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Razmjou H, Robarts S, Denis S, Wainwright A, Dickson P, Murnaghan J. Discordance between self-report and performance-based outcomes: Contribution of psychosocial factors. J Health Psychol 2024:13591053241253895. [PMID: 38801110 DOI: 10.1177/13591053241253895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
The purpose of this study was to examine the role of psychosocial factors in the discordance between perceived and observed physical disability in patients with osteoarthritis of the hip or knee joint. This was a cross-sectional study of patients seen for consideration of joint arthroplasty surgery. Patients completed a psychosocial outcome measure, a patient self-reported functional scale, and two performance-based tests. Data of 121 patients, mean age, 67 (8), 81 (67%) females were used for analysis. The fear avoidance and positive affect domains had the strongest association with the discordance between the self-report and both performance outcome measures. Age, gender, and severity of osteoarthritis were associated with discordance in relation to walking. Fear avoidance beliefs and positive affect play important roles in perception of pain and function. Age, gender, and severity of arthritis should be taken into consideration for a more holistic approach to arthritis care.
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Affiliation(s)
- Helen Razmjou
- Sunnybrook Health Sciences Centre, Canada
- University of Toronto, Canada
| | - Susan Robarts
- Sunnybrook Health Sciences Centre, Canada
- University of Toronto, Canada
| | - Suzanne Denis
- Sunnybrook Health Sciences Centre, Canada
- University of Toronto, Canada
| | - Amy Wainwright
- Sunnybrook Health Sciences Centre, Canada
- University of Toronto, Canada
| | - Patricia Dickson
- Sunnybrook Health Sciences Centre, Canada
- University of Toronto, Canada
| | - John Murnaghan
- Sunnybrook Health Sciences Centre, Canada
- University of Toronto, Canada
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2
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Lay K, Crocker M, Engel L, Ratcliffe J, Charlton S, Hutchinson C. How do older adults receiving aged care services understand and respond to the EQ-5D-5L? A think-aloud study in residential care. Qual Life Res 2023; 32:3161-3170. [PMID: 37386266 PMCID: PMC10522713 DOI: 10.1007/s11136-023-03466-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE The EQ-5D-5L is a preference-based instrument for measuring and valuing health-related quality of life (HRQoL). The EQ-5D-5L has been used extensively in economic evaluation, including in aged care. However, older adults' understanding of the EQ-5D-5L has not been comprehensively investigated to date. This research aimed to assess older adults' understanding of the EQ-5D-5L using a think-aloud protocol with two cognition groups: no cognitive impairment and mild/moderate cognitive impairment. METHODS Participants' cognition was assessed using the Standardised Mini-Mental State Examination (SMMSE). Face-to face interviews were conducted with concurrent and retrospective think-aloud encouraged through verbal probing. Audio recordings were transcribed, and qualitative analysis, informed by the Tourangeau four-stage Response Model (comprehension, retrieval, decision process, response process) was conducted in NVivo. RESULTS In total, 46 older adults (age 65 +) were recruited from 10 residential care facilities across South Australia (n = 25 no cognitive impairment, n = 21 mild/moderate cognitive impairment). Comprehension, retrieval, judgement and response mapping issues were common across all cognition levels and EQ-5D-5L dimensions. The two dimensions resulting in the most response issues were usual activities and personal care. CONCLUSION Older adults may bring a different understanding to the EQ-5D-5L descriptive system than that expected given testing with general population samples. Dimension descriptors that are more relevant to this population may facilitate responses that better align with the underlying EQ-5D-5L concept model.
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Affiliation(s)
- Kiri Lay
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
| | - Matthew Crocker
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Lidia Engel
- Health Economics Division, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | | | - Claire Hutchinson
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
- Health Economics Division, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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3
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Lopez A, Tinella L, Caffò A, Bosco A. Measuring the reliability of proxy respondents in behavioural assessments: an open question. Aging Clin Exp Res 2023; 35:2173-2190. [PMID: 37540380 PMCID: PMC10520105 DOI: 10.1007/s40520-023-02501-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/07/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND In behavioural assessment, information can be gathered from internally referenced self-reports or from proxy informants. AIMS This study aimed to fine-tune a brief but reliable method for evaluating the proxy accuracy in cases where responses obtained from adult and older adults' patient cannot be considered reliable. METHODS We generated a set of items reflecting both overt and covert behaviours related to the basic instrumental activities of daily living. The psychometric properties of the content, factorial, and criterium validity of these items were then checked. The Proxy Reliability Questionnaire-ProRe was created. We tested the frequency of "I don't know" responses as a measure of proxy reliability in a sample of healthy older adults and their proxies, and in a second sample of proxy respondents who answered questions about their parents. RESULTS As expected, response precision was lower for items characterizing covert behaviours; items about covert compared to overt behaviours generated more "I don't know" answers. Proxies provided less "I don't know" responses when evaluating the parent, they claimed they knew better. Moreover, we tried to validate our approach using response confidence. Encouragingly, these results also showed differences in the expected direction in confidence between overt and covert behaviours. CONCLUSIONS The present study encourages clinicians/researchers to how well the proxy the patient know each other, the tendency of proxies to exhibit, for example, response bias when responding to questions about patients' covert behaviours, and more importantly, the reliability of informants in providing a clinical assessment of neurocognitive diseases associated with aging.
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Affiliation(s)
- Antonella Lopez
- Faculty of Law, Giustino Fortunato University, Via Delcogliano, 12, Benevento, Italy
- Department of Educational Sciences, Psychology, Communication, University of Bari, Via Crisanzio 42, 70122 Bari, Italy
| | - Luigi Tinella
- Department of Educational Sciences, Psychology, Communication, University of Bari, Via Crisanzio 42, 70122 Bari, Italy
| | - Alessandro Caffò
- Department of Educational Sciences, Psychology, Communication, University of Bari, Via Crisanzio 42, 70122 Bari, Italy
| | - Andrea Bosco
- Department of Educational Sciences, Psychology, Communication, University of Bari, Via Crisanzio 42, 70122 Bari, Italy
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Buchholz I, Janssen MF. EQ-5D-3L Norms for the European Older Population: Country-Specific Norms for 15 European Countires Based on the Survey of Health, Ageing, and Retirement in Europe. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:721-732. [PMID: 36396535 DOI: 10.1016/j.jval.2022.09.2478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 08/11/2022] [Accepted: 09/29/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVES This study presents a country-specific 3-level version of EQ-5D population norms for the European older population. METHODS Norm data were obtained from the fourth wave of the Survey of Health, Ageing and Retirement in Europe, and determined, for each EQ-5D dimension, the EQ-visual analog scale (EQ-VAS) and EQ-5D index values by 7 age groups and sex for 15 European countries. The EQ-5D index values were calculated using the European VAS value set for all countries. RESULTS Data resulting from 50 013 older respondents (mean age 65.9 years, range 50-111 years, 55.6% women) revealed an increasing number of self-reported health problems on EQ-5D dimensions and decreasing EQ-VAS scores with increasing age and for women compared with men. There are notable differences between countries in terms of the age gradient, the proportion of respondents in full health, and sex. Across all age groups, problems with pain & discomfort are the most frequent (36%-73% any problems), whereas problems with self-care are the least frequent (3%-31% any problems). The mean EQ-VAS score is 71.2 and the mean European VAS score is 0.79. CONCLUSIONS Given the growing number of older adults and elderly people in Europe, these population norms provide a valuable source of reference data that can be used to compare older adults or patient subgroups to the average of the general elderly population in a similar age or sex group in 15 European countries. The index value results may be further used to assess the burden of disease across older European populations and to identify the unmet needs of targeted older patient populations.
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Affiliation(s)
| | - Mathieu F Janssen
- Department of Medical Psychology and Psychotherapy Erasmus MC, Erasmus University, Rotterdam, The Netherlands
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Henstra M, Rhebergen D, van der Velde N, van Schoor N, Collard RM, OudeVoshaar R, Kok A. Patterns of discordance of physical functioning in older persons; different associations for apathy and depression? Results from the NESDO-study. Aging Ment Health 2022; 26:1580-1588. [PMID: 34124966 DOI: 10.1080/13607863.2021.1932738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Discordance between self-reported functional limitations and performance-based physical functioning may have a negative impact in functional independence in older adults. We longitudinally examined baseline apathy- and depressive symptomatology as associates of discordance. METHOD 469 participants from the multi-site cohort study NESDO were included. Self-reported functional limitations were assessed by two items derived from the WHO-Disability Assessment Schedule. Performance-based physical functioning included walking speed and handgrip-strength. Both measures were rescaled, with final sum-scores ranging from 0 to 6. Discordance-scores were computed by subtracting sum-scores on performance-based measures from self-reported functional limitations. Using latent growth curve analysis, we estimated individual trajectories of discordance at baseline, 2-and 6-years follow-up, consisting of the baseline discordance-score (intercept) and the yearly change of discordance-score (slope). We then estimated associations with apathy and depression indicators. RESULTS At baseline, persons (mean age 70.48 years, 65% female, 73% depressed) on average overestimated their daily functioning compared to performance tests (b = 0.77, p < 0.001). The average discordance-scores yearly increased by 0.15 (p < 0.001). Only in models adjusted for several demographic and clinical characteristics, depression severity was negatively associated with discordance-scores at baseline (b=-0.01, p = 0.02), while apathy was not (b=-0.02, p = 0.21). No associations with change over time were found. CONCLUSION In older persons, not indifference and diminished goal-directed activity, but negative emotions appear to underlie underestimation of one's physical capacity. Further research is needed to determine (1) to what extent targeting discordance results in actual preservation of physical functioning and (2) whether older persons with apathy and/or depression need different approaches for this purpose.
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Affiliation(s)
- Marieke Henstra
- Department of Internal Medicine, Geriatrics, Amsterdam UMC, Academic Medical Center, The Netherlands Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Didi Rhebergen
- Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of Psychiatry, GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands.,Department of Psychiatry, Mental Health Care Institute GGZ Centraal, Amersfoort, The Netherlands
| | - Nathalie van der Velde
- Department of Internal Medicine, Geriatrics, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Natasja van Schoor
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Rose Mollard Collard
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Richard OudeVoshaar
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Almar Kok
- Department of Epidemiology & Biostatistics, Medical Faculty Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Coelho-Júnior HJ, Calvani R, Panza F, Allegri RF, Picca A, Marzetti E, Alves VP. Religiosity/Spirituality and Mental Health in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies. Front Med (Lausanne) 2022; 9:877213. [PMID: 35646998 PMCID: PMC9133607 DOI: 10.3389/fmed.2022.877213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/19/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives The present study investigated the association between religious and spiritual (RS) practices with the prevalence, severity, and incidence of mental health problems in older adults. Methods We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated older adults aged 60+ years and assessed RS using valid scales and questions from valid scales, and mental health according to validated multidimensional or specific instruments. Studies were retrieved from MEDLINE, LILACS, SCOPUS, CINAHL, and AgeLine databases until July 31, 2021. The risk of bias was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS). A pooled effect size was calculated based on the log odds ratio (OR) and Z-scores. This study is registered on PROSPERO. Results One hundred and two studies that investigated 79.918 community-dwellers, hospitalized, and institutionalized older adults were included. Results indicated that high RS was negatively associated with anxiety and depressive symptoms, while a positive association was observed with life satisfaction, meaning in life, social relations, and psychological well-being. Specifically, people with high spirituality, intrinsic religiosity, and religious affiliation had a lower prevalence of depressive symptoms. In relation to longitudinal analysis, most studies supported that high RS levels were associated with a lower incidence of depressive symptoms and fear of death, as well as better mental health status. Conclusion Findings of the present study suggest that RS are significantly associated with mental health in older adults. People with high RS levels had a lower prevalence of anxiety and depressive symptoms, as well as reported greater life satisfaction and psychological well-being, better social relations, and more definite meaning in life. Data provided by an increasing number of longitudinal studies have supported most of these findings.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy
- Department of Gerontology, Catholic University of Brasília, Brasília, Brazil
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
- *Correspondence: Hélio José Coelho-Júnior
| | - Riccardo Calvani
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Francesco Panza
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Bari, Italy
| | - Riccardo F. Allegri
- Department of Cognitive Neurology, Instituto de Investigaciones Neurológicas Fleni, Buenos Aires, Argentina
- Department of Neurosciences, Universidad de la Costa (CUC), Barranquilla, Colombia
| | - Anna Picca
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Emanuele Marzetti
- Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Vicente Paulo Alves
- Department of Gerontology, Catholic University of Brasília, Brasília, Brazil
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Witzel DD, Turner SG, Hooker K. Self-Perceptions of Aging Moderate Associations of Within- and Between-Persons Perceived Stress and Physical Health Symptoms. J Gerontol B Psychol Sci Soc Sci 2022; 77:641-651. [PMID: 34888645 DOI: 10.1093/geronb/gbab228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To examine how self-perceptions of aging (SPA) moderated within- and between-persons perceived stress associations with physical health symptoms. METHODS A community-dwelling sample of 103 adults (Meanage = 63, range = 52-88) participated in an online microlongitudinal study for 100 days (Noccasions = 7,064). Participants completed baseline surveys consisting of SPA, social connections, and demographics followed by 100 daily surveys including information about daily stress perceptions and physical health. Utilizing generalized multilevel models, we examined whether daily fluctuations and average levels of perceived stress over 100 days affected physical health symptoms and whether these associations varied by SPA. RESULTS Adults who had higher perceived stress, on average across 100 days, reported significantly more physical health symptoms compared to individuals with lower perceived stress on average (p < .05). On days when individuals reported higher perceived stress than their own average, they had a higher likelihood of reporting more physical health symptoms compared to days when their perceived stress was lower than their own average (p < .05). Further, SPA significantly moderated associations between both within- and between-persons perceived stress and physical health symptoms (ps < .05). Individuals with more positive SPA were less affected by high levels of perceived stress-both on average and on days when perceived stress was higher than their own average. DISCUSSION More positive SPA significantly dampened the impact of perceived stress, suggesting the importance of SPA as an individual characteristic within stress processes. Future work should examine how daily changes in SPA may exacerbate or mitigate the impacts of daily stress processes and health outcomes.
