participants and their carers. A health economic analysis examining the cost and potential benefits of the program will also be undertaken. Methods and design Three hundred and sixty people aged 65 years or older living in the community with CI will be recruited to participate in the trial. Each will have an identifiable carer with a minimum of 3.5 hours of face to face contact each week. Participants will undergo an assessment at baseline with retests at 6 and 12 months. Participants allocated to the intervention group will participate in an exercise and home hazard reduction program tailored to their cognitive and physical abilities. The primary outcome measure will be the rate of falls which will be measured using monthly falls calendars. Secondary outcome measures will include the risk of falling, quality of life, measures of physical and cognitive function, fear of falling and planned and unplanned use of health services. Carers will be followed up to determine carer burden, coping strategies and quality of life. Discussion The study will determine the impact of this tailored intervention in reducing the rate of falls in community dwelling older people with

  14. [Quality of care among older adults with diabetes mellitus: comparison between community-dwelling adults attended to by home care services and nursing home residents in Dresden].

    PubMed

    Coll-Planas, Laura; Bergmann, Antje; Schwarz, Peter; Guillén-Grima, Francisco; Schulze, Jan

    2007-01-01

    Due to changes in the age structure of the population the number of frail elderly diabetics is rising. This change is accompanied by an increase in nursing care efforts and requirements in both home care services and nursing homes. The aim of this study was to evaluate the quality of care in the home care and nursing home setting concerning the structure, the process and the outcome quality at the institutional and patient level. This is an observational transversal study. At the institutional level a standardised questionnaire of the German Diabetes Research Institute was sent to all nursing homes (37) and home care services (88) in Dresden. At the patient level 37 homebound patients and 46 residents were recruited. A Geriatric assessment and a clinical examination were performed and a blood sample was analysed. Patients with moderate or severe cognitive impairment were excluded. The prevalence of diabetes in home care services was 27.2% and in nursing homes 36.1%. The participation rate among the institutions was 21.6% (n = 27). In 14% (n = 12) of the diabetic patients the HbA1c was above 8% (poor metabolic control) and in 24% (20) it was between 7% and 8% (regular metabolic control). 56.6% (n = 21) of the homebound elderly diabetics and 46.7% (n = 21) of the nursing home residents with diabetes were hospitalized at least once during the last 12 months. Our study showed a high prevalence of diabetes in both types of institutions in Dresden and a high hospitalisation rate of the elderly diabetics, although 62% of the patients had an optimum metabolic control. These facts indicate that the quality of care of frail elderly diabetics concerning the multimorbidity might be further improved. PMID:18269054

  15. Lower Body Mass Index is a Risk Factor for In-Hospital Mortality of Elderly Japanese Patients Treated with Ampicillin/sulbactam

    PubMed Central

    Miura, Makoto; Kuwahara, Akiko; Tomozawa, Akinori; Omae, Naoki; Yamamori, Motohiro; Kadoyama, Kaori; Sakaeda, Toshiyuki

    2016-01-01

    Objectives: A retrospective examination was conducted to identify risk factors for in-hospital mortality of elderly patients (65 years or older) treated with the beta-lactam/beta-lactamase inhibitor combination antibiotic, ampicillin/sulbactam (ABPC/SBT). Methods: Clinical data from 96 patients who were hospitalized with infectious diseases and treated with ABPC/SBT (9 g/day or 12 g/day) were analyzed. Risk factors examined included demographic and clinical laboratory parameters. Parameter values prior to treatment and changes after treatment were compared between survivors and non-survivors. Results: The study patients had an average age of 81.9±8.4 years (±SD) and body mass index (BMI) of 19.9±4.2 kg/m2. They were characterized by anemia (low hemoglobin and hematocrit levels), inflammation (high leukocyte count, neutrophil count, C-reactive protein level, and body temperature), and hepatic and renal dysfunction (high aspartate aminotransferase, alanine aminotransferase and blood urea nitrogen levels). The BMI of non-survivors, 16.2±2.9 kg/m2, was lower than that of survivors, 20.4±4.1 kg/m2. In addition, the hematological parameters deteriorated more remarkably, inflammation markers were not altered (or the decrease was marginal), and hepatic function was not improved, in non-survivors. Conclusions: A lower BMI value is a risk factor for in-hospital mortality of elderly patients treated with ABPC/SBT. PMID:27766023

  16. Comparison of multisensory and strength training for postural control in the elderly

    PubMed Central

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

    2012-01-01

    Objective The objective of this study was to analyze the efficacy of multisensory versus muscle strengthening to improve postural control in healthy community-dwelling elderly. Participants We performed a single-blinded study with 46 community-dwelling elderly allocated to strength (GS, n = 23; 70.18 ± 4.8 years 22 women and 1 man) and multisensory exercises groups (GM, n = 23; 68.8 ± 5.9 years; 22 women and 1 man) for 12 weeks. Methods We performed isokinetic evaluations of muscle groups in the ankle and foot including dorsiflexors, plantar flexors, inversion, and eversion. The oscillation of the center of pressure was assessed with a force platform. Results The GM group presented a reduction in the oscillation (66.8 ± 273.4 cm2 to 11.1 ± 11.6 cm2; P = 0.02), which was not observed in the GS group. The GM group showed better results for the peak torque and work than the GS group, but without statistical significance. Conclusion Although the GM group presented better results, it is not possible to state that one exercise regimen proved more efficacious than the other in improving balance control. PMID:22654512

  17. Tobacco use: a modifiable risk factor for dental disease among the elderly.

    PubMed Central

    Jette, A M; Feldman, H A; Tennstedt, S L

    1993-01-01

    OBJECTIVES. Because the public health literature contains few analytic studies of modifiable behavioral risk factors for dental disease among older community-dwelling populations, the New England Elders Dental Study was undertaken as an epidemiologic study of the oral health status of a representative sample of older adults living within the six New England states. METHODS. Five dentists conducted comprehensive in-home oral health examinations on 1156 community-dwelling adults aged 70 and older to determine whether lifetime use of tobacco products was a significant risk factor for tooth loss, caries, and periodontal disease. RESULTS. Among New England elders, tobacco use was more common among men (18.1%) than women (7.9%), with a combined rate of 12.3%. Further, 64.7% of men and 36.6% of women were previous tobacco users. Years of exposure to tobacco products was a statistically significant risk factor for tooth loss, coronal and root caries, and periodontal disease, regardless of other social and behavioral factors. CONCLUSIONS. Lifelong tobacco use is a modifiable risk factor for poor dental health among older adults. Dental practitioners need to intervene with all their adult patients to discourage use of tobacco products for oral as well as general preventive health care. PMID:8363003

  18. Decline in Cognitive Function and Risk of Elder Self-Neglect: Finding from the Chicago Health Aging Project

    PubMed Central

    Dong, XinQi; Simon, Melissa A.; Wilson, Robert S.; Mendes de Leon, Carlos F.; Rajan, K. Bharat; Evans, Denis A.

    2010-01-01

    Objectives This study aimed to examine the longitudinal association between decline in cognitive function and risk of elder self-neglect in a community-dwelling population. Design Prospective population-based study Setting Geographically-defined community in Chicago. Participants Community-dwelling subjects reported to the social services agency from 1993–2005 for self-neglect who also participated in the Chicago Health Aging Project (CHAP). Of the 5,519 participants in the Chicago Health Aging Project, 1,017 were reported to social services agency for suspected elder self-neglect from 1993–2005. Measurements Reported elder self-neglect was identified by social services agency. The primary predictor was decline in cognitive function assessed using the Mini-Mental State Examination (MMSE), the Symbol Digit Modalities Test (Executive Function), and both immediate and delayed recall of the East Boston Memory Test (Episodic Memory). An index of global cognitive function scores was derived by averaging z-scores of all tests. Outcome of interest was elder self-neglect. Logistic and linear regression models were used to assess these longitudinal associations. Results After adjusting for potential confounding factors, decline in global cognitive function, MMSE or episodic memory was not independently associated with increased risk of reported and confirmed elder self-neglect. Decline in executive function was associated with increased risk of reported and confirmed elder self-neglect. Decline in global cognitive function was associated with increased risk of greater self-neglect severity (PE=0.76, SE=0.31, p=0.014). Conclusion Decline in executive function was associated with increased risk of reported and confirmed elder self-neglect. Decline in global cognitive function was associated with increased risk of greater self-neglect severity. PMID:21143438

  19. Effects of Ving Tsun Chinese martial art training on musculoskeletal health, balance performance, and self-efficacy in community-dwelling older adults

    PubMed Central

    Lip, Ryan W.T.; Fong, Shirley S.M.; Ng, Shamay S.M.; Liu, Karen P.Y.; Guo, X.

    2015-01-01

    [Purpose] The aim of this study was to investigate the effects of Ving Tsun (VT) Chinese martial art training on radial bone strength, upper- and lower-limb muscular strength, shoulder joint mobility, balance performance, and self-efficacy in elderly participants. [Subjects and Methods] Twelve seniors voluntarily joined the VT training group, and twenty-seven seniors voluntarily joined the control group. The VT group received VT training for three months, while the control group received no training. The bone strength of the distal radius was assessed using an ultrasound bone sonometer. Muscular strength in the limbs was evaluated using a Jamar handgrip dynamometer and the five times sit-to-stand test. Shoulder joint mobility was examined using a goniometer. Balance performance and self-efficacy were evaluated using the Berg Balance Scale and the Chinese version of the Activities-specific Balance Confidence Scale, respectively. [Results] The results revealed a nonsignificant group-by-time interaction effect, group effect, and time effect for all outcome variables. However, general trends of maintenance or improvement in all outcome parameters were observed to a greater extent in the VT group than in the control group. [Conclusion] VT training might be a potential fall-prevention exercise that can be used to maintain general physique, balance, and confidence in the elderly population. A further randomized controlled trial is needed to confirm this postulation. PMID:25931704

  20. Effects of Ving Tsun Chinese martial art training on musculoskeletal health, balance performance, and self-efficacy in community-dwelling older adults.

    PubMed

    Lip, Ryan W T; Fong, Shirley S M; Ng, Shamay S M; Liu, Karen P Y; Guo, X

    2015-03-01

    [Purpose] The aim of this study was to investigate the effects of Ving Tsun (VT) Chinese martial art training on radial bone strength, upper- and lower-limb muscular strength, shoulder joint mobility, balance performance, and self-efficacy in elderly participants. [Subjects and Methods] Twelve seniors voluntarily joined the VT training group, and twenty-seven seniors voluntarily joined the control group. The VT group received VT training for three months, while the control group received no training. The bone strength of the distal radius was assessed using an ultrasound bone sonometer. Muscular strength in the limbs was evaluated using a Jamar handgrip dynamometer and the five times sit-to-stand test. Shoulder joint mobility was examined using a goniometer. Balance performance and self-efficacy were evaluated using the Berg Balance Scale and the Chinese version of the Activities-specific Balance Confidence Scale, respectively. [Results] The results revealed a nonsignificant group-by-time interaction effect, group effect, and time effect for all outcome variables. However, general trends of maintenance or improvement in all outcome parameters were observed to a greater extent in the VT group than in the control group. [Conclusion] VT training might be a potential fall-prevention exercise that can be used to maintain general physique, balance, and confidence in the elderly population. A further randomized controlled trial is needed to confirm this postulation. PMID:25931704

  1. Effects of Ving Tsun Chinese martial art training on musculoskeletal health, balance performance, and self-efficacy in community-dwelling older adults.

    PubMed

    Lip, Ryan W T; Fong, Shirley S M; Ng, Shamay S M; Liu, Karen P Y; Guo, X

    2015-03-01

    [Purpose] The aim of this study was to investigate the effects of Ving Tsun (VT) Chinese martial art training on radial bone strength, upper- and lower-limb muscular strength, shoulder joint mobility, balance performance, and self-efficacy in elderly participants. [Subjects and Methods] Twelve seniors voluntarily joined the VT training group, and twenty-seven seniors voluntarily joined the control group. The VT group received VT training for three months, while the control group received no training. The bone strength of the distal radius was assessed using an ultrasound bone sonometer. Muscular strength in the limbs was evaluated using a Jamar handgrip dynamometer and the five times sit-to-stand test. Shoulder joint mobility was examined using a goniometer. Balance performance and self-efficacy were evaluated using the Berg Balance Scale and the Chinese version of the Activities-specific Balance Confidence Scale, respectively. [Results] The results revealed a nonsignificant group-by-time interaction effect, group effect, and time effect for all outcome variables. However, general trends of maintenance or improvement in all outcome parameters were observed to a greater extent in the VT group than in the control group. [Conclusion] VT training might be a potential fall-prevention exercise that can be used to maintain general physique, balance, and confidence in the elderly population. A further randomized controlled trial is needed to confirm this postulation.

