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Yang YL, Wang HH, Su H, Lu H, Yu H, Wang J, Zhou YQ, Li L, Chen Y. Reliability and validity tests of the Chinese version of the Geriatric Locomotive Function Scale (GLFS-25) in tumor survivors. Heliyon 2024; 10:e29604. [PMID: 38694053 PMCID: PMC11058285 DOI: 10.1016/j.heliyon.2024.e29604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 04/06/2024] [Accepted: 04/10/2024] [Indexed: 05/03/2024] Open
Abstract
Objective To evaluate the reliability and validity of the Chinese-translated Geriatric Locomotive Function Scale (GLFS-25) for the assessment of locomotive syndrome (LS) in individuals surviving malignancies. Methods 393 tumor survivors at a general hospital in China were recruited. The Chinese version of GLFS-25 was utilized to conduct a cross-sectional survey to ascertain the tool's efficacy in measuring LS in this cohort. The scale's validity was examined through content, structural and discriminant validity assessments, while its reliability was investigated by determining the internal consistency (via Cronbach's α coefficient) and test-retest reliability (via intragroup correlation coefficient, ICC). Results The Chinese-adapted GLFS-25 demonstrated a robust scale-level content validity index of 0.94, while item-level content validity indices ranged from 0.83 to 1.00 across individual items. The suitability of the scale for structural validity assessment was confirmed via exploratory factor analysis, yielding a Kaiser-Meyer-Olkin measure of 0.930 and a significant Bartlett's test of sphericity (χ2 = 3217.714, df = 300, P < 0.001). Subsequent confirmatory factor analysis (CFA) extracted four distinct factors: Social Activity Engagement, Daily Living Ability, Pain Experience and Physical Mobility. These factors accounted for 72.668 % of the variance, indicating substantial construct validity for measuring LS among this population. CFA supported the model's fit with the following indices: χ2/df = 1.559, RMSEA = 0.077, GFI = 0.924, CFI = 0.941, NFI = 0.919, and TLI = 0.933. The factor loadings for the four factors ranged from 0.771 to 0.931, indicating the items corresponding to the four factors effectively represented the constructs they were designed to measure. The correlation coefficients among the four factors were between 0.306 and 0.469, all lower than the square roots of the respective AVEs (0.838-0.867). This suggests a moderate correlation among the four factors and a distinct differentiation between them, indicating the Chinese version of the GLFS-25 exhibits strong discriminant validity in Chinese tumor survivors. Reliability testing revealed a high Cronbach's α coefficient for the overall scale at 0.961, with the subscales yielding coefficients of 0.751, 0.836, 0.930, and 0.952. The overall ICC was determined to be 0.935, with subscale ICCs ranging from 0.857 to 0.941, reinforcing the scale's reliability in this context. Conclusions The Chinese version of the GLFS-25 exhibits strong reliability and validity for the assessment of LS in tumor survivors. It may serve as a diagnostic tool for LS, contributing to the prevention and management of musculoskeletal disorders and enhancing the prognosis for this patient population.
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Affiliation(s)
- Yu-Ling Yang
- Department of Oncology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, Jiangsu Province, China
| | - Hui-Hong Wang
- Department of Oncology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, Jiangsu Province, China
| | - Hui Su
- Department of Oncology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, Jiangsu Province, China
| | - Hui Lu
- Department of Oncology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, Jiangsu Province, China
| | - Hui Yu
- Department of Oncology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, Jiangsu Province, China
| | - Jing Wang
- Department of Oncology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, Jiangsu Province, China
| | - Yu-Qing Zhou
- Department of Oncology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, Jiangsu Province, China
| | - Ling Li
- Department of Oncology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, Jiangsu Province, China
| | - Ying Chen
- Department of Oncology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, Jiangsu Province, China
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Shi L, Pang T, Zheng Q, Liu G, Zhang W, Leung W. Utilisation of community healthcare services among older adults with disabilities in Luohu district, Shenzhen: a community-based survey. BMJ Open 2024; 14:e076249. [PMID: 38286707 PMCID: PMC10826561 DOI: 10.1136/bmjopen-2023-076249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 01/08/2024] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVE China faces the challenge of an ageing population with disabilities. Community healthcare centres (CHCs) serve as frontline community healthcare providers for older adults with and without disabilities. Despite their significance, there is a lack of literature examining the utilisation of CHC services among older adults. This study aims to examine and compare the utilisation and satisfaction of CHC healthcare services among older adults with and without disabilities. SETTING Data from the 2019 Community Health Diagnosis Questionnaire, which interviewed 259 older adults residing in the Luohu district of Shenzhen, were used in the current study. PRIMARY OUTCOME MEASURES Participants self-reported outcomes including use of CHCs, use of home health services from CHCs and satisfaction with CHCs. Five different disability types and an integrated disability variable were assessed as independent variables. Linear probability models were used to determine the relationship between disability types and outcome variables. RESULTS Among 259 older adults aged 60 years and older, 70.66% self-identified as having a disability. No statistically significant associations were found between the use of CHCs, the use of home health services from CHCs and satisfaction with CHCs, and disability status. However, older adults with mobility and cognitive disabilities were more likely to receive home health services from CHCs. CONCLUSION Community health promotion policies should be implemented to improve access to health services for older adults with and without disabilities. In addition, CHCs should implement effective health management plans to ensure the health needs of older adults with disabilities.