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Affiliation(s)
| | - Shelbie G Turner
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Karen Hooker
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, Oregon, USA
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8
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Peña-Longobardo LM, Rodríguez-Sánchez B, Oliva-Moreno J. The impact of widowhood on wellbeing, health, and care use: A longitudinal analysis across Europe. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101049. [PMID: 34371339 DOI: 10.1016/j.ehb.2021.101049] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/19/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To estimate whether becoming widowed had a significant effect on individual's health status as well as on healthcare and non-healthcare resources use, compared to people who remained in a couple in Europe. DATA AND METHOD It was used the Survey of Health, Aging and Retirement in Europe from 2004 to 2015. The statistical technique used was genetic matching which analysed the differences in wellbeing, mental health, health status, risk of death, health care resources and long-term care utilization of people who have become widowed, comparing with people who remained married or with a partner. We considered shortterm and medium-term effects. RESULTS In the short term, those who became widowed had a worse wellbeing and mental health, in addition to a greater probability of receiving formal care and informal care from outside the household. There seems to be a significant effect in the use of formal and informal care from outside the household in the medium term. CONCLUSIONS The results might help to concentrate a major effort of any policy or strategy, not only in the field of health but also in the provision of long-term care, immediately after the negative shock occurs.
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9
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Wu Q, Zhang P. Longitudinal validity of self-rated health: the presence and impact of response shift. Psychol Health 2021:1-21. [PMID: 34714204 DOI: 10.1080/08870446.2021.1994571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: This paper aimed to examine the longitudinal validity of self-rated health (SRH) and whether it would be affected by possible changes in evaluation standards (i.e., response shift) over time.Design: Data are from a longitudinal survey of a nationally representative sample in China. Analytical sample was restricted to respondents aged 45 and above (n = 15,893). Individual fixed effects models were used to analyze changes in ratings on health anchoring vignettes and self-rated health over time.Main outcome measures: SRH at two time points with a -two-year span.Results: Both SRH and anchoring vignettes ratings displayed changes over a two-year span for all the studied age groups. Compared with the self-assessed change in health ("How would you rate your health as compared to that of last year?"), changes in SRH reported over time displayed a more stable and optimistic pattern. SRH responded to doctor diagnosed chronic disease and changes in functional limitation, before and after adjusting for evaluation standards.Conclusion: SRH is responsive to the newly diagnosed chronic disease and functional limitation, regardless of whether we consider response shift within the same respondents over time.
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Affiliation(s)
- Qiong Wu
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Peikang Zhang
- Graduate School of Education, Peking University, Beijing, China
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10
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Fabian M. Scale Norming Undermines the Use of Life Satisfaction Scale Data for Welfare Analysis. JOURNAL OF HAPPINESS STUDIES 2021; 23:1509-1541. [PMID: 34658664 PMCID: PMC8506099 DOI: 10.1007/s10902-021-00460-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
Scale norming is where respondents use qualitatively different scales to answer the same question across survey waves. It makes responses challenging to compare intertemporally or interpersonally. This paper develops a formal model of the cognitive process that could give rise to scale norming in year on year responses to life satisfaction scale questions. It then uses this model to conceptually differentiate scale norming from adaptation and changes in reference points. Scale norming could make life satisfaction responses misleading with regards to the changing welfare of individuals. In particular, individuals who would say that their life is "improving" or "going well" might nonetheless give the same scale response year after year. This has negative implications for the use of scales in cost-benefit analysis and other welfarist applications. While there is already substantial empirical evidence for the existence of scale norming, its implications for welfare analysis are sometimes understated on the grounds that this evidence might simply be the product of errors of memory. The paper presents new empirical evidence for scale norming from two surveys (N1 = 278; N2 = 1050) designed such that errors of memory are an unconvincing explanation for the results.
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Affiliation(s)
- Mark Fabian
- Department of Politics and International Studies, The Bennett Institute for Public Policy, University of Cambridge, Alison Richard Building, 7 West Road, Cambridge, CB3 9DT UK
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11
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Cawthon PM, Patel SM, Kritchevsky SB, Newman AB, Santanasto A, Kiel DP, Travison TG, Lane N, Cummings SR, Orwoll ES, Kwok T, Hirani V, Schousboe J, Karlsson MK, Mellström D, Ohlsson C, Ljunggren Ö, Xue QL, Shardell M, Jordan JM, Pencina KM, Fielding RA, Magaziner J, Correa-de-Araujo R, Bhasin S, Manini TM. What cut-point in gait speed best discriminates community dwelling older adults with mobility complaints from those without? A pooled analysis from the Sarcopenia Definitions and Outcomes Consortium. J Gerontol A Biol Sci Med Sci 2021; 76:e321-e327. [PMID: 34166490 DOI: 10.1093/gerona/glab183] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Cut-points to define slow walking speed have largely been derived from expert opinion. METHODS Study participants (13,589 men and 5,043 women aged ≥65years) had walking speed (m/s) measured over 4-6 meters (mean ± SD: 1.20 ± 0.27 m/s in men and 0.94 ± 0.24 m/s in women.) Mobility limitation was defined as self-reported any difficulty with walking ~1/4 mile (prevalence: 12.6% men, 26.4% women). Sex-stratified classification and regression tree (CART) models with 10-fold cross-validation identified walking speed cut-points that optimally discriminated those who reported mobility limitation from those who did not. RESULTS Among 5,043 women, CART analysis identified two cut-points, classifying 4,144 (82.2%) with walking speed ≥0.75 m/s, which we labeled as "fast"; 478 (9.5%) as "intermediate" (walking speed ≥0.62 m/s but <0.75 m/s); and 421 (8.3%) as "slow" (walking speed <0.62 m/s). Among 13,589 men, CART analysis identified three cut-points, classifying 10,001 (73.6%) with walking speed ≥1.00 m/s ("very fast"); 2,901 (21.3%) as "fast" (walking speed ≥0.74 m/s but <1.00 m/s); 497 (3.7%) as "intermediate" (walking speed ≥0.57 m/s but <0.74 m/s); and 190 (1.4%) as "slow" (walking speed <0.57 m/s). Prevalence of self-reported mobility limitation was lowest in the "fast" or "very fast" (11% for men and 19% for women) and highest in the "slow" (60.5% in men and 71.0% in women). Rounding the two slower cut-points to 0.60 m/s and 0.75 m/s reclassified very few participants. CONCLUSIONS Cut-points in walking speed of ~0.60 m/s and 0.75 m/s discriminate those with self-reported mobility limitation from those without.
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Affiliation(s)
- Peggy M Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, CA.,Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Sheena M Patel
- Research Institute, California Pacific Medical Center, San Francisco, CA
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC
| | - Anne B Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Adam Santanasto
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Douglas P Kiel
- Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Thomas G Travison
- Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Nancy Lane
- Center for Musculoskeletal Health and Department of Internal Medicine, University of California Medical Center, Sacramento, CA
| | - Steven R Cummings
- Research Institute, California Pacific Medical Center, San Francisco, CA.,Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Eric S Orwoll
- Bone and Mineral Unit, Oregon Health & Science University, Portland
| | - Timothy Kwok
- Department of Medicine & Therapeutics and School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong
| | - Vasant Hirani
- Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - John Schousboe
- HealthPartners Institute, Bloomington, Minnesota and Division of Health Policy and Management, University of Minnesota, Minneapolis
| | - Magnus K Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics and Clinical Sciences in Malmo, Skane University Hospital, Lund University, Malmo, Sweden
| | - Dan Mellström
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Drug Treatment, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Drug Treatment, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Östen Ljunggren
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Qian-Li Xue
- Division of Geriatric Medicine and Gerontology and Center on Aging and Health, Johns Hopkins Medical Institute, Baltimore, MD
| | - Michelle Shardell
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Joanne M Jordan
- Thurston Arthritis Research Center, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Karol M Pencina
- Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Roger A Fielding
- Nutrition, Exercise, Physiology, and Sarcopenia Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Jay Magaziner
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | | | - Shalender Bhasin
- Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA
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12
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Takashi N, McCarthy MJ, Suzuki R, Ogahara K, Ono-Kihara M, Kihara M, Nakayama T. Association of patient quality of life with the degree of agreement in the perceptions of patient disability within the stroke patient-rehabilitation therapist dyad: a cross-sectional study in postdischarge rehabilitation setting. BMJ Open 2021; 11:e043824. [PMID: 33952542 PMCID: PMC8103374 DOI: 10.1136/bmjopen-2020-043824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES The purpose of study was to explore the association between patient physical and psychological quality of life (QOL) with the degree of agreement in perceptions of patient disability within the stroke patient-rehabilitation therapist dyad. DESIGN Cross-sectional dyadic study with a tablet-based structured questionnaire. SETTING Rehabilitation, nursing and long-term care facilities that provide rehabilitation services in the Kanagawa prefecture, Japan. PARTICIPANTS The 81 dyads of a male patient with stroke living at home and the rehabilitation therapist in charge of the eligible patient were recruited from March 2019 to February 2020. METHOD Patient physical and psychological QOL was measured using the WHOQOL BREF. Perceptions of patient disability were measured using the 12-item WHO Disability Assessment Schedule V.2.0 (DAS). DAS scores of patients and therapists were classified into two (high and low) and three (high, medium, low) categories, respectively, and six patterns of agreement about patient function were created and used in the analysis. Generalised estimating equations were used to examine multivariable associations between WHOQOL scores in patients and the degree of agreement within dyads adjusting for other covariates and clustering effects. RESULTS Among 81 enrolled dyads, 48 (59.3%) were classified into one of four disagreement groups (low medium, low high, high medium, high low). When the patient appraised himself as having mild disability, the degree of patient-therapist disagreement was negatively associated with patient's physical and psychological QOL. When the patient appraised himself as having severe disability, his physical and/or psychological QOL was poorer, regardless of the degree of agreement. CONCLUSIONS Disagreement in the perception of disability within patient-rehabilitation therapist dyad could be associated with patient's poor QOL, especially when the patient perceives himself as having mild disability. Reaching an agreement about patient disability is needed in the delivery of rehabilitation care for patients with stroke living at home to improve their QOL.