  2. Older people's perceptions of the term elder abuse and characteristics associated with a lower level of awareness.

    PubMed

    Naughton, Corina; Drennan, Jonathan; Lafferty, Attracta

    2014-01-01

    A national representative survey of 2,021 community-dwelling older people was carried out in 2010 using face-to-face interviews. The study examined how the term "elder abuse" was understood by this population and identified factors associated with lower levels of awareness. Over 80% of this population recognized the term elder abuse, and 56% demonstrated specific insight related to typologies, locations, and perpetrators of abuse. Less specific responses were given by 22% of participants, and a further 21% could not give a reply. Less specific or "don't know" responses were independently associated with age 80 years or older, a lower level of education, impaired physical health, and living in economically deprived communities. Despite ongoing public information campaigns, there remained a significant portion of older people who may be unaware of or have limited insight into elder abuse. This study suggests a need for more targeted education campaigns aimed at specific higher-risk groups. PMID:24329480

  3. Expansion of natural killer cells in peripheral blood in a Japanese elderly with human T-cell lymphotropic virus type 1-related skin lesions.

    PubMed

    Imashuku, Shinsaku; Kudo, Naoko; Kubo, Kagekatsu; Ohshima, Kouichi

    2014-01-01

    Natural killer (NK) cells were proposed to play an important role in the pathogenesis of human T-cell lymphotropic virus type 1- (HTLV-1-) associated neurologic disease. Our patient was a 77-year-old Japanese man, who had been treated for infective dermatitis associated with HTLV-1 for nearly 10 years. When referred to us, he had facial eczema/edema as well as extensive dermatitis at the neck/upper chest and nuchal area/upper back regions. Dermal lesions had CD3+CD4+ cells, but no NK cells. Flow cytometry of his peripheral blood showed a phenotype of CD2+ (97%), CD3+ (17%), CD4+ (12%), CD7+ (94%), CD8+ (6%), CD11c+ (70%), CD16+ (82%), CD19+ (0%), CD20+ (0%), CD56+ (67%), HLA-DR+ (68%), and NKp46+ (36%). Absolute numbers of CD56+NK cells in the peripheral blood were in a range of 986/μL-1,270/μL. The expanded NK cells in the peripheral blood are considered to be reactive, to maintain the confinement of the HTLV-1-positive CD4+ cells in the skin, and to prevent the progression of the disease.

  4. Frailty is associated with impairment of vaccine-induced antibody response and increase in post-vaccination influenza infection in community-dwelling older adults.

    PubMed

    Yao, Xu; Hamilton, Robert G; Weng, Nan-ping; Xue, Qian-Li; Bream, Jay H; Li, Huifen; Tian, Jing; Yeh, Shu-Hui; Resnick, Barbara; Xu, Xiyan; Walston, Jeremy; Fried, Linda P; Leng, Sean X

    2011-07-12

    Annual immunization with a trivalent inactivated vaccine (TIV) is considered efficacious for prevention of seasonal influenza in older adults. However, significant controversy exists in the current literature regarding the clinical effectiveness of TIV immunization in this highly heterogeneous population. Frailty is an important geriatric syndrome characterized by decreased physiologic reserve and increased vulnerability to stressors. Using a validated set of frailty criteria, we conducted a prospective observational study to evaluate TIV-induced strain-specific hemagglutination inhibition (HI) antibody titers and post-vaccination rates of influenza-like illness (ILI) and infection in frail and nonfrail older adults. The results indicate that frailty was associated with significant impairment in TIV-induced strain-specific HI titers and increased rates of ILI and laboratory-confirmed influenza infection. These findings suggest that assessing frailty status in the elderly may identify those who are less likely to respond to TIV immunization and be at higher risk for seasonal influenza and its complications.

  5. Dysphagia in the elderly: management and nutritional considerations.

    PubMed

    Sura, Livia; Madhavan, Aarthi; Carnaby, Giselle; Crary, Michael A

    2012-01-01

    Dysphagia is a prevalent difficulty among aging adults. Though increasing age facilitates subtle physiologic changes in swallow function, age-related diseases are significant factors in the presence and severity of dysphagia. Among elderly diseases and health complications, stroke and dementia reflect high rates of dysphagia. In both conditions, dysphagia is associated with nutritional deficits and increased risk of pneumonia. Recent efforts have suggested that elderly community dwellers are also at risk for dysphagia and associated deficits in nutritional status and increased pneumonia risk. Swallowing rehabilitation is an effective approach to increase safe oral intake in these populations and recent research has demonstrated extended benefits related to improved nutritional status and reduced pneumonia rates. In this manuscript, we review data describing age related changes in swallowing and discuss the relationship of dysphagia in patients following stroke, those with dementia, and in community dwelling elderly. Subsequently, we review basic approaches to dysphagia intervention including both compensatory and rehabilitative approaches. We conclude with a discussion on the positive impact of swallowing rehabilitation on malnutrition and pneumonia in elderly who either present with dysphagia or are at risk for dysphagia.

  6. Faster cognitive decline in elders without dementia and decreased risk of cancer mortality

    PubMed Central

    Romero, Juan Pablo; Louis, Elan D.; Bermejo-Pareja, Félix

    2014-01-01

    Objective: To assess whether faster cognitive decline in elders without dementia is associated with decreased risk of cancer mortality. Methods: In this population-based, prospective study of 2,627 people without dementia aged 65 years and older (Neurological Disorders in Central Spain), a 37-item version of the Mini-Mental State Examination (37-MMSE) was administered at 2 visits (baseline and follow-up, approximately 3 years later). We divided change in 37-MMSE into tertiles (lower tertile ≥2 point improvement in score, higher tertile ≥2 point decline in score). Community-dwelling elders were followed for a median of 12.9 years, after which the death certificates of those who died were examined. Results: A total of 1,003 (38.2%) died, including 339 (33.8%) deaths among participants who were in the higher tertile of 37-MMSE change and 664 (66.2%) deaths among those in the remaining tertiles. Cancer was reported significantly less often in those in the higher tertile of MMSE change (20.6%) than in those in the remaining tertiles (28.6%): in an unadjusted Cox model, hazard ratio for cancer mortality in participants within the higher tertile = 0.75 (p = 0.04) compared with the participants within the remaining tertiles. In a Cox model that adjusted for a variety of demographic factors and comorbidities, hazard ratio for cancer mortality in participants within the higher tertile = 0.70 (p = 0.01). Conclusion: In this population-based, prospective study of community-dwelling elders without dementia, faster cognitive decline was associated with a decreased risk of cancer mortality. Further studies are required to elucidate this inverse association in elders without dementia. PMID:24719490

  7. Declines in Mobility and Changes in Performance in the Instrumental Activities of Daily Living Among Mildly Disabled Community-Dwelling Older Adults

    PubMed Central

    Bear-Lehman, Jane; Anderson, Stewart J.

    2015-01-01

    Background. Gait speed is as an important predictor of mortality, volume of medical care, hospitalization, onset of activities of daily living (ADL) disability, and nursing home placement. We examined associations between change in gait speed and change in observed performance in the instrumental ADL (IADL) in a sample of mild-to-moderately disabled older adults. Methods. Participants in the Sources of Independence in the Elderly project (n = 375) were approached to complete a 4-m gait assessment and a performance test of IADL competency at three points over 2 years. IADL competency was assessed by occupational therapists, who rated participants using the Assessment of Motor and Process Skills (AMPS) and who also made a global rating of need for help or supervision. Linear mixed models were developed to assess change in motor AMPS score relative to baseline status and change in gait speed and AMPS process scores. Results. Baseline gait and change in gait were significant correlates of change in the AMPS motor ability measures in models that adjusted for cognitive status and AMPS process ability. Even respondents with gait speeds of 1 m/s at baseline were at risk of declining AMPS motor ability and an occupational therapist rating of IADL disability if gait speed declined. Conclusions. Slowing in gait speed is an important risk factor for IADL disability in mild to moderately disabled older adults. PMID:24952575

  8. A cluster randomised controlled trial of advice, exercise or multifactorial assessment to prevent falls and fractures in community-dwelling older adults: protocol for the prevention of falls injury trial (PreFIT)

    PubMed Central

    Lall, Ranjit; Withers, Emma J; Finnegan, Susanne; Underwood, Martin; Hulme, Claire; Sheridan, Ray; Skelton, Dawn A; Martin, Finbarr; Lamb, Sarah E

    2016-01-01

    Introduction Falls are the leading cause of accident-related mortality in older adults. Injurious falls are associated with functional decline, disability, healthcare utilisation and significant National Health Service (NHS)-related costs. The evidence base for multifactorial or exercise interventions reducing fractures in the general population is weak. This protocol describes a large-scale UK trial investigating the clinical and cost-effectiveness of alternative falls prevention interventions targeted at community dwelling older adults. Methods and analysis A three-arm, pragmatic, cluster randomised controlled trial, conducted within primary care in England, UK. Sixty-three general practices will be randomised to deliver one of three falls prevention interventions: (1) advice only; (2) advice with exercise; or (3) advice with multifactorial falls prevention (MFFP). We aim to recruit over 9000 community-dwelling adults aged 70 and above. Practices randomised to deliver advice will mail out advice booklets. Practices randomised to deliver ‘active’ interventions, either exercise or MFFP, send all trial participants the advice booklet and a screening survey to identify participants with a history of falling or balance problems. Onward referral to ‘active’ intervention will be based on falls risk determined from balance screen. The primary outcome is peripheral fracture; secondary outcomes include number with at least one fracture, falls, mortality, quality of life and health service resource use at 18 months, captured using self-report and routine healthcare activity data. Ethics and dissemination The study protocol has approval from the National Research Ethics Service (REC reference 10/H0401/36; Protocol V.3.1, 21/May/2013). User groups and patient representatives were consulted to inform trial design. Results will be reported at conferences and in peer-reviewed publications. A patient-friendly summary of trial findings will be published on the prevention

  9. Adverse outcomes of frailty in the elderly: the Rotterdam Study.

    PubMed

    Lahousse, Lies; Maes, Bastiaan; Ziere, Gijsbertus; Loth, Daan W; Verlinden, Vincentius J A; Zillikens, M Carola; Uitterlinden, André G; Rivadeneira, Fernando; Tiemeier, Henning; Franco, Oscar H; Ikram, M Arfan; Hofman, Albert; Brusselle, Guy G; Stricker, Bruno H

    2014-06-01

    To investigate the prevalence of frailty in a Dutch elderly population and to identify adverse health outcomes associated with the frailty phenotype independent of the comorbidities. Cross-sectional and longitudinal analyses within the Rotterdam Study (the Netherlands), a prospective population-based cohort study in persons aged ≥55 years. Frailty was defined as meeting three or more of five established criteria for frailty, evaluating nutritional status, physical activity, mobility, grip strength and exhaustion. Intermediate frailty was defined as meeting one or two frailty criteria. Comorbidities were objectively measured. Health outcomes were assessed by means of questionnaires, physical examinations and continuous follow-up through general practitioners and municipal health authorities for mortality. Of 2,833 participants (median age 74.0 years, inter quartile range 9) with sufficiently evaluated frailty criteria, 163 (5.8 %) participants were frail and 1,454 (51.3 %) intermediate frail. Frail elderly were more likely to be older and female, to have an impaired quality of life and to have fallen or to have been hospitalized. 108 (72.0 %) frail participants had ≥2 comorbidities, compared to 777 (54.4 %) intermediate frail and 522 (44.8 %) non-frail participants. Adjusted for age, sex and comorbidities, frail elderly had a significantly increased risk of dying within 3 years (HR 3.4; 95 % CI 1.9-6.4), compared to the non-frail elderly. This study in a general Dutch population of community-dwelling elderly able to perform the frailty tests, demonstrates that frailty is common and that frail elderly are at increased risk of death independent of comorbidities. PMID:24935872