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Affiliation(s)
- Lu Shi
- College of Health, Oregon State University, Corvallis, Oregon, USA
| | | | - Qingming Zheng
- Shenzhen Luohu Disease Prevention and Control Center, Shenzhen, China
| | - Gang Liu
- Shenzhen Luohu Disease Prevention and Control Center, Shenzhen, China
| | - Wei Zhang
- College of Health, Oregon State University, Corvallis, Oregon, USA
| | - Willie Leung
- Health Sciences & Human Performance, The University of Tampa, Tampa, Florida, USA
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Iwaya T, Tanabe H, Ohkuma Y, Ito A, Hayashi K, Ideno Y, Nagai K, Akai M. Statistical model of trajectories of reduced mobility in older people with locomotive disorders: a prospective cohort study with group-based trajectory model. BMC Geriatr 2023; 23:699. [PMID: 37904120 PMCID: PMC10617241 DOI: 10.1186/s12877-023-04405-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: 02/22/2023] [Accepted: 10/13/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Today we experience "Super-aged society", and a drastic increase in the number of older people needing assistance is an urgent matter for everyone from medical and socio-economical standpoints. Locomotive organ dysfunction due to musculoskeletal disorders is one of the main problems in these patients. Although the concepts of frailty and sarcopenia have been proposed for functional decline, pain remains the main and non-negligible complaint in these of such disorders. This prospective cohort study aimed to observe the changes of reduced mobility in patients with locomotive disorders and to determine the risk factors for functional deterioration of those patients using statistical modeling. METHODS A cohort of older adults with locomotive disorders who were followed up every 6 months for up to 18 months was organized. Pain, physical findings related to the lower extremities, locomotive function in performing daily tasks, and Geriatric Locomotive Function Scale-25 (GLFS-25) score were collected to predict the progress of deterioration. Group-based trajectory analysis was used to identify subgroups of changes of GLFS-25 scores, and multinomial logistic regression analysis was performed to investigate potential predictors of the GLFS-25 trajectories. RESULTS Overall, 314 participants aged between 65 and 93 years were included. The participants were treated with various combinations of orthopedic conservative treatments on an outpatient basis. The in-group trajectory model analysis revealed a clear differentiation between the four groups. The mild and severe groups generally maintained their GLFD-25 scores, while the moderate group included a fluctuating group and a no change group. This study showed that comorbidity of osteoporosis was related to GLFS-25 score over 18 months. Age was a weak factor to be moderate or severe group, but gender was not. In addition, the number of pain locations, number of weak muscles, one-leg standing time, grip strength and BMI significantly contributed to the change in GLFS-25 score. CONCLUSIONS This study proposes an effective statistical model to monitor locomotive functions and related findings. Pain and comorbid osteoporosis are significant factors that related to functional deterioration of activities. In addition, the study shows a patient group recovers from the progression and their possible contributing factors.
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Affiliation(s)
- Tsutomu Iwaya
- Nagano University of Health and Medicine, 11-1 Imaihara, Kawanakajima-chou, Nagano-shi, Nagano, 381-2227, Japan
| | - Hideki Tanabe
- Tanabe Orthopaedic Clinic, 3-2-16 Narimasu, Itabashi-ku, Tokyo, 175-0094, Japan
| | - Yusuke Ohkuma
- National Rehabilitation Center for Persons with Disabilities, 2-1 Namiki, Tokorozawa-shi, Saitama, 359-8555, Japan
| | - Ayumi Ito
- Takasaki University of Health and Welfare, 501 Nakaorui-machi, Takasaki-shi, Gunma, 370-0033, Japan
| | - Kunihiko Hayashi
- School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi-shi, Gunma, 371-8514, Japan
| | - Yuki Ideno
- Center for Mathematics and Data Science, Gunma University, 3-39-22 Showa-machi, Maebashi-shi, Gunma, 371-8514, Japan
| | - Kazue Nagai
- Center for Mathematics and Data Science, Gunma University, 3-39-22 Showa-machi, Maebashi-shi, Gunma, 371-8514, Japan
| | - Masami Akai
- International University of Health and Welfare, Graduate School, International University of Health and Welfare, 4-1-26 Akasaka, Minato-ku, Tokyo, 107-8402, Japan.