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Affiliation(s)
- Naoki Takashi
- Graduate School of Medicine, School of Public Health, Department of Health Informatics, Kyoto University, Kyoto, Japan
| | - Michael J McCarthy
- College of Social and Behavioral Sciences, Department of Social Work, Northern Arizona University, Flagstaff, Arizona, USA
| | - Rie Suzuki
- Department of Public Health & Health Sciences, University of Michigan Flint, Flint, Michigan, USA
| | - Kakuya Ogahara
- Department of Occupational Therapy, Kanagawa University of Human Services, Yokosuka, Japan
| | - Masako Ono-Kihara
- Global Health Interdisciplinary Unit, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
- International Institute of Socio-epidemiology, Kyoto, Japan
| | - Masahiro Kihara
- Global Health Interdisciplinary Unit, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
- International Institute of Socio-epidemiology, Kyoto, Japan
| | - Takeo Nakayama
- Graduate School of Medicine, School of Public Health, Department of Health Informatics, Kyoto University, Kyoto, Japan
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13
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Outcome measures used in lower extremity amputation: Review of clinical use and psychometric properties. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.789623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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McCombie AM, Frampton CM, Frizelle FA. Quality of life preferences in colorectal cancer patients aged 80 and over. ANZ J Surg 2021; 91:1859-1865. [PMID: 33851517 DOI: 10.1111/ans.16739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/25/2021] [Accepted: 02/27/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Management of patients with colorectal cancer (CRC) is about not only survival, but also quality of life (QoL). What patients want is important but is not well researched or understood for elderly patients where it is very relevant. This study aimed to measure and compare what patients with CRC aged 80 and over and surgeons consider important in terms of survivorship after surgery for CRC. METHODS Patients aged 80 and over who were having surgery for CRC were recruited and interviewed using closed and open questions about their expectations of surgery and various QoL dimensions. These were assessed preoperatively and 3 months post-operatively. Surgeons ranked the same QoL dimensions of patients by questionnaire. RESULTS Nineteen patients (median age 87.5, range 80-95, eight males and 11 females) were recruited. Patients rated items relating to health, mobility and independence (n = 23) as top three items most often followed by people outside self (n = 13). Surgeons underestimated importance in 17 domains with the biggest discrepancy being in 'avoiding a stoma' (4.11 versus 2.3, P < 0.01). CONCLUSION With patients over 80 years having surgery for CRC, there is a lack of concordance between what surgeons think is important and what patients think is important. Despite this, CRC patients aged 80 and older are almost always satisfied with the outcome of surgery. Surgeons should ensure that they understand patients' expectations and that they are aligned with likely outcomes of surgery.
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Affiliation(s)
- Andrew M McCombie
- Department of General Surgery, Canterbury District Health Board, Christchurch, New Zealand.,Department of Surgery, The University of Otago, Christchurch, New Zealand
| | - Chris M Frampton
- Department of Medicine, The University of Otago, Christchurch, New Zealand
| | - Frank A Frizelle
- Department of General Surgery, Canterbury District Health Board, Christchurch, New Zealand.,Department of Surgery, The University of Otago, Christchurch, New Zealand
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15
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Sprangers MAG, Sajobi T, Vanier A, Mayo NE, Sawatzky R, Lix LM, Oort FJ, Sébille V. Response shift in results of patient-reported outcome measures: a commentary to The Response Shift-in Sync Working Group initiative. Qual Life Res 2021; 30:3299-3308. [PMID: 33481193 PMCID: PMC8602228 DOI: 10.1007/s11136-020-02747-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The Working Group undertook a critical, comprehensive synthesis of the response shift work to date. We aimed to (1) describe the rationale for this initiative; (2) outline how the Working Group operated; (3) summarize the papers that comprise this initiative; and (4) discuss the way forward. METHODS Four interdisciplinary teams, consisting of response shift experts, external experts, and new investigators, prepared papers on (1) definitions and theoretical underpinnings, (2) operationalizations and response shift methods, (3) implications for healthcare decision-making, and (4) on the published magnitudes of response shift effects. Draft documents were discussed during a two-day meeting. Papers were reviewed by all members. RESULTS Vanier and colleagues revised the formal definition and theory of response shift, and applied these in an amended, explanatory model of response shift. Sébille and colleagues conducted a critical examination of eleven response shift methods and concluded that for each method extra steps are required to make the response shift interpretation plausible. Sawatzky and colleagues created a framework for considering the impact of response shift on healthcare decision-making at the level of the individual patient (micro), the organization (meso), and policy (macro). Sajobi and colleagues are conducting a meta-analysis of published response shift effects. Preliminary findings indicate that the mean effect sizes are often small and variable across studies that measure different outcomes and use different methods. CONCLUSION Future response shift research will benefit from collaboration among diverse people, formulating alternative hypotheses of response shift, and conducting the most conclusive studies aimed at testing these (falsification).
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Affiliation(s)
- Mirjam A G Sprangers
- Department of Medical Psychology, Research Institute Amsterdam Public Health, Amsterdam University Medical Centers, Location AMC, Meibergdreef 15, J3-211, 1105 AZ, Amsterdam, The Netherlands.
| | - Tolulope Sajobi
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Antoine Vanier
- Inserm-University of Nantes-University of Tours, UMR 1246 Sphere "Methods in Patient-Centered Outcomes and Health Research", Nantes, France
| | - Nancy E Mayo
- Center for Outcomes Research and Evaluation, McGill University, Montreal, Canada.,Division of Clinical Epidemiology, Department of Medicine, McGill University Health Centre Research Institute, Montreal, Canada
| | - Richard Sawatzky
- School of Nursing, Trinity Western University, Langley, BC, Canada.,Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Lisa M Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Frans J Oort
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Véronique Sébille
- UMR INSERM 1246, SPHERE "methodS in Patient-Centered Outcomes and HEalth ResEarch", University of Nantes, University of Tours, Nantes, France
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16
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Lane CY, Givens DL, Thoma LM. General Functional Status: Common Outcome Measures for Adults With Rheumatic Disease. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:431-451. [PMID: 33091251 DOI: 10.1002/acr.24196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/24/2020] [Indexed: 12/30/2022]
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17
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Kok AAL, Henstra MJ, van der Velde N, Rhebergen D, van Schoor NM. Psychosocial and Health-Related Factors Associated With Discordance Between 13-Year Trajectories of Self-Reported Functional Limitations and Performance-Based Physical Functioning in Old Age. J Aging Health 2020; 32:1084-1097. [PMID: 31686583 PMCID: PMC7731649 DOI: 10.1177/0898264319884404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The objective of this study was to examine correlates of discordance between 13-year trajectories of self-reported functional limitations and performance-based physical functioning in older adults. Method: We included 2,135 participants from the population-based Longitudinal Aging Study Amsterdam, the Netherlands, followed across 1995-2008. Self-reported functional limitations included six (instrumental) activities of daily living. Performance-based functioning was a composite of four tests. We used latent class growth analysis and multinomial logistic regression to examine discordance and its correlates. Results: Patterns of discordance and concordance (41% concordance, 46% "overestimation" of daily functioning, 13% "underestimation") appeared to be persistent over 13 years. Older age, male sex, cognitive impairment, absence of pain, and light alcohol use were associated with overestimation. Younger age, female sex, and lower self-rated health were associated with underestimation. Discussion: Factors associated with overestimation partly differ from those associated with underestimation. Factors that are highly stable over time are particularly good indicators of persistent discordance.
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Affiliation(s)
| | | | | | - Didi Rhebergen
- Amsterdam UMC—Vrije Universiteit Amsterdam,
The Netherlands
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18
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Aw SSY, Ilies R, Li X, Bakker AB, Liu X. Work‐related helping and family functioning: A work–home resources perspective. JOURNAL OF OCCUPATIONAL AND ORGANIZATIONAL PSYCHOLOGY 2020. [DOI: 10.1111/joop.12331] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Xinxin Li
- Antai College of Economics & Management Shanghai Jiao Tong University Shanghai China
| | - Arnold B. Bakker
- Erasmus University Rotterdam The Netherlands
- University of Johannesburg Johannesburg South Africa
| | - Xiao‐Yu Liu
- University of International Business and Economics Beijing China
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19
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Bristol AA, Convery KA, Sotelo V, Schneider CE, Lin SY, Fletcher J, Rupper R, Galvin JE, Brody AA. Protocol for an embedded pragmatic clinical trial to test the effectiveness of Aliviado Dementia Care in improving quality of life for persons living with dementia and their informal caregivers. Contemp Clin Trials 2020; 93:106005. [PMID: 32320844 PMCID: PMC7269690 DOI: 10.1016/j.cct.2020.106005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/27/2020] [Accepted: 04/13/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Persons living with Alzheimer's disease and related dementias (ADRD) frequently experience pain and behavioral and psychological symptoms of dementia (BPSD) which decrease quality of life (QOL) and influence caregiver burden. Home healthcare professionals however may underrecognize or lack the ability to manage BPSD. INTERVENTION This protocol describes an ADRD palliative quality assurance performance improvement program for home healthcare, Aliviado Dementia Care-Home Health Edition. It includes training, mentoring, and a toolbox containing intervention strategies. METHODS This embedded pragmatic clinical trial will utilize a multi-site, cluster randomized control design. Recruitment will occur from three home healthcare agencies located in New Jersey, Utah, and Florida. At each agency, care teams will be randomized as clusters and assigned to either the Aliviado Dementia Care program or usual care. We plan to enroll 345 persons living with ADRD and their informal caregiver dyads. The primary outcome will be to measure QOL in both the person living with ADRD and their informal caregiver, and emergency department visits and hospital admissions. Secondary outcomes in the person living with ADRD will include the examination of pain, BPSD, antipsychotic and analgesic use. Secondary outcomes in caregivers include burden, depressive symptoms, functional health and wellbeing, and healthcare utilization. CONCLUSION This study will be the first large-scale embedded pragmatic clinical trial in home healthcare focused on care quality and outcomes in addressing QOL in ADRD. If proven successful, the intervention can then be disseminated to agencies throughout the country to improve the quality of care for this vulnerable, underserved population. TRIAL REGISTRATION Clinical Trials.gov: NCT03255967.
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Affiliation(s)
| | - Kimberly A Convery
- The Hartford Institute for Geriatric Nursing, NYU Rory Meyers College of Nursing, United States
| | - Victor Sotelo
- The Hartford Institute for Geriatric Nursing, NYU Rory Meyers College of Nursing, United States
| | | | - Shih-Yin Lin
- NYU Rory Meyers College of Nursing, United States
| | | | - Randall Rupper
- University of Utah School of Medicine, United States; George E. Wahlen Department of Veterans Affairs Medical Center, VA Salt Lake City Health Care System, Geriatric Research, Education and Clinical Center, Salt Lake City, UT, United States
| | - James E Galvin
- Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, United States
| | - Abraham A Brody
- The Hartford Institute for Geriatric Nursing, NYU Rory Meyers College of Nursing, United States.