  10. Effectiveness of cognitive training for Chinese elderly in Hong Kong

    PubMed Central

    Kwok, Timothy; Wong, Anita; Chan, Grace; Shiu, YY; Lam, Ko-Chuen; Young, Daniel; Ho, Daniel WH; Ho, Florence

    2013-01-01

    In Hong Kong, the evidence for cognitive-training programs in fighting against memory complaints is lacking. This study aimed to evaluate the effectiveness of the Active Mind cognitive-training program in improving the cognitive function and quality of life (QoL) for local community-dwelling Chinese older adults. A total of 200 subjects were recruited from 20 different district elderly community centers (DECCs). Centers were randomly assigned into either the intervention group or control group. The intervention group underwent eight 1-hour sessions of cognitive training, while the control group were included in the usual group activities provided by the DECCs. Standardized neuropsychological tests (the Chinese version of Mattis Dementia Rating Scale [CDRS] and the Cantonese version of the Mini-Mental State Examination) and the QoL questionnaire SF12 were used to assess participants’ cognitive function and QoL before and after the trial. A total of 176 subjects completed the study. The intervention group showed greater improvement in the cognitive function measured by total CDRS score (treatment: 12.24 ± 11.57 vs control: 4.37 ± 7.99; P < 0.001) and QoL measured by total SF12 score (treatment: 7.82 ± 13.19 vs control: 3.18 ± 11.61; P = 0.014). Subjects with lower education level were associated with better cognitive response to the cognitive-training program. The current findings indicated that the Active Mind cognitive-training program was effective in improving the cognitive function and QoL for community-dwelling Chinese older adults in Hong Kong. PMID:23440076

  11. Conflicting views on elder care responsibility in Japan.

    PubMed

    Lee, Kristen Schultz

    2016-05-01

    I examine the attitudinal ambivalence created by conflicting social expectations regarding parent-child devotion, filial obligation and family membership, and gender norms in a national population of Japanese adults. I ask: in a context of rapidly changing family and elder care norms, how do different beliefs and attitudes overlap and conflict and how are they related to elder care preferences? I analyze data from the 2006 Japanese General Social Survey and use Latent Class Analysis to identify latent groups in the population defined by their beliefs and examine the relationship between class membership and elder care preferences. I found variation in the population with respect to the measured beliefs as well as a relationship between patterns of beliefs and choice of elder caregiver. I found conflicting expectations regarding elder care responsibility in one latent class and this class also expressed elder care preferences that conflict with at least some of their strongly held beliefs.

  12. Japanese Characters in Written Japanese.

    ERIC Educational Resources Information Center

    Buck, James H.

    From the sixth to the eighth century A.D., Japan was the recipient of massive cultural infusions from China. This acceptance of the Chinese pattern included, and to a great extent was based on, the acceptance of the Chinese language. The Chinese writing system was applied to Japanese because there was no other model to follow and in spite of the…

  13. Longitudinal association of dentition status with dietary intake in Japanese adults aged 75 to 80 years.

    PubMed

    Iwasaki, M; Yoshihara, A; Ogawa, H; Sato, M; Muramatsu, K; Watanabe, R; Ansai, T; Miyazaki, H

    2016-10-01

    Limited information is available on the temporal association between dentition status and dietary intake. The aim of this 5-year prospective cohort study was to investigate whether impaired dentition was associated with subsequent decline in dietary intake in older Japanese adults. Two hundred and eighty-six community-dwelling Japanese individuals, all aged 75 years at baseline, were included in the study. Functional tooth units (FTUs), defined as a pair of opposing natural or prosthetic teeth excluding third molars (range: 0-14), were counted on the basis of baseline dental examinations. Individuals with ≤5 FTUs were defined as having impaired dentition. Dietary intake was assessed at baseline and 5 years later, using a validated dietary questionnaire. Robust regression analyses were used to evaluate the differences in change in dietary intake between participants with and without impaired functional dentition, after adjustment for potential confounders. Sixty-one study participants (21·3 %) were defined as having impaired dentition. Overall, mean values for all estimated dietary variables (energy, nutrients and food groups) declined over time. Notably, individuals with impaired dentition demonstrated a significantly (P < 0·05) greater degree of decline in the intake of multiple nutrients (protein, sodium, potassium, calcium, vitamin A, vitamin E and dietary fibre) and food groups (vegetable and meat) than those without impaired dentition, after adjusting for potential confounders. The results of this study describe the temporal association of impaired dentition with the decline in selected nutrient and food group intake among older Japanese adults.

  14. Longitudinal association of dentition status with dietary intake in Japanese adults aged 75 to 80 years.

    PubMed

    Iwasaki, M; Yoshihara, A; Ogawa, H; Sato, M; Muramatsu, K; Watanabe, R; Ansai, T; Miyazaki, H

    2016-10-01

    Limited information is available on the temporal association between dentition status and dietary intake. The aim of this 5-year prospective cohort study was to investigate whether impaired dentition was associated with subsequent decline in dietary intake in older Japanese adults. Two hundred and eighty-six community-dwelling Japanese individuals, all aged 75 years at baseline, were included in the study. Functional tooth units (FTUs), defined as a pair of opposing natural or prosthetic teeth excluding third molars (range: 0-14), were counted on the basis of baseline dental examinations. Individuals with ≤5 FTUs were defined as having impaired dentition. Dietary intake was assessed at baseline and 5 years later, using a validated dietary questionnaire. Robust regression analyses were used to evaluate the differences in change in dietary intake between participants with and without impaired functional dentition, after adjustment for potential confounders. Sixty-one study participants (21·3 %) were defined as having impaired dentition. Overall, mean values for all estimated dietary variables (energy, nutrients and food groups) declined over time. Notably, individuals with impaired dentition demonstrated a significantly (P < 0·05) greater degree of decline in the intake of multiple nutrients (protein, sodium, potassium, calcium, vitamin A, vitamin E and dietary fibre) and food groups (vegetable and meat) than those without impaired dentition, after adjusting for potential confounders. The results of this study describe the temporal association of impaired dentition with the decline in selected nutrient and food group intake among older Japanese adults. PMID:27545519

  15. Oral health status of older adults in Arizona: results from the Arizona Elder Study.

    PubMed

    Berg, R; Berkey, D B; Tang, J M; Baine, C; Altman, D S

    2000-01-01

    This study was undertaken to compare oral health status of independent community-dwelling elders with those using long-term-care services. Clinical examinations and self-reported sociodemographic data were collected for 2927 older adults living independently, using home-care services, or living in nursing facilities. Mean age of dentate participants (n = 2021) was 72.2 years (range, 50-103 years); mean number of teeth, 18.16; mean DFS, 28.86; and mean RCI, 15.23. In multivariate analyses, receiving home-care services or living in a nursing facility was significantly predictive of poorer oral health status with respect to both coronal and root caries. This was also true for ethnic groups other than non-Hispanic-white. We concluded that, in a large, multi-ethnic sample, direct comparisons highlight significant unmet treatment need among users of long-term-care services, compared with independent older adults living in the same communities.

  16. Beyond single indicators of social networks: a LISREL analysis of social ties among the elderly.

    PubMed

    Glass, T A; Mendes de Leon, C F; Seeman, T E; Berkman, L F

    1997-05-01

    While the health promoting influences of social networks have been shown in a number of studies, little attention has been paid to measurement issues within the field of epidemiology. The purpose of this paper is to propose a new set of measures of social networks for use in epidemiological research on the elderly. We use confirmatory factor analysis to test a multidimensional model of social networks using data from a large epidemiologic study of community-dwelling adults age 65 and over (U.S.A.). Confirmatory factor analysis conducted using LISREL showed that our model provides a good fit to the data after several adjustments for correlated measurement error were introduced. Based on this analysis, we developed new measures of four dimensions and a summary index of social networks. Bivariate relationships between our new measures and several sociodemographic variables of interest are also presented.

  17. Mayo's Older African Americans Normative Studies: WMS-R norms for African American elders.

    PubMed

    Lucas, John A; Ivnik, Robert J; Smith, Glenn E; Ferman, Tanis J; Willis, Floyd B; Petersen, Ronald C; Graff-Radford, Neill R

    2005-06-01

    Norms for African American elders on the Wechsler Memory Scale-Revised (WMS-R) were derived from a sample of 309 community-dwelling individuals participating in Mayo's Older African Americans Normative Studies (MOAANS). Normative estimates are provided for traditional WMS-R subtest scores and for supplemental procedures to evaluate forgetting rates and recognition memory. Tables are provided to convert raw WMS-R subtest and supplemental scores to age-corrected scaled scores. These may be further adjusted for years of education, if desired, by applying regression-based corrections. We anticipate that these data will enhance the diagnostic utility and clinical interpretation of WMS-R performance in older African Americans.

  18. Rethinking Japanese Language Pedagogy.

    ERIC Educational Resources Information Center

    Larson, Phyllis

    2003-01-01

    Discusses the work of Seiichi Makino, a scholar of Japanese, noting that his work in establishing the Japanese proficiency guidelines helped make it appear that Japanese language teaching was part of mainstream American language teaching. (Author/VWL)

  19. Frail Elders in an Urban District Setting in Malaysia: Multidimensional Frailty and Its Correlates.

    PubMed

    Sathasivam, Jeyanthini; Kamaruzzaman, Shahrul Bahyah; Hairi, Farizah; Ng, Chiu Wan; Chinna, Karuthan

    2015-11-01

    In the past decade, the population in Malaysia has been rapidly ageing. This poses new challenges and issues that threaten the ability of the elderly to independently age in place. A multistage cross-sectional study on 789 community-dwelling elderly individuals aged 60 years and above was conducted in an urban district in Malaysia to assess the geriatric syndrome of frailty. Using a multidimensional frailty index, we detected 67.7% prefrail and 5.7% frail elders. Cognitive status was a significant correlate for frailty status among the respondents as well as those who perceived their health status as very poor or quite poor; but self-rated health was no longer significant when controlled for sociodemographic variables. Lower-body weakness and history of falls were associated with increasing frailty levels, and this association persisted in the multivariate model. This study offers support that physical disability, falls, and cognition are important determinants for frailty. This initial work on frailty among urban elders in Malaysia provides important correlations and identifies potential risk factors that can form the basis of information for targeted preventive measures for this vulnerable group in their prefrail state.

  20. Systematic review of the association of mastication with food and nutrient intake in the independent elderly.

    PubMed

    Tada, Akio; Miura, Hiroko

    2014-01-01

    Substantial number of elderly people suffer from poor mastication, which is considered to have a detrimental effect on their dietary habits. However, the association between mastication and diet is far from conclusive. The objective of this systematic review was to assess the association of mastication with food and nutrient intake in the community dwelling elderly. We searched the PubMed, Web of Science, Cochrane Library, and Scirus databases to obtain information on the epidemiological studies in this research area. The included publications were analyzed for study design, main conclusions, and strength of evidence. A comprehensive quality assessment of all the included studies (28 cross-sectional and 7 intervention studies) was performed. In 22 of the 28 cross-sectional studies, elderly persons with better mastication and dentition reported significantly higher consumption of foods and intake of some nutrients than those with poorer oral health; however, the remaining studies showed no such differences. Five of the 7 intervention studies with an intervention involving the provision of new prostheses did not show significant improvement in food and/or nutrient intake. These discrepant findings suggest that masticatory ability explains only part of the variance in food and nutrient intake of the elderly. Two intervention studies with the combination of prosthetic treatment and dietary intervention produced changes in intake of foods such as fruits and vegetables.