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Validity and reliability of the loco-check questionnaire after cross-cultural adaptation for Indonesia. J Orthop Sci 2023; 28:267-271. [PMID: 34801343 DOI: 10.1016/j.jos.2021.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 09/06/2021] [Accepted: 10/10/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND A large number of the elderly in Indonesia are affected by an increasing number of disabilities, with reduced mobility being one of the causes. Locomotive syndrome may cause decreased mobility, and its progression can impair the activities of daily living. Early screening is essential to halt its progression. The loco-check, a screening tool for locomotive syndrome, is available in English. A cross-cultural adaptation of this tool for an Indonesian version is important to maintain the validity of the questionnaire for its implementation in Indonesia. The aim of this study was to obtain a valid Indonesian version of the loco-check questionnaire that has been adapted as per Indonesian language and cultural conventions (through a cross-cultural adaptation process). METHODS The subjects in the study were community-dwelling geriatrics over 65 years of age who were recruited using consecutive non-probability judgment sampling according to the inclusion criteria. This study, conducted from February to October 2019, was divided into two stages consisting of: (1) language and cultural adaptation; (2) validity and reliability testing. The seven items on the loco-check were translated using forward-backward translation. The final questionnaire was generated through an expert panel discussion. The validity and reliability were evaluated using concurrent validity and Cronbach's alpha using SPSS Version 23.0. RESULTS In the first stage, the first and second trials showed a strong correlation between the English and Indonesian versions of the questionnaire with r = 0.997 (p < 0.001) and r = 0.825 (p = 0.003), respectively. The final Indonesian version of the loco-check had a good validity and reliability with r = 0.981 (p < 0.001) and Cronbach's alpha of 0.768, respectively. CONCLUSION The Indonesian cross-cultural adaptation of the loco-check questionnaire is a valid and reliable general questionnaire that could enable screening for locomotive syndrome in Indonesia.
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Kim MC, Park HS, Kim HI, Paik JK, Chung DK. An analysis study of sarcopenia and locomotive syndrome in the old people using evaluation tool. J Exerc Rehabil 2022; 18:256-263. [PMID: 36110258 PMCID: PMC9449084 DOI: 10.12965/jer.2244234.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/25/2022] [Indexed: 11/22/2022] Open
Abstract
This study was conducted to analyze the relationship between locomotive syndrome and sarcopenia in the old people using a functional evaluation tool. In this study, 237 Korean old people selected from the Miraeseum Seongnam Senior Complex and the Misa Riverside Welfare Center were diagnosed with the two diseases and the Berg balance scale was performed to confirm the deterioration of dynamic balance sensory. Through the diagnostic evaluation of the two diseases, the locomotive group (n= 180) and the sarcopenia group (n= 34) were classified and statistically analyzed. As a result of the study, a significant difference in dynamic balance sensory between the two diseases was confirmed, and a significant negative correlation was confirmed with 25-question geriatric locomotive function scale and grip strength among the diagnostic evaluation items of the two diseases. These results suggest that gradual deterioration of locomotive syndrome and sarcopenia occurs in the deterioration of physical performance in the old people, suggesting that the evaluation of locomotive syndrome can be used as a screening test for sarcopenia.