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20
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Olsen AL, Magnussen LH, Skjaerven LH, Assmus J, Sundal MA, Ostelo R, Strand LI. Movement quality evaluation and its correlation with recommended functional measures in hip osteoarthritis. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2020; 25:e1848. [PMID: 32449252 DOI: 10.1002/pri.1848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 04/07/2020] [Accepted: 04/29/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Hip osteoarthritis may cause compensational movement strategies that require extra physical and mental effort. Such aberrant functioning can be captured in movement quality evaluation. The objective of this study was to explore whether movement quality, evaluated as a multiperspective phenomenon, is reflected in commonly used and recommended functional measures in this group of patients. METHODS A cross-sectional study design was used. Baseline included 80 female and 21 male participants with hip osteoarthritis. Movement quality was evaluated by the Body Awareness Rating Scale-Movement Quality and Experience (BARS-MQE), part one, including 12 movement items. Correlation analyses (Pearson and Spearman) were performed to explore associations between BARS-MQE (sum score and single item scores), and scores on measures of physical capacity (Chair test, Stairs test, 6 minutes walking test; 6MWT), self-reported activity level (UCLA), function (HOOS subscales), pain during walking (NRS), self-efficacy (ASES) and health (EQ-5D-5L). Based on previous evidence, we hypothesized moderate associations between BARS-MQE and these measures. RESULTS BARS-MQE's sum score showed moderate associations with Stairs test, 6MWT and UCLA (r = -0.425 to 0.304) and weak associations (r = 0.29 to 0.12) with ASES Pain and Symptoms, HOOS ADL, Chair test, NRS, HOOS Pain and Sports, and EQ-5D-5L. No association was found between BARS-MQE and HOOS Symptoms and Quality of life. Movement quality in item 12, walking, demonstrated moderate or weak association with all included measures. CONCLUSION In this study of participants diagnosed with hip osteoarthritis, movement quality evaluated by BARS-MQE was moderately reflected in measures of physical capacity and activity, but weakly reflected in self-reported measures of health problems. With its particular dynamic procedure and inclusion of the whole moving person, movement quality evaluation by the BARS-MQE was shown to provide supplementary information on functioning, scarcely captured by the commonly used and recommended measures.
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Affiliation(s)
- Aarid Liland Olsen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway
| | - Liv Heide Magnussen
- Department of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Liv Helvik Skjaerven
- Department of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Jörg Assmus
- Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway
| | - Mary-Anne Sundal
- Department of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Raymond Ostelo
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, Location VUmc, Amsterdam, The Netherlands.,Department of Health Sciences, VU University and Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Liv Inger Strand
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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21
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Sironi M, Ploubidis GB, Grundy EM. Fertility History and Biomarkers Using Prospective Data: Evidence From the 1958 National Child Development Study. Demography 2020; 57:529-558. [PMID: 32133595 PMCID: PMC7162827 DOI: 10.1007/s13524-020-00855-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Research on the later-life health implications of fertility history has predominantly considered associations with mortality or self-reported indicators of health. Most of this previous research has either not been able to account for selection factors related to both early-life and later-life health or has had to rely on retrospectively reported accounts of childhood circumstances. Using the 1958 National Child Development Study, and in particular the biomedical survey conducted in 2002-2003, we investigate associations between fertility histories (number of children and age at first and at last birth) and biomarkers for cardiometabolic risk and respiratory function in midlife among both men and women. Results from models that adjusted for a very wide range of childhood factors, including early-life socioeconomic position, cognitive ability, and mental health, showed weak associations between parity and biomarkers. However, we found an inverse association between age at first birth and biomarkers indicative of worse cardiometabolic health, with poorer outcomes for those with very young ages at entry to parenthood and increasingly better outcomes for those becoming parents at older ages. A very young age at last birth was also associated with less favorable biomarker levels, especially among women. Results highlight the value of prospectively collected data and the availability of biomarkers in studies of life course determinants of health in midlife and later.
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Affiliation(s)
- Maria Sironi
- Department of Social Science, University College London, 55-59 Gordon Square, London, WC1H 0NU United Kingdom
| | - George B. Ploubidis
- Department of Social Science, University College London, 55-59 Gordon Square, London, WC1H 0NU United Kingdom
- UCL Center for Longitudinal Studies, University College London, 55-59 Gordon Square, London, WC1H 0NU United Kingdom
| | - Emily M. Grundy
- Institute for Social & Economic Research, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ United Kingdom
- Centre for Fertility and Health, Norwegian Institute for Public Health, Lovisenberggata 8, 0456 Oslo, Norway
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22
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Coelho-Júnior HJ, Calvani R, Picca A, Gonçalves IO, Landi F, Bernabei R, Cesari M, Uchida MC, Marzetti E. Protein-Related Dietary Parameters and Frailty Status in Older Community-Dwellers across Different Frailty Instruments. Nutrients 2020; 12:nu12020508. [PMID: 32079345 PMCID: PMC7071300 DOI: 10.3390/nu12020508] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/12/2020] [Accepted: 02/12/2020] [Indexed: 12/22/2022] Open
Abstract
The present study investigated the associations between frailty status and (a) daily protein intake, (b) daily body weight-adjusted protein intake, (c) branched-chain amino acid (BCAA) consumption, (d) evenness of protein distribution across main meals, (e) number of daily meals providing at least 30 g of protein, and (f) number of daily meals providing at least 0.4 g protein/kg of body weight in community-dwelling older adults. The relationship between frailty status and protein-related dietary parameters was explored across different frailty assessment tools. Two hundred older adults were enrolled in the study. Participant frailty status was determined according to a modified Fried’s frailty phenotype (mFP), the FRAIL scale, and the Study of Osteoporotic Fracture (SOF) index. Diet was assessed by 24-h dietary recall, while diet composition was estimated using a nutritional software. A frailty instrument-dependent relationship was observed between frailty status and protein-related dietary parameters. Protein consumption was associated with frailty status only in participants identified as frail according to the mFP. In addition, protein and BCAA intake was found to be greater in robust and pre-frail participants relative to their frail counterparts. Our findings suggest that the association between frailty and protein-related dietary parameters is tool dependent. Specifically, protein and BCAA consumption appears to be lower only in older adults identified as frail by the mFP.
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Affiliation(s)
- Hélio J. Coelho-Júnior
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (R.C.); (F.L.)
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, 083-851 Campinas-SP, Brazil;
- Mãe Mariana Nursing Home, Rehabilitation unit, 08562-460 Poá-SP, Brazil
- Correspondence: (H.J.C.-J.); (E.M.); Tel.: +39-06-3015-5559 (H.J.C.-J.)
| | - Riccardo Calvani
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (R.C.); (F.L.)
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
| | - Anna Picca
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (R.C.); (F.L.)
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
| | - Ivan O. Gonçalves
- Center of Health Sciences, University of Mogi das Cruzes, 08780-911 Mogi das Cruzes, Brazil;
| | - Francesco Landi
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (R.C.); (F.L.)
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
| | - Roberto Bernabei
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (R.C.); (F.L.)
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, Università di Milano, 20133 Milan, Italy
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Marco C. Uchida
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, 083-851 Campinas-SP, Brazil;
| | - Emanuele Marzetti
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (R.C.); (F.L.)
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
- Correspondence: (H.J.C.-J.); (E.M.); Tel.: +39-06-3015-5559 (H.J.C.-J.)
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23
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Graham SA, Jeste DV, Lee EE, Wu TC, Tu X, Kim HC, Depp CA. Associations Between Heart Rate Variability Measured With a Wrist-Worn Sensor and Older Adults' Physical Function: Observational Study. JMIR Mhealth Uhealth 2019; 7:e13757. [PMID: 31647469 PMCID: PMC6913722 DOI: 10.2196/13757] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 07/16/2019] [Accepted: 08/19/2019] [Indexed: 02/06/2023] Open
Abstract
Background Heart rate variability (HRV), or variation in beat-to-beat intervals of the heart, is a quantitative measure of autonomic regulation of the cardiovascular system. Low HRV derived from electrocardiogram (ECG) recordings is reported to be related to physical frailty in older adults. Recent advances in wearable technology offer opportunities to more easily integrate monitoring of HRV into regular clinical geriatric health assessments. However, signals obtained from ECG versus wearable photoplethysmography (PPG) devices are different, and a critical first step preceding their widespread use is to determine whether HRV metrics derived from PPG devices also relate to older adults’ physical function. Objective This study aimed to investigate associations between HRV measured with a wrist-worn PPG device, the Empatica E4 sensor, and validated clinical measures of both objective and self-reported physical function in a cohort of older adults living independently within a continuing care senior housing community. Our primary hypothesis was that lower HRV would be associated with lower physical function. In addition, we expected that HRV would explain a significant proportion of variance in measures of physical health status. Methods We evaluated 77 participants from an ongoing study of older adults aged between 65 and 95 years. The assessments encompassed a thorough examination of domains typically included in a geriatric health evaluation. We collected HRV data with the Empatica E4 device and examined bivariate correlations between HRV quantified with the triangular index (HRV TI) and 3 widely used and validated measures of physical functioning—the Short Physical Performance Battery (SPPB), Timed Up and Go (TUG), and Medical Outcomes Study Short Form 36 (SF-36) physical composite scores. We further investigated the additional predictive power of HRV TI on physical health status, as characterized by SF-36 physical composite scores and Cumulative Illness Rating Scale for Geriatrics (CIRS-G) scores, using generalized estimating equation regression analyses with backward elimination. Results We observed significant associations of HRV TI with SPPB (n=52; Spearman ρ=0.41; P=.003), TUG (n=51; ρ=−0.40; P=.004), SF-36 physical composite scores (n=49; ρ=0.37; P=.009), and CIRS-G scores (n=52, ρ=−0.43; P=.001). In addition, the HRV TI explained a significant proportion of variance in SF-36 physical composite scores (R2=0.28 vs 0.11 without HRV) and CIRS-G scores (R2=0.33 vs 0.17 without HRV). Conclusions The HRV TI measured with a relatively novel wrist-worn PPG device was related to both objective (SPPB and TUG) and self-reported (SF-36 physical composite) measures of physical function.
In addition, the HRV TI explained additional variance in self-reported physical function and cumulative illness severity beyond traditionally measured aspects of physical health. Future steps include longitudinal tracking of changes in both HRV and physical function, which will add important insights regarding the predictive value of HRV as a biomarker of physical health in older adults.
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Affiliation(s)
- Sarah Anne Graham
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Dilip V Jeste
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Department of Neurosciences, University of California San Diego, La Jolla, CA, United States
| | - Ellen E Lee
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Tsung-Chin Wu
- Department of Mathematics, University of California San Diego, La Jolla, CA, United States
| | - Xin Tu
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Ho-Cheol Kim
- Scalable Knowledge Intelligence, IBM Research - Almaden, San Jose, CA, United States
| | - Colin A Depp
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,VA San Diego Healthcare System, San Diego, CA, United States
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Carlier IVE, van Eeden WA, de Jong K, Giltay EJ, van Noorden MS, van der Feltz-Cornelis C, Zitman FG, Kelderman H, van Hemert AM. Testing for response shift in treatment evaluation of change in self-reported psychopathology amongst secondary psychiatric care outpatients. Int J Methods Psychiatr Res 2019; 28:e1785. [PMID: 31206911 PMCID: PMC6852603 DOI: 10.1002/mpr.1785] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 03/18/2019] [Accepted: 04/01/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES If patients change their perspective due to treatment, this may alter the way they conceptualize, prioritize, or calibrate questionnaire items. These psychological changes, also called "response shifts," may pose a threat to the measurement of therapeutic change in patients. Therefore, it is important to test the occurrence of response shift in patients across their treatment. METHODS This study focused on self-reported psychological distress/psychopathology in a naturalistic sample of 206 psychiatric outpatients. Longitudinal measurement invariance tests were computed across treatment in order to detect response shifts. RESULTS Compared with before treatment, post-treatment psychopathology scores showed an increase in model fit and factor loading, suggesting that symptoms became more coherently interrelated within their psychopathology domains. Reconceptualization (depression/mood) and reprioritization (somatic and cognitive problems) response shift types were found in several items. We found no recalibration response shift. CONCLUSION This study provides further evidence that response shift can occur in adult psychiatric patients across their mental health treatment. Future research is needed to determine whether response shift implies an unwanted potential bias in treatment evaluation or a desired cognitive change intended by treatment.