  1. Health coaching and pedometers to enhance physical activity and prevent falls in community-dwelling people aged 60 years and over: study protocol for the Coaching for Healthy AGEing (CHAnGE) cluster randomised controlled trial

    PubMed Central

    Tiedemann, Anne; Rissel, Chris; Howard, Kirsten; Tong, Allison; Merom, Dafna; Smith, Stuart; Wickham, James; Bauman, Adrian; Lord, Stephen R; Vogler, Constance; Lindley, Richard I; Simpson, Judy M; Allman-Farinelli, Margaret; Sherrington, Catherine

    2016-01-01

    Introduction Prevention of falls and promotion of physical activity are essential for maximising well-being in older age. However, there is evidence that promoting physical activity among older people without providing fall prevention advice may increase fall rates. This trial aims to establish the impact of a physical activity and fall prevention programme compared with a healthy eating programme on physical activity and falls among people aged 60+ years. Methods and analysis This cluster randomised controlled trial will involve 60 groups of community-dwelling people aged 60+ years. Participating groups will be randomised to: (1) a physical activity and fall prevention intervention (30 groups), involving written information, fall risk assessment and prevention advice, a pedometer-based physical activity tracker and telephone-based health coaching; or (2) a healthy eating intervention (30 groups) involving written information and telephone-based dietary coaching. Primary outcomes will be objectively measured physical activity at 12 months post-randomisation and self-reported falls throughout the 12-month trial period. Secondary outcomes include: the proportion of fallers, the proportion of people meeting the Australian physical activity guidelines, body mass index, eating habits, mobility goal attainment, mobility-related confidence, quality of life, fear of falling, risk-taking behaviour, mood, well-being, self-reported physical activity, disability, and health and community service use. The between-group difference in the number of falls per person-year will be analysed using negative binomial regression models. For the continuously scored primary and secondary outcome measures, linear regression adjusted for corresponding baseline scores will assess the effect of group allocation. Analyses will be preplanned, conducted while masked to group allocation, will take into account cluster randomisation, and will use an intention-to-treat approach. Ethics and

  2. The Multidomain Intervention to preveNt disability in ElDers (MINDED) project: rationale and study design of a pilot study.

    PubMed

    Cesari, Matteo; Demougeot, Laurent; Boccalon, Henri; Guyonnet, Sophie; Vellas, Bruno; Andrieu, Sandrine

    2014-05-01

    Disability is hardly reversible at old age, negatively impacts on the elders' quality of life, and significantly threatens the sustainability of public health services. Therefore, preventive interventions become necessary for successfully avoiding its onset. The translation of the successful clinical approach represented by the geriatric comprehensive assessment at the community-level and the specific targeting of frailty (a well-established geriatric syndrome) might represent a promising possibility. This approach may allow the implementation of preventive interventions before the irreversible features of disability onset. Unfortunately, there is a lack of evidence on the effectiveness of primary prevention programs against disability in community-dwelling elders. Moreover, the novelty of the topic makes it difficult for the immediate design and conduction of a full-scale trial. For these reasons, a pilot project aimed at obtaining the preliminary information for the design of a subsequent definitive trial is required. In the present article, we describe the objectives, design, and methods of the Multidomain Intervention to preveNt Disability in ElDers (MINDED) project. MINDED is articulated into three sequential phases. First, a screening tool for indentifying non-disabled frail older persons in the community (ideal target population for preventive interventions against disability) will be validated. Then, the organization of a multidisciplinary team in the development and design of a multidomain preventive plan against disability will be verified/optimized. Finally, a randomized controlled trial measuring the effect size of a multicomponent intervention (based on physical exercise, nutrition, and cognitive training) against incident mobility disability versus usual care in community-dwelling frail elders will be conducted.

  3. Image Making and Personal Narratives with Japanese-American Survivors of World War II Internment Camps

    ERIC Educational Resources Information Center

    Yates, Carleen; Kuwada, Kali; Potter, Penelope; Cameron, Danielle; Hoshino, Janice

    2007-01-01

    This qualitative study explored the verbal and art making responses of Japanese-American elders who experienced the trauma of internment during World War II. Six Nisei (second generation Japanese-Americans) were asked to recall memories of their experiences during and immediately following internment; 3 of the participants also created art images…

  4. Japanese encephalitis.

    PubMed

    Morita, K; Nabeshima, T; Buerano, C C

    2015-08-01

    Japanese encephalitis (JE) is an inflammation of the central nervous system in humans and animals, specifically horses and cattle. The disease, which can sometimes be fatal, is caused by the flavivirus Japanese encephalitis virus (JEV), of which there are five genotypes (genotypes 1, 2, 3, 4 and 5). The transmission cycle of the virus involves pigs and wild birds as virus amplifiers and mosquitoes as vectors for transferring the virus between amplifying hosts and to dead- end hosts, i.e. humans, horses and cattle. In horses and cattle the disease is usually asymptomatic, but when clinical signs do occur they include fever, decreased appetite, frothing at the mouth, rigidity of the legs and recumbency, and neurological signs, such as convulsive fits, circling, marked depression and disordered consciousness. In pigs, it can cause abortion and stillbirths. At present, the virus is detected in a wide area covering eastern and southern Asia, Indonesia, northern Australia, Papua New Guinea and Pakistan. JEV RNA has also been detected in Italy, first in dead birds in 1997 and 2000 and then in mosquitoes in 2010. Genotype shift, i.e. a change of genotype from genotype 3 to genotype 1, has occurred in some countries, namely Japan, South Korea, Chinese Taipei and Vietnam. Laboratory methods are available for confirming the causative agent of the disease. There are control measures to prevent or minimise infection and, among them, vaccination is one of the most important and one which should be adopted in endemic and epidemic areas. PMID:26601447

  5. Japanese encephalitis

    PubMed Central

    Yun, Sang-Im; Lee, Young-Min

    2014-01-01

    Japanese encephalitis (JE) is an infectious disease of the central nervous system caused by Japanese encephalitis virus (JEV), a zoonotic mosquito-borne flavivirus. JEV is prevalent in much of Asia and the Western Pacific, with over 4 billion people living at risk of infection. In the absence of antiviral intervention, vaccination is the only strategy to develop long-term sustainable protection against JEV infection. Over the past half-century, a mouse brain-derived inactivated vaccine has been used internationally for active immunization. To date, however, JEV is still a clinically important, emerging, and re-emerging human pathogen of global significance. In recent years, production of the mouse brain-derived vaccine has been discontinued, but 3 new cell culture-derived vaccines are available in various parts of the world. Here we review current aspects of JEV biology, summarize the 4 types of JEV vaccine, and discuss the potential of an infectious JEV cDNA technology for future vaccine development. PMID:24161909

  6. The Influence of Sekentei on Family Caregiving and Underutilization of Social Services among Japanese Caregivers

    ERIC Educational Resources Information Center

    Asai, Masayuki O.; Kameoka, Velma A.

    2005-01-01

    The Asian family is regarded as a close-knit social unit in which elderly people are believed to occupy a highly respected position. Family members are thought to provide care for elderly parents gratefully because of filial piety. This stereotypic portrayal of Asian families, however, may not apply fully to Japanese families. This article points…

  7. Mediational effect of meaning in life on the relationship between optimism and well-being in community elderly.

    PubMed

    Ju, Haewon; Shin, Jong Wook; Kim, Chan-won; Hyun, Myoung-ho; Park, Jin-woo

    2013-01-01

    The purpose of the present study was to examine the mediational role of meaning in life on the relationship between optimism and subjective well-being in older adults. Two hundred and fifty community-dwelling subjects completed several instruments assessing the above constructs. Results from structural equation modeling indicated that optimism was positively associated with both meaning in life and subjective well-being. Furthermore, the relationship between optimism and wellbeing was partially mediated by meaning in life. Although numerous studies have found that optimism is a significant predictor of well-being, the current results indicate that it might not be a key predictor in elders. Our findings suggest that a focus on meaning in life may be a productive avenue to enhance subjective well-being in later life although stable internal resources such as optimism and pessimism impact their subjective well-being.

  8. Perceived neighborhood safety and incident mobility disability among elders: the hazards of poverty

    PubMed Central

    Clark, Cheryl R; Kawachi, Ichiro; Ryan, Louise; Ertel, Karen; Fay, Martha E; Berkman, Lisa F

    2009-01-01

    Background We investigated whether lack of perceived neighborhood safety due to crime, or living in high crime neighborhoods was associated with incident mobility disability in elderly populations. We hypothesized that low-income elders and elders at retirement age (65 – 74) would be at greatest risk of mobility disability onset in the face of perceived or measured crime-related safety hazards. Methods We conducted the study in the New Haven Established Populations for Epidemiologic Studies of the Elderly (EPESE), a longitudinal cohort study of community-dwelling elders aged 65 and older who were residents of New Haven, Connecticut in 1982. Elders were interviewed beginning in 1982 to assess mobility (ability to climb stairs and walk a half mile), perceptions of their neighborhood safety due to crime, annual household income, lifestyle characteristics (smoking, alcohol use, physical activity), and the presence of chronic co-morbid conditions. Additionally, we collected baseline data on neighborhood crime events from the New Haven Register newspaper in 1982 to measure local area crime rates at the census tract level. Results At baseline in 1982, 1,884 elders were without mobility disability. After 8 years of follow-up, perceiving safety hazards was associated with increased risk of mobility disability among elders at retirement age whose incomes were below the federal poverty line (HR 1.56, 95% CI 1.02 – 2.37). No effect of perceived safety hazards was found among elders at retirement age whose incomes were above the poverty line. No effect of living in neighborhoods with high crime rates (measured by newspaper reports) was found in any sub-group. Conclusion Perceiving a safety hazard due to neighborhood crime was associated with increased risk of incident mobility disability among impoverished elders near retirement age. Consistent with prior literature, retirement age appears to be a vulnerable period with respect to the effect of neighborhood conditions on

  9. Handgrip explosive force is correlated with mobility in the elderly women.

    PubMed

    Borges, Lucio Santos; Fernandes, Marcos Henrique; Schettino, Ludmila; DA Silva Coqueiro, Raildo; Pereira, Rafael

    2015-01-01

    The analysis of explosive force, through rate of force development (RFD) and contractile impulse (CI), from handgrip strength data seems to be useful and promising information to study the aging of musculoskeletal system and health status. We aimed to test the hypothesis that, in elderly women, the handgrip explosive force could be better associated to the functional mobility than maximum handgrip strength. Handgrip strength and the performance of Timed Up & Go Test (TUG) were measured from sixty-five community-dwelling healthy elderly women. The average slope of the moment-time curve (Δ moment/Δ time) over the time interval of 0-200 ms relative to the onset of contraction was calculated to provide the RFD and CI. The highest strength achieved during the isometric contraction was used as maximum handgrip strength. Pearson correlations were used to assess the strength of the relationship between the handgrip strength parameters (Maximum strength and explosive force from 0-200 ms) and TUG test performance from older women. The correlation analysis showed that the TUG test performance was inversely correlated to the handgrip strength parameters, with better relationship with explosive force parameters. The handgrip explosive force seems to be a promising predictor of functional mobility of elderly women, since it showed a better relationship with functional mobility than maximum handgrip strength.

  10. Does arm swing emphasized deliberately increase the trunk stability during walking in the elderly adults?

    PubMed

    Nakakubo, Sho; Doi, Takehiko; Sawa, Ryuichi; Misu, Shogo; Tsutsumimoto, Kota; Ono, Rei

    2014-09-01

    The purpose of this study was to determine whether trunk stability while walking changes when arm swing is deliberately altered in elderly individuals. Participants included 21 community-dwelling elderly individuals (7 men and 14 women; age, 81.8 ± 5.0 years). We measured trunk acceleration by using a wireless miniature sensor unit containing a tri-axial linear accelerometer under 3 walking conditions: normal walking (normal condition), deliberately walking without any arm swing (no swing condition), and walking with a deliberately emphasized arm swing (over swing condition). To evaluate trunk stability during walking, we calculated harmonic ratios (HRs) based on trunk tri-axial acceleration signals (anteroposterior: AP, vertical: VT, and mediolateral: ML). HR-AP and HR-VT were not significantly different across the 3 conditions, but HR-ML in the over swing condition was significantly higher than that in the other 2 conditions by generalized estimating equations (GEE) adjusted for walking speed (p<0.05). These findings indicate that trunk stability in the ML direction increased when the elderly individuals walked with a deliberately emphasized arm swing.