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Affiliation(s)
- Myung-Chul Kim
- Department of Physical Therapy, College of Health Sciences, Eulji University, Seongnam,
Korea
| | - Hang-Sik Park
- Department Faculty of Liberal Arts, Eulji University, Seongnam,
Korea
- Corresponding author: Hang-Sik Park, Department of Faculty of Liberal Arts, Eulji University, 553 Sanseong-daero, Sujeong-gu, Seongnam 13135, Korea,
| | - Hae-In Kim
- Department of Physical Therapy, College of Health Sciences, Eulji University, Seongnam,
Korea
| | - Jean-Kyung Paik
- Department of Food & Nutrition, College of Bio Convergence, Eulji University, Seongnam,
Korea
| | - Dong-Kun Chung
- Department of Medical IT, College of Bio Convergence, Eulji University, Seongnam,
Korea
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Saito Y, Ishida T, Kataoka Y, Takeda R, Tadano S, Suzuki T, Nakamura K, Nakata A, Osuka S, Yamada S, Samukawa M, Tohyama H. Evaluation of gait characteristics in subjects with locomotive syndrome using wearable gait sensors. BMC Musculoskelet Disord 2022; 23:457. [PMID: 35568855 PMCID: PMC9107686 DOI: 10.1186/s12891-022-05411-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 05/09/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Individuals with locomotive syndrome (LS) require nursing care services owing to problems with locomotion and the musculoskeletal system. Individuals with LS generally have a reduced walking speed compared with those without LS. However, differences in lower-limb kinematics and gait between individuals with and without LS are not fully understood. This study aimed to clarify the characteristics of the gait kinematics of individuals with LS using wearable sensors. METHODS We assessed 125 participants (mean age 73.0 ± 6.7 years) who used a public health promotion facility. Based on the 25-question Geriatric Locomotive Function Scale (GLFS-25), these participants were grouped into the non-LS (GLFS-25 < 7), LS-stage 1 (GLFS-25 7-16), and LS-stage 2 (GLFS-25 ≥ 16) groups (larger GLFS-25 scores indicate worse locomotive ability). Spatiotemporal parameters and lower-limb kinematics during the 10-m walk test were analyzed by the "H-Gait system", which is a motion analysis system that was developed by the authors and is based on seven inertial sensors. The peak joint angles during the stance and swing phases, as well as the gait speed, cadence, and step length were compared among all groups. RESULTS There were 69 participants in the non-LS group, 33 in the LS-stage 1 group, and 23 in the LS-stage 2 group. Compared with the non-LS group, the LS-stage 2 group showed significantly smaller peak angles of hip extension (9.5 ± 5.3° vs 4.2 ± 8.2°, P = 0.002), hip flexion (34.2 ± 8.8° vs 28.5 ± 9.5°, P = 0.026), and knee flexion (65.2 ± 18.7° vs 50.6 ± 18.5°, P = 0.005). The LS-stage 1 and LS-stage 2 groups had a significantly slower mean gait speed than the non-LS group (non-LS: 1.3 ± 0.2 m/s, LS-stage 1: 1.2 ± 0.2 m/s, LS-stage 2: 1.1 ± 0.2 m/s, P < 0.001). CONCLUSIONS The LS-stage 2 group showed significantly different lower-limb kinematics compared with the non-LS group, including smaller peak angles of hip extension, hip flexion, and knee flexion. It would be useful to assess and improve these small peak joint angles during gait for individuals classified as LS-stage 2.
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Affiliation(s)
- Yuki Saito
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Tomoya Ishida
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Yoshiaki Kataoka
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, 060-0812, Japan.
| | - Ryo Takeda
- Faculty of Engineering, Hokkaido University, Kita 13, Nishi 8, Kita-ku, Sapporo, 060-8628, Japan
| | - Shigeru Tadano
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, 060-0812, Japan
- Faculty of Engineering, Hokkaido University, Kita 13, Nishi 8, Kita-ku, Sapporo, 060-8628, Japan
- National Institute of Technology, HakodateCollege, 14-1 Tokura-cho, Hakodate, 042-8501, Japan
| | - Teppei Suzuki
- Hokkaido University of Education, 2-34, Iwamizawa CampusMidorigaoka, Iwamizawa, 068-864, Japan
| | - Kentaro Nakamura
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Akimi Nakata
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Satoshi Osuka
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Satoshi Yamada
- Faculty of Engineering, Hokkaido University, Kita 13, Nishi 8, Kita-ku, Sapporo, 060-8628, Japan
| | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Harukazu Tohyama
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, 060-0812, Japan
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Interventions to Improve Physical Capability of Older Adults with Mild Disabilities: A Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052651. [PMID: 35270341 PMCID: PMC8910335 DOI: 10.3390/ijerph19052651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 02/06/2023]
Abstract
Ageing is related to changes in physical health, including loss of mobility and muscle function. It can lead to impaired physical capability and reduced quality of life. The purpose of this study was to investigate whether a physical activity rehabilitation program (PARP) could improve range of joint motion (ROM), grip strength, and gait speed of older adults with mild disabilities. Forty older adults in a long-term care center in Taiwan joined as human participants and were split into control and experimental groups. The participants in the experimental group joined a PARP for eight weeks. The ROM of bodily joints, grip strength, and gait speed of all participants were measured both before and after the eight-week period. The results showed that all the ROMs, grip strength, and gait speed of the participants in the experimental group increased significantly after attending the program. The improvement of the ROMs for male and female participants in the experimental group ranged from 3.8% to 71% and from 7.8% to 75%, respectively. Male participants had greater improvement on gait speed (50%) than their female counterparts (22.9%). Female participants, on the other hand, had greater improvement on grip strength (25.4%) than their male counterparts (20.3%). The ROM, grip strength, and gait speed of the control group, on the other hand, did not change significantly during the same period. The results showed that the PARP adopted in this study was effective in increasing the ROM, grip strength, and gait speed of those who had joined the PARP. This study shows that an eight-week PARP without the use of gym machines was beneficial in reducing sarcopenia in elderly people with mild disabilities.