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Affiliation(s)
- Ingrid V E Carlier
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | - Wessel A van Eeden
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | - Kim de Jong
- Clinical Psychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | | | | | - Frans G Zitman
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | - Henk Kelderman
- Department of Methodology and Statistics, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Albert M van Hemert
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
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Lawrence BJ, Jayakody DMP, Bennett RJ, Eikelboom RH, Gasson N, Friedland PL. Hearing Loss and Depression in Older Adults: A Systematic Review and Meta-analysis. THE GERONTOLOGIST 2019; 60:e137-e154. [DOI: 10.1093/geront/gnz009] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Indexed: 12/31/2022] Open
Abstract
AbstractBackground and ObjectivesStudies reporting an association between hearing loss and depression in older adults are conflicting and warrant a systematic review and meta-analysis of the evidence.Research Design and MethodsA search of academic databases (e.g., MEDLINE) and gray literature (e.g., OpenGrey) identified relevant articles published up to July 17, 2018. Cross-sectional or cohort designs were included. Outcome effects were computed as odds ratios (ORs) and pooled using random-effects meta-analysis (PROSPERO: CRD42018084494).ResultsA total of 147,148 participants from 35 studies met inclusion criteria. Twenty-four studies were cross-sectional and 11 were cohort designs. Overall, hearing loss was associated with statistically significantly greater odds of depression in older adults (OR = 1.47, 95% confidence interval [CI] = 1.31−1.65). When studies were stratified by design, hearing loss was associated with greater odds of depression in cross-sectional studies (OR = 1.54, 95% CI = 1.31−1.80) and cohort studies (OR = 1.39, 95% CI = 1.16 − 1.67), and there was no difference between cross-sectional or cohort effect estimates (Q = 0.64, p = .42). There was no effect of moderator variables (i.e., hearing aid use) on the association between hearing loss and depression, but these findings must be interpreted with caution. There was no presence of publication bias but certainty in the estimation of the overall effect was classified as “low.”Discussion and ImplicationsOlder adults may experience increased odds of depression associated with hearing loss, and this association may not be influenced by study or participant characteristics.
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Affiliation(s)
- Blake J Lawrence
- Ear Science Institute Australia, Subiaco, Western Australia, Crawley, Australia
- Ear Sciences Centre, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
| | - Dona M P Jayakody
- Ear Science Institute Australia, Subiaco, Western Australia, Crawley, Australia
- Ear Sciences Centre, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
| | - Rebecca J Bennett
- Ear Science Institute Australia, Subiaco, Western Australia, Crawley, Australia
- Ear Sciences Centre, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
| | - Robert H Eikelboom
- Ear Science Institute Australia, Subiaco, Western Australia, Crawley, Australia
- Ear Sciences Centre, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - Natalie Gasson
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Bentley, Western Australia
| | - Peter L Friedland
- Ear Science Institute Australia, Subiaco, Western Australia, Crawley, Australia
- Ear Sciences Centre, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
- Department of Otolaryngology Head Neck Skull Based Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Medicine, Notre Dame University, Fremantle, Western Australia, Australia
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Using structural equation modeling to detect response shift in quality of life in patients with Alzheimer's disease. Int Psychogeriatr 2019; 31:123-132. [PMID: 29720293 DOI: 10.1017/s1041610218000595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
UNLABELLED ABSTRACTBackground:Our study aims to detect different types of response shifts (RS) and true changes of quality of life (QOL) measurement in patients with Alzheimer's disease (AD) using structural equation modeling (SEM) in domain level. METHODS Patients with AD aged over 60 years old were collected from the Department of Neurology and Geriatrics in Taiyuan Central Hospital, China. The 12-item Short Form (SF-12) Health Survey was measured in 238 patients with AD prior to hospitalization and one month following discharge. RS was detected by SEM approach. The statistical process consisted of four steps and fitted four models. We interpreted changes of parameters in models to detect RS and to assess true change. RESULTS The results showed reprioritization of social functioning (SF) (χ2 = 4.13, p < 0.05), reconceptualization of role limitations due to emotional problems (RE) (χ2 = 17.03, p < 0.001), uniform recalibration of bodily pain (BP) (χ2 = 12.24, p < 0.001), and non-uniform recalibration of mental health (MH) (χ2 = 4.41, p < 0.05), respectively. The true changes of common factors were deteriorated in general physical health (PHYS) (-0.10, χ2 = 8.30, p < 0.005) and improved in general mental health (MENT) (+0.29, χ2 = 20.95, p < 0.001). The effect-sizes of RS were only small. CONCLUSION This study showed that patients with AD occurred three types of RS and true changes one month following discharge. RS had effects on the QOL of patients. Better understanding of potential changes in QOL in patients with AD is crucial.
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Leysen L, Adriaenssens N, Nijs J, Pas R, Bilterys T, Vermeir S, Lahousse A, Beckwée D. Chronic Pain in Breast Cancer Survivors: Nociceptive, Neuropathic, or Central Sensitization Pain? Pain Pract 2018; 19:183-195. [DOI: 10.1111/papr.12732] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 07/07/2018] [Accepted: 07/29/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Laurence Leysen
- Pain in Motion International Research Group; Brussels Belgium
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
| | - Nele Adriaenssens
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
- Department of Oncology; University Hospital Brussels; Brussels Belgium
| | - Jo Nijs
- Pain in Motion International Research Group; Brussels Belgium
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
- Department of Physical Medicine and Physiotherapy; University Hospital Brussels; Brussels Belgium
| | - Roselien Pas
- Pain in Motion International Research Group; Brussels Belgium
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
| | - Thomas Bilterys
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
| | - Sofie Vermeir
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
| | - Astrid Lahousse
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
| | - David Beckwée
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
- Frailty in Ageing Research Department; Vrije Universiteit Brussel; Brussels Belgium
- Department of Rehabilitation Sciences and Physiotherapy; Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp Belgium
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Garcia MA, Reyes AM. Physical Functioning and Disability Trajectories by Age of Migration Among Mexican Elders in the United States. J Gerontol B Psychol Sci Soc Sci 2018. [PMID: 28052929 DOI: 10.1093/geronb/gbw167.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives To address a gap in our understanding of the long-term consequences of nativity and age of migration for the health of the Mexican elderly population. Method We employ age graded latent growth curve models stratified by gender to examine the extent of physical functioning and disability, measured in terms of performance-oriented mobility assessments (POMAs) and activities of daily living (ADLs) after age 65 in a large longitudinal sample of Mexican-origin individuals. Results Self-care measured ADLs show no age of migration differences. However, physical capacity measured POMAs differ significantly for men and women by age of migration. Migrants who arrived in midlife have fewer functional limitations at age 65 but have steeper increase in POMAs with age. Discussion With a rapidly changing demographic profile that includes a large number of aging Mexican-origin immigrants, our society must implement social and health policies to ameliorate the negative health outcomes among immigrant and U.S.-born minority groups.
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Affiliation(s)
- Marc A Garcia
- Sealy Center on Aging, University of Texas Medical Branch, Galveston
| | - Adriana M Reyes
- Population Studies Center, University of Michigan, Ann Arbor
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Garcia MA, Reyes AM. Physical Functioning and Disability Trajectories by Age of Migration Among Mexican Elders in the United States. J Gerontol B Psychol Sci Soc Sci 2018; 73:1292-1302. [PMID: 28052929 PMCID: PMC6146757 DOI: 10.1093/geronb/gbw167] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 11/28/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives To address a gap in our understanding of the long-term consequences of nativity and age of migration for the health of the Mexican elderly population. Method We employ age graded latent growth curve models stratified by gender to examine the extent of physical functioning and disability, measured in terms of performance-oriented mobility assessments (POMAs) and activities of daily living (ADLs) after age 65 in a large longitudinal sample of Mexican-origin individuals. Results Self-care measured ADLs show no age of migration differences. However, physical capacity measured POMAs differ significantly for men and women by age of migration. Migrants who arrived in midlife have fewer functional limitations at age 65 but have steeper increase in POMAs with age. Discussion With a rapidly changing demographic profile that includes a large number of aging Mexican-origin immigrants, our society must implement social and health policies to ameliorate the negative health outcomes among immigrant and U.S.-born minority groups.
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Affiliation(s)
- Marc A Garcia
- Sealy Center on Aging, University of Texas Medical Branch, Galveston
| | - Adriana M Reyes
- Population Studies Center, University of Michigan, Ann Arbor
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Effects of physical exercise in older adults with reduced physical capacity: meta-analysis of resistance exercise and multimodal exercise. Int J Rehabil Res 2018; 40:303-314. [PMID: 29023317 DOI: 10.1097/mrr.0000000000000249] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Older adults with reduced physical capacity are at greater risk of progression to care dependency. Progressive resistance strength exercise and multimodal exercise have been studied to restore reduced physical capacity. To summarize the best evidence of the two exercise regimes, this meta-analysis study appraised randomized-controlled trials from published systematic reviews. Medline, Embase, and the Cochrane Database of Systematic Review and Cochrane Central Register of Controlled Clinical Trials were searched for relevant systematic reviews. Two reviewers independently screened the relevant systematic reviews to identify eligible trials, assessed trial methodological quality, and extracted data. RevMan 5.3 software was used to analyze data on muscle strength, physical functioning, activities of daily living, and falls. Twenty-three eligible trials were identified from 22 systematic reviews. The mean age of the trial participants was 75 years or older. Almost all multimodal exercise trials included muscle strengthening exercise and balance exercise. Progressive resistance exercise is effective in improving muscle strength of the lower extremity and static standing balance. Multimodal exercise is effective in improving muscle strength of the lower extremity, dynamic standing balance, gait speed, and chair stand. In addition, multimodal exercise is effective in reducing falls. Neither type of exercise was effective in improving activities of daily living. For older adults with reduced physical capacity, multimodal exercise appears to have a broad effect on improving muscle strength, balance, and physical functioning of the lower extremity, and reducing falls relative to progressive resistance exercise alone.
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Gwinnutt JM, Sharp CA, Symmons DPM, Lunt M, Verstappen SMM. Baseline patient reported outcomes are more consistent predictors of long-term functional disability than laboratory, imaging or joint count data in patients with early inflammatory arthritis: A systematic review. Semin Arthritis Rheum 2018; 48:384-398. [PMID: 29680162 PMCID: PMC6562164 DOI: 10.1016/j.semarthrit.2018.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 02/19/2018] [Accepted: 03/13/2018] [Indexed: 12/27/2022]
Abstract
Objective To assess baseline predictors of long-term functional disability in patients with inflammatory arthritis (IA). Methods We conducted a systematic review of the literature from 1990 to 2017 using MEDLINE and EMBASE. Studies were included if (i) they were prospective observational studies, (ii) all patients had IA with symptom duration ≤2 years at baseline, (iii) follow-up was at least 5 years, and (iv) baseline predictors of HAQ score at long-term follow-up (i.e., ≥5 years following baseline) were assessed. Information on the included studies and estimates of the association between baseline variables and long-term HAQ scores were extracted from the full manuscripts. Results Of 1037 abstracts identified by the search strategy, 37 met the inclusion/exclusion criteria and were included in the review. Older age at baseline and female gender were reported to be associated with higher long-term HAQ scores in the majority of studies assessing these relationships, as were higher baseline HAQ and greater pain scores (total patients included in analyses reporting significant associations/total number of patients analysed: age 9.8k/10.7k (91.6%); gender 9.9k/11.3k (87.4%); HAQ 4.0k/4.0k (99.0%); pain 2.8k/2.9k (93.6%)). Tender joint count, erythrocyte sedimentation rate (ESR) and DAS28 were also reported to predict long-term HAQ score; other disease activity measures were less consistent (tender joints 2.1k/2.5k (84.5%); erythrocyte sedimentation rate 1.6k/2.2k (72.3%); DAS28 888/1.1k (79.2%); swollen joints 684/2.6k (26.6%); C-reactive protein 279/510 (54.7%)). Rheumatoid factor (RF) and erosions were not useful predictors (RF 546/4.6k (11.9%); erosions 191/2.7k (7.0%)), whereas the results for anti-citrullinated protein antibody positivity were equivocal (ACPA 2.0k/3.8k (52.9%)). Conclusions Baseline age, gender, HAQ and pain scores are associated with long-term disability and knowledge of these may aid the assessment of prognosis.
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Affiliation(s)
- James M Gwinnutt
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Charlotte A Sharp
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Greater Manchester, Greater Manchester, Alliance Manchester Business School, The University of Manchester, UK
| | - Deborah P M Symmons
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Mark Lunt
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Suzanne M M Verstappen
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, UK.