  11. Loneliness among very old Mexican Americans: findings from the Hispanic Established Populations Epidemiologic Studies of the Elderly.

    PubMed

    Gerst-Emerson, Kerstin; Shovali, Tamar E; Markides, Kyriakos S

    2014-01-01

    Increasing numbers of researchers are finding that loneliness is a significant risk factor for morbidity and mortality, and several variables have been found to be closely related to the experience of loneliness among elders. However, much of the research has focused on the general older population, with no research to date focusing on minority populations. The objective of this study was to determine the prevalence and the correlates of loneliness among a community-dwelling older Mexican American population. This study used a three-item loneliness scale to determine the prevalence of loneliness. Pearson's correlation and linear regression analyses were used to determine the cross-sectional association between sociodemographic, interpersonal relationship and health variables with the scale. Data used came from the most recent wave (2011) of the Hispanic Established Populations for the Epidemiological Study of the Elderly (H-EPESE). A total of 873 Mexican Americans completed the loneliness scale. The age range was from 80 to 102, with a majority (65%) female. The mean score on the scale was 4.05 (range 3-9), indicating relatively low levels of loneliness. Regression results indicate that depressive symptoms, cognitive status, and living alone were significantly associated with higher loneliness scores. Being married and having a confidante were significantly associated with lower loneliness. Age, number of close relatives and frequency of contact were not associated with loneliness. Findings suggest that among community-dwelling Mexican American older adults, loneliness has multiple determinants. Loneliness is a significant public health topic and clinicians should be aware of the various factors that can affect loneliness.

  12. Serum Creatinine and Functional Limitation in Elderly Persons

    PubMed Central

    Shlipak, Michael G.; Tager, Ira B.

    2009-01-01

    Background Creatinine is a commonly used measure of kidney function, but serum levels are also influenced by muscle mass. We hypothesized that higher serum creatinine would be associated with self-reported functional limitation in community-dwelling elderly. Methods Subjects (n = 1,553) were participants in the Study of Physical Performance and Age-Related Changes in Sonomans, a cohort to study aging and physical function. We explored three strategies to account for the effects of muscle mass on serum creatinine. Results We observed a J-shaped association of creatinine with functional limitation. Above the study-specific mean creatinine (0.97 mg/dL in women and 1.15 mg/dL in men), the unadjusted odds ratio of functional limitation per standard deviation (0.20 mg/dL in women and 0.23 mg/dL in men) higher creatinine was 2.27 (95% confidence interval [CI] 1.75–2.94, p < .001) in women and 1.42 (95% CI 1.12–1.80, p = .003) in men. This association was inverted in persons with creatinine levels below the mean. Adjustment for muscle mass did not have an important effect on the association between creatinine and functional limitation. These associations remained after multivariable adjustment for demographics and health conditions but were statistically significant only in women. Conclusions In elderly adults, higher creatinine levels are associated with functional limitation, consistent with prior literature that has demonstrated reduced physical performance in persons with kidney disease. However, the association of low creatinine levels with functional limitation suggests that creatinine levels are influenced by factors other than kidney function and muscle mass in the elderly. PMID:19181716

  13. Linear variability of gait according to socioeconomic status in elderly

    PubMed Central

    2016-01-01

    Aim: To evaluate the linear variability of comfortable gait according to socioeconomic status in community-dwelling elderly. Method: For this cross-sectional observational study 63 self- functioning elderly were categorized according to the socioeconomic level on medium-low (n= 33, age 69.0 ± 5.0 years) and medium-high (n= 30, age 71.0 ± 6.0 years). Each participant was asked to perform comfortable gait speed for 3 min on an 40 meters elliptical circuit, recording in video five strides which were transformed into frames, determining the minimum foot clearance, maximum foot clearance and stride length. The intra-group linear variability was calculated by the coefficient of variation in percent. Results: The trajectory parameters variability is not different according to socioeconomic status with a 30% (range= 15-55%) for the minimum foot clearance and 6% (range= 3-8%) in maximum foot clearance. Meanwhile, the stride length consistently was more variable in the medium-low socioeconomic status for the overall sample (p= 0.004), female (p= 0.041) and male gender (p= 0.007), with values near 4% ​​(range = 2.5-5.0%) in the medium-low and 2% (range = 1.5-3.5%) in the medium-high. Conclusions: The intra-group linear variability is consistently higher and within reference parameters for stride length during comfortable gait for elderly belonging to medium-low socioeconomic status. This might be indicative of greater complexity and consequent motor adaptability. PMID:27546931

  14. Confronting Challenges in Intervention Research with Ethnically Diverse Older Adults: The USC Well Elderly II Trial

    PubMed Central

    Jackson, Jeanne; Mandel, Deborah; Blanchard, Jeanine; Carlson, Mike; Cherry, Barbara; Azen, Stanley; Chou, Chih-Ping; Jordan-Marsh, Maryalice; Forman, Todd; White, Brett; Granger, Douglas; Knight, Bob; Clark, Florence

    2011-01-01

    Background Community-dwelling older adults are at risk for declines in physical health, cognition, and psychosocial well-being. However, their enactment of active and health-promoting lifestyles can reduce such declines. Purpose The purpose of this article is to describe the USC Well Elderly II study, a randomized clinical trial designed to test the effectiveness of a healthy lifestyle program for elders, and document how various methodological challenges were addressed during the course of the trial. Methods In the study, 460 ethnically diverse elders recruited from a variety of sites in the urban Los Angeles area were enrolled in a randomized experiment involving a crossover design component. Within either the first or second six month phase of their study involvement, each elder received a lifestyle intervention designed to improve a variety of aging outcomes. At 4–5 time points over an 18–24 month interval, the research participants were assessed on measures of healthy activity, coping, social support, perceived control, stress-related biomarkers, perceived physical health, psychosocial well-being, and cognitive functioning to test the effectiveness of the intervention and document the process mechanisms responsible for its effects. Results The study protocol was successfully implemented, including the enrollment of study sites, the recruitment of 460 older adults, administration of the intervention, adherence to the plan for assessment, and establishment of a large computerized data base. Limitations Methodological challenges were encountered in the areas of site recruitment, participant recruitment, testing, and intervention delivery. Conclusions The completion of clinical trials involving elders from numerous local sites requires careful oversight and anticipation of threats to the study design that stem from: (a) social situations that are particular to specific study sites; and (b) physical, functional, and social challenges pertaining to the elder

  15. The heterogeneous health latent classes of elderly people and their socio-demographic characteristics in Taiwan.

    PubMed

    Liu, Li-Fan; Tian, Wei-Hua; Yao, Hui-Ping

    2014-01-01

    The health care needs of elderly people were influenced by their heterogeneity. This study aimed to identify the health latent classes of elderly people by using latent class analysis to deal with heterogeneity and examine their socio-demographic characteristics. Data came from the 2005 National Health Interview Survey (NHIS) in Taiwan. In total, 2449 elderly individuals with available health indicators were examined in latent class analysis (LCA), and 2217 elderly community-dwellings with complete socio-demographic data were analyzed by multinomial logistic regression. Four health latent classes were identified which included 1066 (43.5%) people in the High Comorbidity (HC), 152 (6.2%) in the Functional Impairment (FI), 252 (10.3%) in the Frail (FR), and 979 (40.0%) in the Relatively Healthy (RH) group. Multinomial logistic regressions revealed socio-demographic characteristics among health classes. The variables associated with an increased likelihood of being in the FR group were age, female, and living with families. They were also correlated to ethnicity and educations. Apart from age and gender, the Functional Impairment group was less likely to be ethnicity of Hakka, more likely to live with others than were the RH group. The HC group tended to be younger, with higher educations, and more likely to live in urban area than the Functional Impairment group. The correlations between health classes and socio-demographic factors were discussed. The health status of elderly people includes a variety of health indicators. A person-centered approach is critical to identify the health heterogeneity of elderly people and manage their care needs by targeting differential aging.

  16. Characteristics of residential areas and transportational walking among frail and non-frail Dutch elderly: does the size of the area matter?

    PubMed Central

    2014-01-01

    Background A residential area supportive for walking may facilitate elderly to live longer independently. However, current evidence on area characteristics potentially important for walking among older persons is mixed. This study hypothesized that the importance of area characteristics for transportational walking depends on the size of the area characteristics measured, and older person’s frailty level. Methods The study population consisted of 408 Dutch community-dwelling persons aged 65 years and older participating in the Elderly And their Neighborhood (ELANE) study in 2011–2012. Characteristics (aesthetics, functional features, safety, and destinations) of areas surrounding participants’ residences ranging from a buffer of 400 meters up to 1600 meters (based on walking path networks) were linked with self-reported transportational walking using linear regression analyses. In addition, interaction effects between frailty level and area characteristics were tested. Results An increase in functional features (e.g. presence of sidewalks and benches) within a 400 meter buffer, in aesthetics (e.g. absence of litter and graffiti) within 800 and 1200 meter buffers, and an increase of one destination per buffer of 400 and 800 meters were associated with more transportational walking, up to 2.89 minutes per two weeks (CI 1.07-7.32; p < 0.05). No differences were found between frail and non-frail elderly. Conclusions Better functional and aesthetic features, and more destinations in the residential area of community-dwelling older persons were associated with more transportational walking. The importance of area characteristics for transportational walking differs by area size, but not by frailty level. Neighbourhood improvements may increase transportational walking among older persons, thereby contributing to living longer independently. PMID:24588848

  17. The influence of novel compliant floors on balance control in elderly women--A biomechanical study.

    PubMed

    Wright, Alexander D; Laing, Andrew C

    2011-07-01

    Novel compliant floors aim to decrease the risk for fall-related injury by providing substantial force attenuation during the impact phase of falls. Certain models of compliant flooring have been shown to have limited influence on postural sway and successful completion of dynamic balance tasks. However, the effects of these products on balance recovery mechanisms following an externally induced perturbation have yet to be quantified. We used a floor translation paradigm to induce a balance perturbation to thirteen elderly community-dwelling women. Outcome measures included the displacement rates and margins of safety for both the underfoot centre-of-pressure and whole-body centre-of-mass across two novel compliant floors (SmartCell, SofTile), two basic foam surfaces (Firm-Foam, Soft-Foam) and a standard 'Rigid' floor as a control condition. The centre-of-mass and centre-of-pressure margins of safety, and all centre-of-mass displacement rates, were not significantly lower for the two novel compliant flooring systems compared to the control floor. The centre-of-pressure displacement rates were similar to the control floor for the SmartCell floor condition. The majority of the margin of safety and displacement rate variables for the foam floors were significantly lower than the control condition. This study illustrates that the SmartCell and SofTile novel compliant floors have minimal influences on balance and balance control responses following externally induced perturbations in older community-dwelling women, and supports pilot installations of these floors to inform decisions regarding the development of clinical trials.

  18. Animal-assisted activity: experiences of institutionalized Japanese older adults.

    PubMed

    Kawamura, Namiko; Niiyama, Masayoshi; Niiyama, Harue

    2009-01-01

    The purpose of this study was to determine how a group of institutionalized elderly Japanese women perceived animal-assisted activity (AAA) and how their perceptions may be relevant to clinical nursing practices in the AAA context. The participants in this study, 8 elderly Japanese women residing in a nursing home in a northern Japanese city, had attended AAA sessions two times per month for 2 years prior to this study's data collection. Semi-structured interviews were conducted, and data were analyzed using phenomenological procedures. Six themes emerged concerning the interactive relationships between the participants and the animals; in addition, participants were able to develop interest in themselves, other residents, and their environment, due to feelings of ease and the development of one-on-one relationships with the AAA dogs. Volunteers from outside the nursing home made residents feel refreshed and gave them opportunities to broaden their contact with society. PMID:19227109

  19. Japanese and Japanese American Youth in Literature.

    ERIC Educational Resources Information Center

    Zitlow, Connie S.; Stover, Lois

    1998-01-01

    Explores the wealth of literature by and about Japan and Japanese Americans. Presents a structure for a history unit focusing on Japanese Americans. Summarizes curricular and literary issues to consider. Presents annotations of 69 works of literature and reference and teaching materials. (RS)

  20. The Japanese Mind: Understanding Contemporary Japanese Culture.

    ERIC Educational Resources Information Center

    Davies, Roger J., Ed.; Ikeno, Osamu, Ed.

    This collection of essays offers an overview of contemporary Japanese culture, and can serve as a resource for classes studying Japan. The 28 essays offer an informative, accessible look at the values, attitudes, behavior patterns, and communication styles of modern Japan from the unique perspective of the Japanese people. Filled with examples…

  1. English Loanwords in Japanese.

    ERIC Educational Resources Information Center

    Kay, Gillian

    1995-01-01

    Examines the historical and cultural contexts of word borrowing from English into Japanese, processes of nativization, and functions served by English loanwords. Notes that linguistic and cultural borrowing is to some extent kept separate from native language and culture, resulting in a Japanese/Western dichotomy in Japanese life and language. (20…

  2. Japanese Radio Exercises. Revised.

    ERIC Educational Resources Information Center

    Young, Jocelyn

    This unit focuses on Japanese radio exercises which became popular in Japan just after World War II and are still used among students and workers in companies to help raise morale and form group unity. The exercises reflect the general role of exercise in Japanese culture--to serve as a symbol of unity and cooperation among the Japanese, as well…

  3. The dementia and disability project in Thai elderly: rational, design, methodology and early results

    PubMed Central

    2013-01-01

    Background A strong inverse relationship of functional limitation and socioeconomic status has been established in western ageing society. Functional limitation can be related to chronic diseases, disuse, cognitive decline, and ageing. Among chronic diseases in the Thai population, cerebrovascular diseases, diabetes, and arthritis are common. These factors are known to contribute to disability and poor quality of life in the elder population. Neuropsychiatric problems, cognitive decline, dementia, and cultural issues in elderly people also can alter the quality of life of the elderly. Methods The Dementia and Disability Project in Thai Elderly (DDP) aims at comprehensively assessing community dwelling Thai elderly to understand the relationship between disability and motor function, neuropsychiatric symptoms, cognitive function, and chronic diseases. The DDP is the first study to look at the prevalence and etiology of dementia and of mild cognitive impairment (MCI) in Thai elders and to explore the relationship of cognition, disability, small vessel diseases and cortical degeneration with neuroimaging in Thai elderly people. 1998 Thai elders were screened in 2004–2006 and diagnosed as having MCI or dementia. 223 elders with MCI or dementia and cognitively normal elderly had brain magnetic resonance imaging (MRI) or at baseline. 319 elders from the 3 groups had blood tests to investigate the risks and possible etiologies of dementia including genotyping at baseline. Results The mean age of elders in this study is 69.51(SD=6.71, min=60, max=95) years. 689(34.9%) are men and 1284(65.1%) are women. Mean body weight was 58.36(SD=11.20) kgs. The regression model reveals that performance on gait and balance and serum triglyceride predicts activity of daily living performance (adjusted r2 = 0.280, f=2.644, p=0.003). The majority of abnormal gait in Thai elders was lower level gait disturbance. Only 1.5% (29/1952) had highest level gait disorders. 39.5% of 1964 subjects

  4. Ethnic elders.

    PubMed Central

    Ebrahim, S.

    1996-01-01

    The numbers of elderly people from ethnic groups within Britain is rising rapidly as postwar immigrants age. Ethnic elders face problems owing to age-associated increased risks of common chronic diseases, racial discrimination, and poor access to many health services and social services. This disadvantage will be alleviated through increased understanding of health beliefs held by ethnic elders and ensuring better access to services through mechanisms such as employment of more staff from ethnic minority groups in senior positions, better training of staff, and more appropriate and sensitive environments. The myths that family care is sufficient, that no use of services implies no need, and that assimilation into the majority population will occur must be discounted. Images p610-a Fig 1 PMID:8806256

  5. Association between sex steroids and cognition in elderly men

    PubMed Central

    LeBlanc, Erin S.; Wang, Patty Y.; Janowsky, Jeri S.; Neiss, Michelle B.; Fink, Howard A.; Yaffe, Kristine; Marshall, Lynn M.; Lapidus, Jodi A.; Stefanick, Marcia L.; Orwoll, Eric S.

    2009-01-01

    SUMMARY Objective Examine the association of cognitive function with sex steroid and sex hormone binding globulin (SHBG) levels among elderly men. Design Prospective cohort study, The Osteoporotic Fractures in Men Study (MrOS), consisting of 5995 US community dwelling men 65 years or older. Patients 1602 men chosen randomly from MrOS cohort for sex steroid level measurements by Mass Spectrometry (MS) at baseline. 2623 MrOS participants with sex steroids measured using RIA were also examined. Measurements Baseline and follow-up (4.5 years later) performance on two cognitive tests: Trails B (executive function and motor speed) and 3MS (global cognitive function). Baseline total testosterone and estradiol were measured by MS. Free testosterone (free-T) and free estradiol (free-E) were calculated. SHBG was measured by radioimmunoassay. Data were analyzed using linear regression. Results Baseline free-T and free-E levels were not associated with cognitive performance or change in cognition, following adjustment for age, education, race, health status and alcohol use. Baseline SHBG levels were inversely associated with follow-up trails B (p=0.03) and 3MS performance (p=0.02). Higher SHBG was associated with an increased risk of cognitive decline. Total sex steroid levels were not associated with cognitive performance. Conclusions Despite large numbers of participants and rigorous sex steroid measurements, we did not observe an association between cognition and either testosterone or estradiol levels. We conclude that endogenous sex steroids in the normal range are not related to executive function or global cognitive function in elderly men. High SHBG deserves further examination as a risk factor for cognitive decline. PMID:19744108

  6. Isolated Elderly.

    ERIC Educational Resources Information Center

    Fischer, Lucy Rose; And Others

    The Minnesota Senior Study, the first statewide survey of the elderly in nearly 20 years, was based on a telephone survey with a statewide sample of 1,500 non-institutionalized Minnesotans age 60 and older. Substantial numbers of Minnesotans age 60-plus were found to have low social contacts. Five percent, or about 33,000 older Minnesotans, fell…

  7. America's Elderly.

    ERIC Educational Resources Information Center

    Soldo, Beth J.; Agree, Emily M.

    1988-01-01

    The older population in the United States grew twice as fast as the rest of the population in the last 20 years. This growth is expected to accelerate early in the next century as the large baby-boom cohorts move through middle age and become elderly. Substantial improvements in life expectancy at all ages, particularly at extreme old age, mean…

  8. Elderly Suicide

    MedlinePlus

    ... for completing suicide among the elderly. Men use firearms more often than women. • Alcohol or substance abuse plays a diminishing role in later life suicides compared to younger suicides. Source: Centers for Disease Control and Prevention. National Vital Statistics System. Mortality Data. ...

  9. Mobility and Balance and Their Correlation with Physiological Factors in Elderly with Different Foot Postures

    PubMed Central

    Mohd Said, Aisyah; Manaf, Haidzir; Bukry, Saiful Adli; Justine, Maria

    2015-01-01

    This study determines (1) the correlation between mobility and balance performances with physiological factors and (2) the relationship between foot postures with anthropometric characteristics and lower limb characteristics among elderly with neutral, pronated, and supinated foot. A cross-sectional observational study was conducted in community-dwelling elderly (age: 69.86 ± 5.62 years). Participants were grouped into neutral (n = 16), pronated (n = 14), and supinated (n = 14) foot based on the foot posture index classification. Anthropometric data (height, weight, and BMI), lower limb strength (5-STS) and endurance (30 s chair rise test), mobility (TUG), and balance (FSST) were determined. Data were analyzed using Spearman's correlation coefficient. Body weight was negatively and moderately correlated (rs = −0.552, P < 0.05) with mobility in supinated foot; moderate-to-high positive linear rank correlation was found between lower limb strength and mobility (rs = 0.551 to 0.804, P < 0.05) for pronated and neutral foot. Lower limb endurance was negatively and linearly correlated with mobility in pronated (rs = −0.699) and neutral (rs = −0.573) foot. No correlation was observed in balance performance with physiological factors in any of the foot postures. We can conclude that muscle function may be the most important feature to make movement possible in older persons regardless of the type of foot postures. PMID:26583104

  10. Clinical Correlates of Hachinski Ischemic Score and Vascular Factors in Cognitive Function of Elderly

    PubMed Central

    Kim, Youn Ho

    2014-01-01

    The aim of this study is to investigate the relationship between Hachinski ischemic score (HIS) and vascular factors as well as between HIS and the cognitive function in elderly community. Demographic characteristics, such as sex, age, education, history of drinking and smoking, family history of dementia and stroke, diabetes mellitus, hypertension, hyperlipidemia, cardiovascular disease, stroke, and dementia, were surveyed. Neurological examination was administered to every subject and HIS was checked by a neurologist. From a total of 392 participants aged 65 and over in a rural community, 348 completed the survey and were finally enrolled. Among the vascular factors, history of hypertension (P = 0.008), history of stroke (P < 0.001), family history of dementia (P = 0.01), and history of cardiac diseases (P = 0.012) showed a significant relationship with HIS. In the cognitive function tests, both Korean version of the Mini-Mental State Examination and the Clinical Dementia Rating (Global and Sum of Boxes) had a significant relationship with HIS. Our study suggested HIS may have an association with some vascular factors and cognitive scales in community dwelling elderly. In this study, the HIS seemed to contribute to the evaluation of the quantity of vascular factors and to the prediction of status of cognitive function. PMID:25247189

  11. The burden of community-acquired pneumonia in the elderly: the Spanish EVAN-65 Study

    PubMed Central

    Ochoa-Gondar, Olga; Vila-Córcoles, Angel; de Diego, Cinta; Arija, Victoria; Maxenchs, Monica; Grive, Montserrat; Martin, Enrique; Pinyol, Josep L

    2008-01-01

    Background Community-acquired pneumonia (CAP) is generally considered a major cause of morbidity and mortality in the elderly. However, population-based data are very limited and its overall burden is unclear. This study assessed incidence and mortality from CAP among Spanish community-dwelling elderly. Methods Prospective cohort study that included 11,240 individuals aged 65 years or older, who were followed from January 2002 until April 2005. Primary endpoints were all-cause CAP (hospitalised and outpatient) and 30-day mortality after the diagnosis. All cases were radiographically proved and validated by checking clinical records. Results Incidence rate of overall CAP was 14 cases per 1,000 person-year (95% confidence interval: 12.7 to 15.3). Incidence increased dramatically by age (9.9 in people 65–74 years vs 29.4 in people 85 years or older), and it was almost double in men than in women (19.3 vs 10.1). Hospitalisation rate was 75.1%, with a mean length-stay of 10.4 days. Overall 30-days case-fatality rate was 13% (15% in hospitalised and 2% in outpatient cases). Conclusion CAP remains as a major health problem in older adults. Incidence rates in this study are comparable with rates described in Northern Europe and America, but they largely doubled prior rates reported in other Southern European regions. PMID:18582392

  12. Cognitive Impairment, Depression, and Cooccurrence of Both among the Elderly in Panama: Differential Associations with Multimorbidity and Functional Limitations

    PubMed Central

    Villarreal, Alcibiades E.; Grajales, Shantal; Lopez, Lineth; Britton, Gabrielle B.; Initiative, Panama Aging Research

    2015-01-01

    Cognitive impairment and depression are common mental health problems among the elderly, although few studies have examined their cooccurrence in older adults in Latin America. The purpose of this study was to examine cognitive impairment, depression, and cooccurrence of the two conditions and associated factors in a sample of older adults in Panama. This study included 304 community-dwelling elderly (≥65 years) individuals. Participants underwent a clinical interview and assessments of cognitive function by the Minimental State Examination and depressive symptoms by the Geriatric Depression Scale. Limitations in basic (BADL) and instrumental (IADL) activities in daily living and the presence of chronic illnesses were recorded. Multinomial regression analysis revealed that cooccurrence of cognitive impairment and depressive symptoms was explained by increasing age (OR: 3.2, 95% CI: 1.20, 8.30), low education (OR: 3.3, 95% CI: 1.33, 8.38), having four or more chronic conditions (OR: 11.5, 95% CI: 2.84, 46.63), and BADL limitations (OR: 5.0, 95% CI: 1.26, 19.68). Less education and limitations in BADL and IADL increased the odds of cognitive impairment alone, while less education and three or more chronic conditions increased the odds of depression alone. These findings underscore the relevance of assessing cognitive impairment in the elderly as part of a long-term approach to managing depression and vice versa. PMID:26798641

  13. Listening to the Voices of Native Hawaiian Elders and ‘Ohana Caregivers: Discussions on Aging, Health, and Care Preferences

    PubMed Central

    Mokuau, Noreen; Ka’opua, Lana S.; Kim, Bum Jung; Higuchi, Paula; Braun, Kathryn L.