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Kumar S, Ichhpujani P, Singh R, Thakur S, Sharma M, Nagpal N. The impact of primary open-angle glaucoma: Quality of life in Indian patients. Indian J Ophthalmol 2018; 66:416-419. [PMID: 29480254 PMCID: PMC5859598 DOI: 10.4103/ijo.ijo_847_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose: Glaucoma significantly affects the quality of life (QoL) of a patient. Despite the huge number of glaucoma patients in India, not many, QoL studies have been carried out. The purpose of the present study was to evaluate the QoL in Indian patients with varying severity of glaucoma. Methods: This was a hospital-based, cross-sectional, analytical study of 180 patients. The QoL was assessed using orally administered QoL instruments comprising of two glaucoma-specific instruments; Glaucoma Quality of Life-15 (GQL-15) and Viswanathan 10 instrument, and 1 vision-specific instrument; National Eye Institute Visual Function Questionnaire-25 (NEIVFQ25). Results: Using NEIVFQ25, the difference between mean QoL scores among cases (88.34 ± 4.53) and controls (95.32 ± 5.76) was statistically significant. In GQL-15, there was a statistically significant difference between mean scores of cases (22.58 ± 5.23) and controls (16.52 ± 1.24). The difference in mean scores with Viswanathan 10 instrument in cases (7.92 ± 0.54) and controls (9.475 ± 0.505) was also statistically significant. QoL scores also showed moderate correlation with mean deviation, pattern standard deviation, and vertical cup-disc ratio. Conclusion: In our study, all the three instruments showed decrease in QoL in glaucoma patients compared to controls. With the increase in severity of glaucoma, corresponding decrease in QoL was observed. It is important for ophthalmologists to understand about the QoL in glaucoma patients so as to have a more holistic approach to patients and for effective delivery of treatment.
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Affiliation(s)
- Suresh Kumar
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Parul Ichhpujani
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Roopali Singh
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Sahil Thakur
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Madhu Sharma
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Nimisha Nagpal
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
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Jin Y, Tanaka T, Ma Y, Bandinelli S, Ferrucci L, Talegawkar SA. Cardiovascular Health Is Associated With Physical Function Among Older Community Dwelling Men and Women. J Gerontol A Biol Sci Med Sci 2017; 72:1710-1716. [PMID: 28184412 PMCID: PMC5861882 DOI: 10.1093/gerona/glw329] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 01/06/2017] [Indexed: 01/08/2023] Open
Abstract
Background Age related decline in physical function is a significant concern affecting the quality of life of older individuals. Methods We examined the associations between baseline overall cardiovascular health (CVH), its components, and physical function in 906 men and women from the InCHIANTI cohort. Physical function was assessed using the Short Performance Physical Battery and poor physical function was defined as an Short Performance Physical Battery score less than 10. Overall CVH score, ranging from 0 to 12 in the cohort, was operationalized using adherence to ideal levels for health behaviors including smoking status, physical activity, body mass index, and diet quality; and health factors including blood pressure, plasma cholesterol, fasting blood glucose, with higher scores indicating better CVH. Results Mean age at baseline was 74 (SD = 6.7) years and 55% were women. At baseline and over 9 years, as compared to the lowest tertile of overall CVH score, the highest tertile was associated with a 69% (p < .001) and 63% (p < .001), respectively, lower risk of poor physical function. Among the CVH components, adherence to ideal levels of health behaviors was more strongly and consistently associated with lower odds of poor physical function than health factors. Conclusions Better overall CVH was protective against poor physical function in community-dwelling men and women aged 65 years and older. Improving CVH may be instrumental in the prevention of poor physical function in older adults.
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Affiliation(s)
- Yichen Jin
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, District of Columbia
| | - Toshiko Tanaka
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland
| | - Yan Ma
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, District of Columbia
| | | | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland
| | - Sameera A Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, District of Columbia.,Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, District of Columbia.,Sumner M. Redstone Global Center for Prevention and Wellness at the George Washington University, District of Columbia
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Wilkinson TJ, Lemmey AB, Clayton RJ, Jones JG, O'Brien TD. The 8-foot up and go test is the best way to assess physical function in the rheumatoid arthritis clinic. Rheumatol Adv Pract 2017; 2:rkx017. [PMID: 31431948 PMCID: PMC6649989 DOI: 10.1093/rap/rkx017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 08/01/2017] [Indexed: 12/24/2022] Open
Abstract
Objectives RA is characterized by poor physical function, which compromises patients’ quality of life and outcome. Clinical assessment of function is usually performed using self-reported questionnaires, such as the Multi-Dimensional HAQ (MDHAQ) and the Short Form-36 (physical component) (SF36-PC). However, such subjective measures may not accurately reflect real functional status. This study aimed to determine: (i) which clinically practicable objective test best represents overall physical function; and (ii) the extent to which self-reported subjective functional measures reflect objectively assessed function. Methods Objective [isometric knee extensor strength, handgrip strength, sit-to-stands in 30 s, 8-foot up and go (8′UG), 50-foot walk (50′W) and estimated aerobic capacity (V̇O2max)] and subjective (MDHAQ and SF36-PC) measures of function were correlated with one another to determine the best overall test of functional status in 82 well-controlled RA patients (DAS28 (s.d.) = 2.8 (1.0)). Results In rank order of size, averaged correlations (r) to the other outcome measures were as follows: 8′UG: 0.650; 50′W: 0.636; isometric knee extensor strength: 0.502; handgrip strength: 0.449; sit-to-stands in 30 s: 0.432; and estimated V̇O2max: 0.358. The MDHAQ was weakly (0.361) and the SF36-PC moderately correlated (0.415) with objective measures. Conclusion Our results show that the most appropriate measure of objective physical function in RA patients is the 8′UG, followed by the 50′W. We found discordance between objectively and subjectively measured function. In clinical practice, an objective measure that is simple and quick to perform, such as the 8′UG, is advocated for assessing real functional status.
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Affiliation(s)
- Thomas J Wilkinson
- Rehabilitation of Musculoskeletal Disorders with Exercise Sciences (ReMeDES) group, School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK.,Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Andrew B Lemmey
- Rehabilitation of Musculoskeletal Disorders with Exercise Sciences (ReMeDES) group, School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK
| | - Rebecca J Clayton
- Rehabilitation of Musculoskeletal Disorders with Exercise Sciences (ReMeDES) group, School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK
| | - Jeremy G Jones
- Rehabilitation of Musculoskeletal Disorders with Exercise Sciences (ReMeDES) group, School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK.,Peter Maddison Rheumatology Centre, Betsi Cadwaladr University Health Board, Llandudno Hospital, Llandudno, UK
| | - Thomas D O'Brien
- Research Institute for Sport & Exercise Sciences, Liverpool John Moore's University, Liverpool, UK
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Cubí-Mollá P, Jofre-Bonet M, Serra-Sastre V. Adaptation to health states: Sick yet better off? HEALTH ECONOMICS 2017; 26:1826-1843. [PMID: 28425680 DOI: 10.1002/hec.3509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 09/12/2016] [Accepted: 02/21/2017] [Indexed: 05/05/2023]
Abstract
Healthcare funding decisions in the UK rely on health state valuations of the general public. However, it has been shown that there is disparity between the valuation of the impact of hypothetical conditions on health and the reported health by those experiencing them. Patients' adaptation to health states is among the most common explanations for this discrepancy. Being diagnosed with a disease appears to affect individual perception of health over time so that better subjective health may be reported over a disease trajectory. This paper examines adaptation to health states using a longitudinal dataset. We use four waves of the British Cohort Study (BCS70), which tracks a sample of British individuals since birth in 1970 and contains information on self-assessed health (SAH), morbidity, and socioeconomic characteristics. We implement a dynamic ordered probit model controlling for health state dependence. Results are supportive of the existence of adaptation: Time since diagnosis has a positive impact on SAH. Moreover, adaptation happens over relatively long durations. We do not find significant results proving different adaptation paths for patients reporting prior better SAH. The analysis by specific conditions generally supports the existence of adaptation, but results are statistically significant only for a subset of conditions.
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Rebouças M, Coelho-Filho JM, Veras RP, Lima-Costa MF, Ramos LR. Validity of questions about activities of daily living to screen for dependency in older adults. Rev Saude Publica 2017; 51:84. [PMID: 28876414 PMCID: PMC5574464 DOI: 10.11606/s1518-8787.2017051006959] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 08/23/2016] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To determine the criterion validity of the activities of daily living present in functionality questionnaires in older adults for population surveys and to identify which activities are valid to quantify the real daily need for help of this population. METHODS This is a population sample of older adults stratified by levels of functionality, according to self-perception of dependency in the activities of daily living. Self-perception was compared with the gold standard – direct observation of these activities in the household of older adults by a trained professional, blinded to the answers in the questionnaire. At the visit, it was decided if the older adult needed help to perform any of the activities of daily living for the research. The sensitivity of each activity of daily living was greater when the self-assessment that there was no need for help coincided with the assessment of the professional. Specificity indicates coincidence regarding the need for help in the activities of daily living – coefficients of sensitivity and specificity above 70% were considered as indicative of good validity. RESULTS Self-assessments showed better sensitivity than specificity – older adults and observers agreed more on daily independency than on dependency. All activities showed sensitivity above 70%. Some activities had low (go shopping: 55%) or very low specificity (brush the hair: 33%). The best specificities were to take a shower and dress up (95.8% for both), among the personal ones, and to use transportation and perform banking transactions (78% for both), among the instrumental ones. CONCLUSIONS Activities of daily living can be valid indicators of functional dependence. The best coefficients of validity were generally obtained for personal activities. Some activities with good sensitivities and specificities – walk 100 meters, take a shower, and lie down in and get out of the bed – can be used to classify older adults into low, average, and high need for help depending on the affected activities and, therefore, can help in the planning of health services aimed at them.
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Affiliation(s)
- Monica Rebouças
- Programa de Pós-Graduação em Saúde Coletiva. Escola Paulista de Medicina. Universidade Federal de São Paulo. São Paulo, SP, Brasil
| | - João Macedo Coelho-Filho
- Departamento de Medicina Clínica. Faculdade de Medicina. Universidade Federal do Ceará. Fortaleza, CE, Brasil
| | - Renato Peixoto Veras
- Universidade Aberta da Terceira Idade. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
| | - Maria Fernanda Lima-Costa
- Centro de Pesquisa René Rachou. Fundação Oswaldo Cruz. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brasil
| | - Luiz Roberto Ramos
- Departamento de Medicina Preventiva. Escola Paulista de Medicina. Universidade Federal de São Paulo. São Paulo, SP, Brasil
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Norrefalk JR, Borg K. The Functional Barometer - An analysis of a self-assessment questionnaire with ICF-coding regarding functional/activity limitations and quality of life due to pain - Differences in age gender and origin of pain. Scand J Pain 2017; 17:16-21. [PMID: 28850368 DOI: 10.1016/j.sjpain.2017.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/11/2017] [Indexed: 11/18/2022]
Abstract
Long standing non-malignant pain leads to a variety of limitations which can be assessed by means of the self-assessment questionnaire Functional Barometer. It is designed to assess the extent and limitations in function, activity and decreased quality-of-life and is adapted to the International Classification of Functioning and Health. AIM To investigate the outcome and differences in age, gender and origin of pain in patients with long-standing non-malignant pain regarding the subjective experience of functional-, activity- and quality-of-life limitations. METHOD 300 patients with a median duration of pain of 49 months referred to a Pain Management Centre filled out the Functional Barometer questionnaire, adapted to the International Classification of Functioning and Health. RESULTS 66% patients were women and 34% were men. Seventy-five percent were in working age, 18-64 years. The duration before being referred to a pain specialist was over 4 years and 65% reported pain from more than three origins. Significant differences in functioning, activity and quality-of-life were found in comparing gender, age and origin of pain. Men more often reported physiological limitations while women more often reported psychological limitations of functioning, activity and quality-of-life. The most important were that men more often had difficulties in walking and climbing stairs, while women reported problems with concentration, stress and psychological demands, family relations and contact with friends. CONCLUSION The significant differences regarding functioning, activity and quality-of-life between women and men as age and origin of pain must be taken into account when tailoring individual treatment and rehabilitation programmes.