    2015-01-01

    Native Hawaiians, the indigenous people of Hawai’i, are affected by varying social and health disparities that result in high prevalence of chronic disease, early onset of disability, and shorter life expectancy compared to other ethnic groups in Hawai’i. Six listening meetings were conducted, involving 41 community-dwelling kūpuna (Native Hawaiian elders) and ‘ohana (family) caregivers to investigate health and care preferences that offer the potential for improving well-being in later life for Native Hawaiian elders. As background, we provide three explanatory perspectives and theories—life course perspective, minority stress theory, and historical trauma—that guided the design of this study and provided the study’s context. A number of overarching themes and subthemes were identified, some of which point to universal concerns with age and caregiving (such as challenges and costs associated with growing old and caregiving) and others that are culturally specific (such as influence of culture and social stressors, including discrimination, on health needs and care preferences). Results give further support to the urgency of affordable, accessible, and acceptable programs and policies that can respond to the growing health and care needs of native elders and family caregivers. PMID:24659060

  14. Acculturation Stress and Depression among Asian Immigrant Elders

    ERIC Educational Resources Information Center

    Mui, Ada C.; Kang, Suk-Young

    2006-01-01

    This study examines the association between acculturation stress and depressive symptoms in a regional probability sample (n = 407) of six groups of Asian immigrant elders (Chinese, Korean, Indian, Filipino, Vietnamese, and Japanese). Findings suggest that about 40 percent of the sample were depressed, indicating higher depression rates than found…

  15. Associations between Depressive State and Impaired Higher-Level Functional Capacity in the Elderly with Long-Term Care Requirements.

    PubMed

    Ogata, Soshiro; Hayashi, Chisato; Sugiura, Keiko; Hayakawa, Kazuo

    2015-01-01

    Depressive state has been reported to be significantly associated with higher-level functional capacity among community-dwelling elderly. However, few studies have investigated the associations among people with long-term care requirements. We aimed to investigate the associations between depressive state and higher-level functional capacity and obtain marginal odds ratios using propensity score analyses in people with long-term care requirements. We conducted a cross-sectional study based on participants aged ≥ 65 years (n = 545) who were community dwelling and used outpatient care services for long-term preventive care. We measured higher-level functional capacity, depressive state, and possible confounders. Then, we estimated the marginal odds ratios (i.e., the change in odds of impaired higher-level functional capacity if all versus no participants were exposed to depressive state) by logistic models using generalized linear models with the inverse probability of treatment weighting (IPTW) for propensity score and design-based standard errors. Depressive state was used as the exposure variable and higher-level functional capacity as the outcome variable. The all absolute standardized differences after the IPTW using the propensity scores were < 10% which indicated negligible differences in the mean or prevalence of the covariates between non-depressive state and depressive state. The marginal odds ratios were estimated by the logistic models with IPTW using the propensity scores. The marginal odds ratios were 2.17 (95%CI: 1.13-4.19) for men and 2.57 (95%CI: 1.26-5.26) for women. Prevention of depressive state may contribute to not only depressive state but also higher-level functional capacity.

  16. Diffusion Tensor Imaging, White Matter lesions, the Corpus Callosum and Gait in the Elderly

    PubMed Central

    Bhadelia, Refeeque A.; Price, Lori Lyn; Tedesco, Kurtis L.; Scott, Tammy; Qiu, Wei Qiao; Patz, Samuel; Folstein, Marshal; Rosenberg, Irwin; Caplan, Louis R.; Bergethon, Peter

    2009-01-01

    Background and Purpose Gait impairment is common in the elderly, especially those with stroke and white matter hyperintensities (WMH) on conventional brain MRI. Diffusion Tensor Imaging (DTI) is more sensitive to white matter damage than conventional MRI. The relationship between DTI measures and gait has not been previously evaluated. Our purpose was to investigate the relationship between the integrity of white matter in the corpus callosum as determined by DTI and quantitative measures of gait in the elderly. Methods One hundred seventy-three participants of a community-dwelling elderly cohort had neurological and neuropsychological examinations and brain MRI. Gait function was measured by Tinetti gait (0-12), balance (0-16) and total (0-28) scores. DTI assessed Fractional Anisotropy in the genu and splenium of the corpus callosum. Conventional MRI was used to evaluate for brain infarcts and WMH volume. Results Participants with abnormal gait had low fractional anisotropy in the genu of the corpus callosum but not the splenium. Multiple regressions analyses showed an independent association between these genu abnormalities and all three Tinetti scores (p <0.001). This association remained significant after adding MRI infarcts and WMH volume to the analysis. Conclusions The independent association between quantitative measures of gait function and DTI findings shows that white matter integrity in the genu of corpus callosum is an important marker of gait in the elderly. DTI analyses of white matter tracts in brain and spinal cord may improve knowledge about the pathophysiology of gait impairment and help target clinical interventions. PMID:19797696

  17. Exergaming for balance training of elderly: state of the art and future developments

    PubMed Central

    2013-01-01

    balance training tools for community dwelling elderly. PMID:24063521

  18. Validity of Short and Long Self-Administered Food Frequency Questionnaires in Ranking Dietary Intake in Middle-Aged and Elderly Japanese in the Japan Public Health Center-Based Prospective Study for the Next Generation (JPHC-NEXT) Protocol Area

    PubMed Central

    Yokoyama, Yuta; Takachi, Ribeka; Ishihara, Junko; Ishii, Yuri; Sasazuki, Shizuka; Sawada, Norie; Shinozawa, Yurie; Tanaka, Junta; Kato, Erika; Kitamura, Kaori; Nakamura, Kazutoshi; Tsugane, Shoichiro

    2016-01-01

    Background Longitudinal epidemiological studies require both the periodic update of intake information via repeated dietary survey and the minimization of subject burden in responding to questionnaires. We developed a 66-item Food Frequency Questionnaire (short-FFQ) for the Japan Public Health Center-based prospective Study for the Next Generation (JPHC-NEXT) follow-up survey using major foods from the FFQ developed for the original JPHC Study. For the JPHC-NEXT baseline survey, we used a larger 172-item FFQ (long-FFQ), which was also derived from the JPHC-FFQ. We compared the validity of ranking individuals by levels of dietary consumption by these FFQs among residents of selected JPHC-NEXT study areas. Methods From 2012 to 2013, 240 men and women aged 40–74 years from five areas in the JPHC-NEXT protocol were asked to respond to the long-FFQ and provide 12-day weighed food records (WFR) as reference; 228 also completed the short-FFQ. Spearman’s correlation coefficients (CCs) between estimates from the FFQs and WFR were calculated and corrected for intra-individual variation of the WFR. Results Median CC values for energy and 53 nutrients for the short-FFQ for men and women were 0.46 and 0.44, respectively. Respective values for the long-FFQ were 0.50 and 0.43. Compared with the long-FFQ, cross-classification into exact plus adjacent quintiles with the short-FFQ ranged from 68% to 91% in men and 58% to 85% in women. Conclusions Similar to the long-FFQ, the short-FFQ provided reasonably valid measures for ranking middle-aged and elderly Japanese for many nutrients and food groups. The short-FFQ can be used in follow-up surveys in prospective cohort studies aimed at updating diet rank information. PMID:27064130

  19. The Japanese American Story.

    ERIC Educational Resources Information Center

    Fukei, Budd

    This book presents a view of the Japanese American experience from the time of their immigration to this country in the 1800s to their acculturation into American society in the 1970s. Topics dealt with include the prejudice and mistrust experienced by the Japanese immigrants in this country, particularly their evacuation and internment in…

  20. Japanese Quality Control Circles.

    ERIC Educational Resources Information Center

    Nishiyama, Kazuo

    In recent years, United States scholars with an interest in international business and organizational communication have begun to notice the success of Japanese "quality control circles." These are small groups, usually composed of seven to ten workers, who are organized at the production levels within most large Japanese factories. A typical…

  1. Japanese Media in English.

    ERIC Educational Resources Information Center

    Tanaka, Sachiko Oda

    1995-01-01

    Describes the use of English in the media in Japan, focusing on the role and history of English-language newspapers, radio, and television programs, as well as the proliferation of English-language films shown in Japanese cinemas. Discusses the implications of English in the Japanese media. (20 references) (MDM)

  2. Japanese Elementary School Education.

    ERIC Educational Resources Information Center

    Stevenson, Harold W.

    1991-01-01

    Discusses the development of Japanese elementary education in the context of three periods of its history. Considers salient characteristics of Japanese elementary schools and teaching procedures; these include curriculum; social and moral education; classroom environment; teachers; afterschool classes; college entrance examinations; the kyoiku…

  3. A long-term, comprehensive exercise program that incorporates a variety of physical activities improved the blood pressure, lipid and glucose metabolism, arterial stiffness, and balance of middle-aged and elderly Japanese.

    PubMed

    Kawasaki, Terukazu; Sullivan, Corbet V; Ozoe, Naomi; Higaki, Hidehiko; Kawasaki, Junya

    2011-09-01

    A 6-month, twice-a-week exercise program emphasizing swimming was conducted for 11 men (57-73 years) and 24 women (51-68 years). The control group comprised 11 male (59-70 years) and 11 female (53-70) volunteers. The exercise program significantly improved the systolic and diastolic blood pressure (SBP/DBP) and lipid and glucose metabolism, with no change in the controls. Brachial-ankle pulse wave velocity (baPWV), as an index of systemic arterial stiffness, was measured during medical examinations before and after each exercise session using a volume-plethysmographic apparatus. SBP and DBP of the extremities were significantly decreased after exercise, but did not change in the controls. Average baPWV decreased significantly in the exercise group, from 1661±50 to 1581±40 cm per sec. No change was seen in the controls. The sway path of the center of balance was analyzed using a force plate. The length of postural sway, the length of postural sway per sec and the area of postural sway were measured with eyes open and eyes closed, and the rectangular area was calculated. The eyes open/eyes closed ratio (Romberg sign) was also calculated. All parameters of body sway were significantly lower after 6 months in the exercise group, with no change in the controls. The Romberg sign did not change for either group. In addition to promoting better health, as shown by the clinical data, this type of exercise program improves balance function, which could help prevent falls of the elderly.

  4. The First Intervention Study in Elder Self-Neglect: A Randomized Clinical Trial to Improve Vitamin D Levels

    NASA Technical Reports Server (NTRS)

    Burnett, Jason; Hochschild, Ann; Smith, Scott M.; Diamond, Pam; Stotts, Angela; Dyer, Carmel

    2011-01-01

    Despite high mortality rates, elder self-neglect is characterized by refusal of medical and social interventions. To date there have been no tested clinical interventions in elders who self-neglect. Previous research from the TEAM Institute has shown significantly low vitamin D levels in this population. This study aimed to determine the feasibility of a clinical intervention. Replacement of vitamin D was chosen because of its ease of administration and favorable safety profile. Methods: A randomized clinical trial using directly observed therapy of vitamin D was conducted using 50 elders, >65 years of age, with Adult Protective Services (APS) validated self-neglect. A staggered intervention with waiting controls was used to maximize statistical power. One-third (n=17) of the group was administered 50,000 IU vitamin D2 (ergocalciferol) monthly and the remainder (n=33) were administered 400 IU monthly. Serum 25-OH vitamin D was assessed at baseline and 5-months. Results: 69% agreed to participate in the study and of those n=40 (80%) remained at 5-months. At baseline, 12% (n=7) were deficient in vitamin D (<30nmol/L) and approximately 38% (n=22) had inadequate vitamin D levels (<50nmol/L). The baseline 25-OH vitamin D level was 59 nmol/L +25 (mean SD), and increased significantly to 72nmol/L +21 nmol/L at 5-months. Conclusion: These data are the first to provide evidence that clinical interventions are feasible in elders who self-neglect. The increase in vitamin D levels confirmed that the study personnel were able to successfully intervene community-dwelling elders with self-neglect. This study sets the precedent for future intervention and prevention studies

  5. Association between Dietary Intake and Bone Mineral Density in Japanese Postmenopausal Women: The Yokogoshi Cohort Study.

    PubMed

    Hirata, Harumi; Kitamura, Kaori; Saito, Toshiko; Kobayashi, Ryosaku; Iwasaki, Masanori; Yoshihara, Akihiro; Watanabe, Yumi; Oshiki, Rieko; Nishiwaki, Tomoko; Nakamura, Kazutoshi

    2016-01-01

    Diet and food intake play an important role in the development of osteoporosis. However, apart from calcium and vitamin D, how nutrients affect bone status is not fully understood. The purpose of this study was to determine cross-sectional and longitudinal associations between dietary intake and bone mineral density (BMD) in Japanese postmenopausal women. This 5-year cohort study included 600 community-dwelling women aged 55-74 years at baseline in 2005. Information on demographics, nutrition, and lifestyle was obtained through interviews, and nutritional and dietary intake was assessed using a validated food frequency questionnaire. BMD measurements were performed by dual energy X-ray absorptiometry. In 2010, 498 women underwent follow-up BMD examinations. Multiple linear regression analysis was performed to determine associations of predictor variables with BMD, adjusting for confounders. In cross-sectional analyses, coffee or black tea consumption was positively associated with lumbar spine (P = 0.004) and total hip (P = 0.003) BMD, and alcohol intake was positively associated with femoral neck (P = 0.005) and total hip (P = 0.001) BMD. In longitudinal analyses, vitamin K (P = 0.028) and natto (fermented soybeans) (P = 0.023) were positively associated with lumbar spine BMD, and meat or meat product consumption was inversely associated with total hip (P = 0.047) BMD. In conclusion, dietary factors other than calcium and vitamin D intake are predictors of bone mass and bone loss in Japanese postmenopausal women. In particular, natto intake is recommended for preventing postmenopausal bone loss on the basis of current evidence.

  6. The Association between Sarcopenic Obesity and Depressive Symptoms in Older Japanese Adults

    PubMed Central

    Chang, Chang; Tanaka, Tomoki; Kuroda, Aki; Tsuji, Tetsuo; Akishita, Masahiro; Iijima, Katsuya

    2016-01-01

    The effects of sarcopenic obesity, the co-existence of sarcopenia and obesity, on mood disorders have not been studies extensively. Our objective was to examine the association of depressive symptoms with sarcopenia and obesity status in older Japanese adults. We analyzed data from 1731 functionally-independent, community-dwelling Japanese adults aged 65 years or older (875 men, 856 women) randomly selected from the resident register of Kashiwa city, Chiba, Japan in 2012. Sarcopenia was defined based on appendicular skeletal muscle mass, grip strength and usual gait speed. Obesity was defined as the highest sex-specific quintile of the percentage body fat. Depressive symptoms were defined as a Geriatric Depression Scale 15-item score ≥ 6. Multiple logistic regression was employed to examine the association of depressive symptoms with four groups defined by the presence/absence of sarcopenia and obesity. The prevalence of depressive symptoms was 10.1% and the proportions of sarcopenia/obesity, sarcopenia/non-obesity, non-sarcopenia/obesity, non-sarcopenia/non-obesity were 3.7%, 13.6%, 16.9% and 65.8%, respectively. After adjustment for potential confounders, sarcopenia/obesity was positively associated with depressive symptoms compared with non-sarcopenia/non-obesity, whereas either sarcopenia or obesity alone was not associated with depressive symptoms. The association was particularly pronounced in those aged 65 to 74 years in age-stratified analysis. We conclude that our findings suggest a synergistic impact exerted by sarcopenic obesity on the risk of depressive symptoms, particularly in those aged 65 to 74 years. PMID:27627756

  7. Association between Dietary Intake and Bone Mineral Density in Japanese Postmenopausal Women: The Yokogoshi Cohort Study.

    PubMed

    Hirata, Harumi; Kitamura, Kaori; Saito, Toshiko; Kobayashi, Ryosaku; Iwasaki, Masanori; Yoshihara, Akihiro; Watanabe, Yumi; Oshiki, Rieko; Nishiwaki, Tomoko; Nakamura, Kazutoshi

    2016-01-01

    Diet and food intake play an important role in the development of osteoporosis. However, apart from calcium and vitamin D, how nutrients affect bone status is not fully understood. The purpose of this study was to determine cross-sectional and longitudinal associations between dietary intake and bone mineral density (BMD) in Japanese postmenopausal women. This 5-year cohort study included 600 community-dwelling women aged 55-74 years at baseline in 2005. Information on demographics, nutrition, and lifestyle was obtained through interviews, and nutritional and dietary intake was assessed using a validated food frequency questionnaire. BMD measurements were performed by dual energy X-ray absorptiometry. In 2010, 498 women underwent follow-up BMD examinations. Multiple linear regression analysis was performed to determine associations of predictor variables with BMD, adjusting for confounders. In cross-sectional analyses, coffee or black tea consumption was positively associated with lumbar spine (P = 0.004) and total hip (P = 0.003) BMD, and alcohol intake was positively associated with femoral neck (P = 0.005) and total hip (P = 0.001) BMD. In longitudinal analyses, vitamin K (P = 0.028) and natto (fermented soybeans) (P = 0.023) were positively associated with lumbar spine BMD, and meat or meat product consumption was inversely associated with total hip (P = 0.047) BMD. In conclusion, dietary factors other than calcium and vitamin D intake are predictors of bone mass and bone loss in Japanese postmenopausal women. In particular, natto intake is recommended for preventing postmenopausal bone loss on the basis of current evidence. PMID:27238552

  8. The Association between Sarcopenic Obesity and Depressive Symptoms in Older Japanese Adults.

    PubMed

    Ishii, Shinya; Chang, Chang; Tanaka, Tomoki; Kuroda, Aki; Tsuji, Tetsuo; Akishita, Masahiro; Iijima, Katsuya

    2016-01-01

    The effects of sarcopenic obesity, the co-existence of sarcopenia and obesity, on mood disorders have not been studies extensively. Our objective was to examine the association of depressive symptoms with sarcopenia and obesity status in older Japanese adults. We analyzed data from 1731 functionally-independent, community-dwelling Japanese adults aged 65 years or older (875 men, 856 women) randomly selected from the resident register of Kashiwa city, Chiba, Japan in 2012. Sarcopenia was defined based on appendicular skeletal muscle mass, grip strength and usual gait speed. Obesity was defined as the highest sex-specific quintile of the percentage body fat. Depressive symptoms were defined as a Geriatric Depression Scale 15-item score ≥ 6. Multiple logistic regression was employed to examine the association of depressive symptoms with four groups defined by the presence/absence of sarcopenia and obesity. The prevalence of depressive symptoms was 10.1% and the proportions of sarcopenia/obesity, sarcopenia/non-obesity, non-sarcopenia/obesity, non-sarcopenia/non-obesity were 3.7%, 13.6%, 16.9% and 65.8%, respectively. After adjustment for potential confounders, sarcopenia/obesity was positively associated with depressive symptoms compared with non-sarcopenia/non-obesity, whereas either sarcopenia or obesity alone was not associated with depressive symptoms. The association was particularly pronounced in those aged 65 to 74 years in age-stratified analysis. We conclude that our findings suggest a synergistic impact exerted by sarcopenic obesity on the risk of depressive symptoms, particularly in those aged 65 to 74 years. PMID:27627756

  9. Elder neglect.

    PubMed

    del Carmen, Tessa; LoFaso, Veronica M

    2014-11-01

    Because neglect is the most common form of elder abuse, identifying patients who are vulnerable to neglect allows clinicians to intervene early and potentially prevent situations that can escalate and lead to harm or even death. Health care workers have a unique opportunity to uncover these unfortunate situations and in many cases may be the only other contact isolated vulnerable patients have with the outside world. Responding appropriately and quickly when neglect is suspected and using a team approach can improve the health and well-being of older victims of neglect.

  10. Validity and reliability of the modified John Hopkins Fall Risk Assessment Tool for elderly patients in home health care.

    PubMed

    Hnizdo, Sandra; Archuleta, Raquel A; Taylor, Barbara; Kim, Son Chae

    2013-01-01

    This prospective cohort study was conducted to evaluate the validity and reliability of the modified Johns Hopkins Fall Risk Assessment Tool (mJH-FRAT) among elderly patients receiving home health care visits. Out of 107 patients, 33 (30.8%) had one or more falls and seven (6.5%) experienced falls with injury. Receiver Operating Characteristics of the tool in predicting falls showed an Area Under Curve (AUC) of 0.66 (p = 0.011) with sensitivity and specificity of 72.5% and 52.2% at the cutoff score of 14. For predicting falls with injury, the AUC was 0.82 (p = 0.016) with sensitivity and specificity of 100% and 65.9% at the cutoff score of 17. Inter-rater reliability of the tool was 85.7% agreement with Cohen's kappa of 0.714 (p < 0.001). The mJH-FRAT is a simple and easy-to-use multi-factor fall risk assessment tool with promising sensitivity, specificity and inter-rater reliability for prospectively identifying patients at risk of falls with injury among community-dwelling elderly populations.

  11. A Supplemental Report to a Randomized Cluster Trial of a 20-Week Sun-Style Tai Chi for Osteoarthritic Knee Pain in Elders with Cognitive Impairment

    PubMed Central

    Tsai, Pao-Feng; Chang, Jason Y.; Beck, Cornelia; Kuo, Yong-Fang; Keefe, Francis J.; Rosengren, Karl

    2015-01-01

    Objective This was a secondary data analysis of a cluster-randomized clinical trial that tested the efficacy of a 20-week Sun-style Tai Chi (TC) program in reducing pain in community-dwelling elders with cognitive impairment and knee osteoarthritis (OA). The study also examined whether elders’ level of cognitive function was related to the outcomes of the TC program. Method Elders (N=55) were recruited from 8 study sites. Each site was randomly assigned to participate in either a 20-week TC or an education program. Verbal report of pain was measured by a Verbal Descriptor Scale (VDS) at Weeks 1, 5, 9, 13, 17 and 21 (designated as Times 1-6). Pain behaviors and analgesic intake were also recorded at Times 1-6. Results At post-test, scores on the VDS and observed pain behaviors were significantly better in the TC group than in the control group (p=.008-.048). The beneficial effects of TC were not associated with cognitive ability. Conclusion These results suggest that TC can be used as an adjunct to pharmacological intervention to relieve OA pain in elders with cognitive impairment. PMID:26275650

  12. The Community-Acquired Pneumonia immunization Trial in Adults (CAPiTA): what is the future of pneumococcal conjugate vaccination in elderly?

    PubMed

    van Werkhoven, Cornelis H; Bonten, Marc J M

    2015-01-01

    Pneumococcal community-acquired pneumonia (PCAP) and invasive pneumococcal disease (IPD) are important causes of morbidity and mortality in elderly. In the Community-Acquired Pneumonia immunization Trial in Adults (CAPiTA), a randomized double-blind placebo-controlled trial of 84,496 community-dwelling immunocompetent adults over 65 years of age, the 13-valent pneumococcal conjugate vaccine (PCV13) reduced the incidence of first episode of vaccine-type (VT) PCAP with 38 and of VT-IPD with 76% in the modified intention-to-treat population. In The Netherlands, where PCV7 immunization of newborns was introduced in 2007 and replaced by PCV10 in 2011, introduction of PCV13 immunization of elderly--based on 2012 data--would be highly cost effective. However, this is probably different in countries where the VT disease burden has declined more, for instance due to herd effects following child immunization with PCV13. Apart from cost-effectiveness analyses, ethical aspects of PCAP prevention should be taken into account in policy making for pneumococcal vaccination in elderly.