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Affiliation(s)
- Jan-Rickard Norrefalk
- Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
| | - Kristian Borg
- Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
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Figueiredo S, Morais JA, Mayo N. Managing mobility outcomes in vulnerable seniors ( MMOVeS): a randomized controlled pilot study. Clin Rehabil 2017; 31:1604-1615. [PMID: 28459155 DOI: 10.1177/0269215517705941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To estimate feasibility and potential for efficacy of an individualized, exercise-focused, self-management program (i.e. Managing Mobility Outcomes In Vulnerable Seniors ( MMOVeS)), in comparison to exercise information in improving mobility after six months among seniors recently discharged from hospital. DESIGN Randomized pilot study. SETTING Two McGill University-teaching hospitals. SUBJECTS Community dwelling seniors, aged 70 years and older, recently discharged from either participating hospitals. INTERVENTIONS The physiotherapy-facilitated intervention consisted of (1) evaluation of mobility capacity, (2) setting short- and long-term goals, (3) delineation of an exercise treatment plan, (4) an educational booklet to enhance mobility self-management skills, and (5) six monthly telephone calls. Control group received a booklet with information on exercises targeting mobility limitations in seniors. MAIN MEASURES Mobility, pain, and health status were assessed at baseline and at six months using multiple indicators drawn from Disabilities of the Arm, Shoulder, and Hand (DASH) Score, Lower Extremity Functional Scale (LEFS) and Short-Form (SF)-36. RESULTS In all, 26 people were randomized to the intervention (mean age: 81 ± 8; 39% women), and 23 were randomized to the control (mean age: 79 ± 7; 33% women). The odds ratio for the mobility outcomes combined was 3.08 and the 95% confidence interval excluded 1 (1.65-5.77). The odds ratio for pain and health perception favored the MMOVeS group, but the 95% confidence interval included the null value. CONCLUSIONS This feasibility study highlights the potential for efficacy of an individualized, exercise-focused, self-management program in comparison to exercise information in improving mobility outcome for seniors. Furthermore, a home-program combining self-management skills and exercise taught with minimal supervision prove to be feasible. Finally, data from this study can be used to estimate sample size for a confirmatory trial.
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Affiliation(s)
- Sabrina Figueiredo
- 1 School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Jose A Morais
- 2 Division of Geriatric Medicine, McGill University Health Center, Montreal General Hospital, Montreal, QC, Canada
| | - Nancy Mayo
- 1 School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada.,2 Division of Geriatric Medicine, McGill University Health Center, Montreal General Hospital, Montreal, QC, Canada.,3 Division of Clinical Epidemiology, McGill University Health Center, Royal Victoria Hospital, Montreal, QC, Canada
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Schneider S, Stone AA. The meaning of vaguely quantified frequency response options on a quality of life scale depends on respondents' medical status and age. Qual Life Res 2016; 25:2511-2521. [PMID: 27071685 PMCID: PMC5345903 DOI: 10.1007/s11136-016-1293-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE Self-report items in quality of life (QoL) scales commonly use vague quantifiers like "sometimes" or "often" to measure the frequency of health-related experiences. This study examined whether the meaning of such vaguely quantified response options differs depending on people's medical status and age, which may undermine the validity of QoL group comparisons. METHODS Respondents (n = 600) rated the frequency of positive and negative QoL experiences using vague quantifiers (never, rarely, sometimes, often, always) and provided open-ended numeric frequency counts for the same items. Negative binomial regression analyses examined whether the numeric frequencies associated with each vague quantifier differed between medical status (no vs. one or more medical conditions) and age (18-40 vs. 60+ years) groups. RESULTS Compared to respondents without a chronic condition, those with a medical condition assigned a higher numeric frequency to the same vague quantifiers for negative QoL experiences; this effect was not evident for positive QoL experiences. Older respondents' numeric frequencies were more extreme (i.e., lower at the low end and somewhat higher at the high end of the response range) than those of younger respondents. After adjusting for these effects, differences in QoL became somewhat more pronounced between medical status groups, but not between age groups. CONCLUSIONS The results suggest that people with different medical backgrounds and age do not interpret vague frequency quantifiers on a QoL scale in the same way. Open-ended numeric frequency reports may be useful to detect and potentially correct for differences in the meaning of vague quantifiers.
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Affiliation(s)
- Stefan Schneider
- Dornsife Center for Self-Report Science, Center for Economic and Social Research, University of Southern California, 635 Downey Way, Los Angeles, CA, 90089-3332, USA.
| | - Arthur A Stone
- Dornsife Center for Self-Report Science, Center for Economic and Social Research, University of Southern California, 635 Downey Way, Los Angeles, CA, 90089-3332, USA
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Haas R, Bowles KA, O'Brien L, Haines T. Patient and Therapist Agreement on Performance-Rated Ability Using the de Morton Mobility Index. Arch Phys Med Rehabil 2016; 97:2157-2165. [PMID: 27485364 DOI: 10.1016/j.apmr.2016.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 07/07/2016] [Accepted: 07/07/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the level of agreement between patient self-report and therapist-assessed performance of mobility using the de Morton Mobility Index (DEMMI). DESIGN Interrater agreement study. SETTING Outpatient hospital clinic. PARTICIPANTS Consecutive sample of patients (N=128) undergoing preoperative assessment for elective lower limb (LL) arthroplasty. INTERVENTIONS Participants completed a therapist-directed assessment of the DEMMI followed by self-report of performance. A random subsample (n=62, 48%) also completed a self-report of anticipated performance before the therapist-directed assessment. Both raters (participant and therapist) were blinded to the scores obtained from the other rater. MAIN OUTCOME MEASURES Interrater agreement between patient self-report and therapist-directed assessment of the total DEMMI scores was assessed using the intraclass correlation coefficient model 2,1 (ICC2,1) with a 95% confidence interval. The Bland-Altman plots were also used to illustrate the agreement between the 2 raters. RESULTS The intraclass correlation coefficient (ICC) between patient self-report after performance and therapist-directed assessment of the total DEMMI score was .967 (95% confidence interval, .952-.977). The ICC between patient self-report of anticipated performance and therapist-directed assessment of the total DEMMI score was .830 (95% confidence interval, .730-.894). The Bland-Altman plots depicted higher levels of agreement among participants with impaired levels of mobility (≤74 out of 100) than did those with near-maximum DEMMI scores. CONCLUSIONS Patient self-report of anticipated performance is an acceptable proxy for DEMMI scores derived from the therapist rating of performance. Caution should be exercised when interpreting self-report scores of patients with near-maximum levels of mobility. Further research is required to establish whether these results can be generalized across a range of patient populations and to clinicians with differing backgrounds and expertise.
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Affiliation(s)
- Romi Haas
- Department of Physiotherapy, School of Primary Health Care, Monash University, Frankston, Victoria, Australia; Monash Health Allied Health Research Unit, Cheltenham, Victoria, Australia.
| | - Kelly-Ann Bowles
- Department of Physiotherapy, School of Primary Health Care, Monash University, Frankston, Victoria, Australia; Monash Health Allied Health Research Unit, Cheltenham, Victoria, Australia
| | - Lisa O'Brien
- Monash Health Allied Health Research Unit, Cheltenham, Victoria, Australia; Department of Occupational Therapy, School of Primary Health Care, Monash University, Frankston, Victoria, Australia
| | - Terry Haines
- Department of Physiotherapy, School of Primary Health Care, Monash University, Frankston, Victoria, Australia; Monash Health Allied Health Research Unit, Cheltenham, Victoria, Australia
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McPhail SM. Multimorbidity in chronic disease: impact on health care resources and costs. Risk Manag Healthc Policy 2016; 9:143-56. [PMID: 27462182 PMCID: PMC4939994 DOI: 10.2147/rmhp.s97248] [Citation(s) in RCA: 271] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Effective and resource-efficient long-term management of multimorbidity is one of the greatest health-related challenges facing patients, health professionals, and society more broadly. The purpose of this review was to provide a synthesis of literature examining multimorbidity and resource utilization, including implications for cost-effectiveness estimates and resource allocation decision making. In summary, previous literature has reported substantially greater, near exponential, increases in health care costs and resource utilization when additional chronic comorbid conditions are present. Increased health care costs have been linked to elevated rates of primary care and specialist physician occasions of service, medication use, emergency department presentations, and hospital admissions (both frequency of admissions and bed days occupied). There is currently a paucity of cost-effectiveness information for chronic disease interventions originating from patient samples with multimorbidity. The scarcity of robust economic evaluations in the field represents a considerable challenge for resource allocation decision making intended to reduce the burden of multimorbidity in resource-constrained health care systems. Nonetheless, the few cost-effectiveness studies that are available provide valuable insight into the potential positive and cost-effective impact that interventions may have among patients with multiple comorbidities. These studies also highlight some of the pragmatic and methodological challenges underlying the conduct of economic evaluations among people who may have advanced age, frailty, and disadvantageous socioeconomic circumstances, and where long-term follow-up may be required to directly observe sustained and measurable health and quality of life benefits. Research in the field has indicated that the impact of multimorbidity on health care costs and resources will likely differ across health systems, regions, disease combinations, and person-specific factors (including social disadvantage and age), which represent important considerations for health service planning. Important priorities for research include economic evaluations of interventions, services, or health system approaches that can remediate the burden of multimorbidity in safe and cost-effective ways.
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Affiliation(s)
- Steven M McPhail
- Centre for Functioning and Health Research, Metro South Health; Institute of Health and Biomedical Innovation and School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
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Smith S, Madden AM. Body composition and functional assessment of nutritional status in adults: a narrative review of imaging, impedance, strength and functional techniques. J Hum Nutr Diet 2016; 29:714-732. [PMID: 27137882 DOI: 10.1111/jhn.12372] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The accurate and valid assessment of body composition is essential for the diagnostic evaluation of nutritional status, identifying relevant outcome measures, and determining the effectiveness of current and future nutritional interventions. Developments in technology and our understanding of the influences of body composition on risk and outcome will provide practitioners with new opportunities to enhance current practice and to lead future improvements in practice. This is the second of a two-part narrative review that aims to critically evaluate body composition methodology in diverse adult populations, with a primary focus on its use in the assessment and monitoring of under-nutrition. Part one focused on anthropometric variables [Madden and Smith (2016) J Hum Nutr Diet 29: 7-25] and part two focuses on the use of imaging techniques, bioelectrical impedance analysis, markers of muscle strength and functional status, with particular reference to developments relevant to practice.
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Affiliation(s)
- S Smith
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - A M Madden
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
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Botoseneanu A, Allore HG, Mendes de Leon CF, Gahbauer EA, Gill TM. Sex Differences in Concomitant Trajectories of Self-Reported Disability and Measured Physical Capacity in Older Adults. J Gerontol A Biol Sci Med Sci 2016; 71:1056-62. [PMID: 27071781 DOI: 10.1093/gerona/glw038] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 02/15/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Despite documented age-related declines in self-reported functional status and measured physical capacity, it is unclear whether these functional indicators follow similar trajectories over time or whether the patterns of change differ by sex. METHODS We used longitudinal data from 687 initially nondisabled adults, aged 70 or older, from the Precipitating Events Project, who were evaluated every 18 months for nearly 14 years. Self-reported disability was assessed with a 12-item disability scale. Physical capacity was measured using grip strength and a modified version of Short Physical Performance Battery. Hierarchical linear models estimated the intra-individual trajectory of each functional indicator and differences in trajectories' intercept and slope by sex. RESULTS Self-reported disability, grip strength, and Short Physical Performance Battery score declined over 13.5 years following nonlinear trajectories. Women experienced faster accumulation of self-reported disability, but slower declines in measured physical capacity, compared with men. Trajectory intercepts revealed that women had significantly weaker grip strength and reported higher levels of disability compared with men, with no differences in starting Short Physical Performance Battery scores. These findings were robust to adjustments for differences in sociodemographic characteristics, length-of-survival, health risk factors, and chronic-disease status. CONCLUSIONS Despite the female disadvantage in self-reported disability, older women preserve measured physical capacity better than men over time. Self-reported and measured indicators should be viewed as complementary rather than interchangeable assessments of functional status for both clinical and research purposes, especially for sex-specific comparisons.
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Affiliation(s)
- Anda Botoseneanu
- Department of Health & Human Services, University of Michigan, Dearborn, Michigan. Institute of Gerontology, University of Michigan, Ann Arbor, Michigan.
| | - Heather G Allore
- Department of Internal Medicine/Geriatrics, Yale School of Medicine, New Haven, Connecticut. Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | | | - Evelyne A Gahbauer
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Thomas M Gill
- Department of Internal Medicine/Geriatrics, Yale School of Medicine, New Haven, Connecticut
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Nam S, Al Snih S, Markides KS. A concordance of self-reported and performance-based assessments of mobility as a mortality predictor for older Mexican Americans. Geriatr Gerontol Int 2016; 17:433-439. [PMID: 26799255 DOI: 10.1111/ggi.12734] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 11/23/2015] [Accepted: 12/08/2015] [Indexed: 10/22/2022]
Abstract
AIM To assess the efficacy in mortality prediction of a concordance of performance-based (timed 10-foot walk; performance-oriented mobility assessment [POMA]) and self-rated (reported ability to walk across a small room with no help from people or devices; activities of daily living [ADL]) assessments of mobility for Mexican Americans aged 75 years and older. METHODS A longitudinal study of 2069 participants aged 75 years and older from the Hispanic Established Population for the Epidemiological Study of the Elderly wave 5 (June 2004 to January 2006) and wave 6 (February 2007 to February 2008) was carried out. Sociodemographic variables, performance-based (timed 10-foot walk) and self-rated assessments (reported ability to walk across a small room without the help of any people or devices) of mobility, and mortality data were obtained. RESULTS The ADL/POMA concordance assessment showed a prevalence of the "positively concordant" group (completed the walk and reported being able to walk, ADL and POMA both positive), followed by the "pessimist," "optimist," and "negatively concordant" groups at 80.09%, 10.50%, 3.78% and 5.63%, respectively. Logistic regression analyses showed that "negatively concordant" was a critical mortality predictor (OR 4.80; 95% CI 2.59-8.90) followed by "pessimist" (OR 1.94; 95% CI 1.12-3.36) as compared with the reference group, "positively concordant." CONCLUSION The ADL/POMA concordance is an effective predictor of mortality for older Mexican Americans in the Hispanic Established Population for the Epidemiological Study of the Elderly. Geriatr Gerontol Int 2017; 17: 433-439.
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Affiliation(s)
- Sanggon Nam
- Department of Health Administration, Division of Applied Health Sciences, Pfeiffer University, Morrisville, North Carolina, USA
| | - Soham Al Snih
- Division of Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, Texas, USA.,Division Geriatrics, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA.,Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, USA
| | - Kyriakos S Markides
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, USA.,Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas, USA
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Serra AJ, de Carvalho PDTC, Lanza F, de Amorim Flandes C, Silva SC, Suzuki FS, Bocalini DS, Andrade E, Casarin C, Silva JA. Correlation of six-minute walking performance with quality of life is domain- and gender-specific in healthy older adults. PLoS One 2015; 10:e0117359. [PMID: 25695668 PMCID: PMC4335060 DOI: 10.1371/journal.pone.0117359] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 12/22/2014] [Indexed: 11/19/2022] Open
Abstract
We analyzed the relationship between performance on the 6-min walk test (6MWT) and health-related quality of life (HRQoL) in older subjects. Our secondary aim was to determine the distance to be completed on the 6MWT for the subject to achieve a score of 50 on the Short Form (36) Health Survey (SF-36). Associations were tested using linear correlation and multivariate linear regression. Participants were 130 healthy older individuals. The predictive performance of the 6MWT based on an SF-36 score of 50 was assessed using a receiver operating characteristic curve and its area under curve (AUC). Associations were observed between physical functioning, role-emotional, social functioning, vitality, general health score, and 6MWT performance in women, after adjusting for confounding variables (coefficients: 0.57, 0.38, 0.40, and 0.46, respectively; p < 0.05). No association was found for men. The distance for the 6MWT to predict an SF-36 score of 50 was 481 m for men in the physical functioning (AUC: 0.79) and role-physical (AUC: 0.84) domains, and 420 m for women in role-emotional (AUC: 0.75), role-physical (AUC: 0.80), and general health (AUC: 0.80) domains. Our results indicate that superior 6MWT performance may be associated with better HRQoL in several domains in only healthy older women. No association between 6MWT performance and role-emotional, mental health, or vitality domains was found. We suggest that a score of 50 is represented by a 6MWT distance of 481 m for men and 420 m for women, at least in the role-physical domain.
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Affiliation(s)
- Andrey Jorge Serra
- Post-Graduation at Biophotonic Applied to Health Science, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | | | - Fernanda Lanza
- Post-graduation Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Camila de Amorim Flandes
- Post-Graduation at Biophotonic Applied to Health Science, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Shirley Cardoso Silva
- Post-Graduation at Biophotonic Applied to Health Science, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Frank Shiguemitsu Suzuki
- Post-Graduation at Biophotonic Applied to Health Science, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Danilo Sales Bocalini
- Post-Graduation at Physical Education, São Judas Tadeu University (USJT), São Paulo, SP, Brazil
| | - Erinaldo Andrade
- Post-Graduation at Biophotonic Applied to Health Science, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Cezar Casarin
- Post-Graduation at Biophotonic Applied to Health Science, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - José Antonio Silva
- Post-Graduation at Medicine, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
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Mystakidou K, Parpa E, Tsilika E, Panagiotou I, Theodorakis PN, Galanos A, Gouliamos A. Self-Efficacy and Its Relationship to Posttraumatic Stress Symptoms and Posttraumatic Growth in Cancer Patients. JOURNAL OF LOSS & TRAUMA 2014. [DOI: 10.1080/15325024.2013.838892] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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de Luca K, Parkinson L, Byles J. A study protocol for the profile of pain in older women: assessing the multi dimensional nature of the experience of pain in arthritis. Chiropr Man Therap 2014. [DOI: 10.1186/s12998-014-0028-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Arthritis is a significant contributor to illness, pain and disability and imposes a considerable burden upon the community. Pain is a cardinal symptom of arthritis and has significant implications on biopsychosocial wellbeing. The multidimensional nature of the experience of pain in arthritis has not been well defined in community-based samples.
Aims
The two aims of this study are to generate profiles of pain from a community sample of older women and to compare profiles for women with and without arthritis.
Methods
The sub study is a cross-sectional postal survey of 700 Australian community-based women. The survey includes a range of measures on health, arthritis and pain that will be used to examine the multidimensional nature of the experience of pain in arthritis and generate profiles of pain.
Discussion
With no core set of measures for the evaluation of arthritis pain, this survey was created from an amalgamation of measures to capture multiple dimensions of pain. Findings from this study will assist in defining the symptom of pain in arthritis and may lead to further research in evidence-based treatment options for people with arthritis.
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Schwartz CE, Sajobi TT, Verdam MGE, Sebille V, Lix LM, Guilleux A, Sprangers MAG. Method variation in the impact of missing data on response shift detection. Qual Life Res 2014; 24:521-8. [PMID: 25008260 DOI: 10.1007/s11136-014-0746-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE Missing data due to attrition or item non-response can result in biased estimates and loss of power in longitudinal quality-of-life (QOL) research. The impact of missing data on response shift (RS) detection is relatively unknown. This overview article synthesizes the findings of three methods tested in this special section regarding the impact of missing data patterns on RS detection in incomplete longitudinal data. METHODS The RS detection methods investigated include: (1) Relative importance analysis to detect reprioritization RS in stroke caregivers; (2) Oort's structural equation modeling (SEM) to detect recalibration, reprioritization, and reconceptualization RS in cancer patients; and (3) Rasch-based item-response theory-based (IRT) models as compared to SEM models to detect recalibration and reprioritization RS in hospitalized chronic disease patients. Each method dealt with missing data differently, either with imputation (1), attrition-based multi-group analysis (2), or probabilistic analysis that is robust to missingness due to the specific objectivity property (3). RESULTS Relative importance analyses were sensitive to the type and amount of missing data and imputation method, with multiple imputation showing the largest RS effects. The attrition-based multi-group SEM revealed differential effects of both the changes in health-related QOL and the occurrence of response shift by attrition stratum, and enabled a more complete interpretation of findings. The IRT RS algorithm found evidence of small recalibration and reprioritization effects in General Health, whereas SEM mostly evidenced small recalibration effects. These differences may be due to differences between the two methods in handling of missing data. CONCLUSIONS Missing data imputation techniques result in different conclusions about the presence of reprioritization RS using the relative importance method, while the attrition-based SEM approach highlighted different recalibration and reprioritization RS effects by attrition group. The IRT analyses detected more recalibration and reprioritization RS effects than SEM, presumably due to IRT's robustness to missing data. Future research should apply simulation techniques in order to make conclusive statements about the impacts of missing data according to the type and amount of RS.
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Klijs B, Nusselder WJ, Looman CW, Mackenbach JP. Educational disparities in the burden of disability: contributions of disease prevalence and disabling impact. Am J Public Health 2014; 104:e141-8. [PMID: 24922134 DOI: 10.2105/ajph.2014.301924] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES We assessed the contributions of the prevalence and disabling impact of specific diseases to educational disparities in the prevalence of disability. METHODS We examined a large representative survey of the Dutch population, the Dutch Permanent Survey of Living Conditions (2001-2007; n = 24 883; ages 40-97 years). We attributed the prevalence of disability to chronic diseases by using their empirical associations and assuming independent competing causes of disability. We estimated contributions of prevalence and the disabling impact of diseases to disparities in disability using counterfactuals. RESULTS We found that the prevalence of disability in individuals with only an elementary education was 19 to 20 percentage points higher than that in individuals with tertiary education. Sixty-five percent of this difference could be attributed to specific chronic diseases, but more so to their disabling impact (49%-51%) than to their prevalence (20%-29%). Back pain, neck or arm conditions, and peripheral vascular disease contributed most to the disparity in men, and arthritis, back pain, and chronic nonspecific lung disease contributed most to the disparity in women. CONCLUSIONS Educational disparities in the burden of disability were primarily caused by high disabling impacts of chronic diseases among low educated groups. Tackling disparities might require more effective treatment or rehabilitation of disability in lower socioeconomic groups.
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Affiliation(s)
- Bart Klijs
- At the time of the study, Bart Klijs, Wilma J. Nusselder, Caspar W. Looman, and Johan P. Mackenbach were with the Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands. Bart Klijs was also with the Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands
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Brown CL, Finlayson ML. Performance measures rather than self-report measures of functional status predict home care use in community-dwelling older adults. The Canadian Journal of Occupational Therapy 2014; 80:284-94. [PMID: 24640643 DOI: 10.1177/0008417413501467] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Occupational therapists frequently assess functional status (FS) to determine the home care (HC) service requirements of older adults. However, it is unclear which type of FS measure is most effective for this purpose. PURPOSE This study investigated the predictive ability of three measures of FS (a self-report measure of usual behaviour, a self-report measure of capacity, and an observational performance measure-the Performance Assessment of Self-Care Skills [PASS]) on formal HC utilization. METHOD A secondary analysis of 2001 Aging in Manitoba Longitudinal Study (AIM) data was conducted. FINDINGS The odds of receiving HC within the 30-month follow-up period were 1.32 times (or 30%) higher for each increase in the number of dependent tasks based upon a standardized performance measure. The self-report measures did not predict HC utilization. IMPLICATIONS This study suggests that standardized performance measures-in particular, the PASS-are more predictive of formal HC use in community-dwelling older adults than self-report measures.
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