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Nishimura T, Hagio A, Hamaguchi K, Kurihara T, Iemitsu M, Sanada K. Associations between locomotive and non-locomotive physical activity and physical performance in older community-dwelling females with and without locomotive syndrome: a cross-sectional study. J Physiol Anthropol 2021; 40:18. [PMID: 34736515 PMCID: PMC8570009 DOI: 10.1186/s40101-021-00268-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/22/2021] [Indexed: 11/16/2022] Open
Abstract
Background Locomotive syndrome (LS) is a condition of reduced mobility due to a disorder of the locomotive system. Increasing moderate to vigorous physical activity (MVPA) has been recommended to prevent LS. However, to increase daily MVPA is difficult for older people with LS. The MVPA consists of not only locomotive activities such as walking but also non-locomotive activities such as household activities. The aim of this study was to examine the associations between locomotive/non-locomotive MVPA and physical performance in older females with and without LS. Methods Participants of this cross-sectional study were 143 older community-dwelling Japanese females. The participants were divided into two groups based on the results of the stand-up test: the normal group (NL) (n = 86) and the LS group (n = 57). Both the locomotive and non-locomotive PA seperately measured with its intensity. The intensity of physical activity (PA) was calculated as METs and classified as sedentary behavior (SB 1–1.5 metabolic equivalent tasks (METs)), low-intensity physical activity (LPA 1.6–2.9 METs), and MVPA (≥ 3 METs). For example, locomotive LPA is slow walking speed of 54 m/min, and locomotive MVPA is walking speed of 67 m/min. While non-locomotive LPA is office work and cooking, non-locomotive MVPA is housecleaning. Physical function was evaluated by handgrip strength, walking speed, and 2-step test. Results Walking speed, hand-grip strength, 2-step test, daily step counts, and all PA measurements were not significantly different between two groups. In the LS, locomotive MVPA (r = 0.293, p < 0.05) and total MVPA (r = 0.299, p < 0.05) was significantly correlated with walking speed, but not in the NL. Conclusions Walking speed was positively correlated with locomotive MVPA and total MVPA in the LS group, but not in NL group. This result suggests that slow walking speed in older people with LS occur in connection with lower locomotive MVPA and total MVPA.
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Affiliation(s)
- Tomohiro Nishimura
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji Higashi, Kusatsu, Shiga, 525-8577, Japan.,Osaka College of Rehabilitation, Osaka, 530-0043, Japan
| | - Atsushi Hagio
- Department of Public Health Care and Welfare of Yawata City, Kyoto, 614-8501, Japan
| | - Kanako Hamaguchi
- Research Organization of Science and Technology, Ritsumeikan University, Shiga, 525-8577, Japan
| | - Toshiyuki Kurihara
- Research Organization of Science and Technology, Ritsumeikan University, Shiga, 525-8577, Japan
| | - Motoyuki Iemitsu
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji Higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Kiyoshi Sanada
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji Higashi, Kusatsu, Shiga, 525-8577, Japan.
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Prevalence of Locomotive Organ Impairment and Associated Factors among Middle-Aged and Older People in Nan Province, Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010871. [PMID: 34682616 PMCID: PMC8536190 DOI: 10.3390/ijerph182010871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/06/2021] [Accepted: 10/13/2021] [Indexed: 11/17/2022]
Abstract
While locomotive organ impairment among older people is attracting worldwide attention, this issue has not yet been widely investigated in Thailand. This study aimed to measure locomotive organ impairment prevalence and identify the determinants of locomotive function decline among middle-aged and older people in Nan Province, Thailand. This cross-sectional study included anthropometric measurements, a two-step test to investigate locomotive function, and a structured questionnaire to obtain socio-demographic and related information. Logistic regression analysis and multiple regression analysis were used to identify the determinants of locomotive organ impairment. The study participants were aged 50–87 years old (n = 165), and 71.5% of them had begun experiencing declining locomotive function; < 6 years of school education (adjusted odds ratio: 4.46), body mass index ≥25 kg/m2 (AOR: 3.06), comorbidities (AOR: 2.55), and continuous walking for <15 min (AOR: 2.51) were identified as factors associated with locomotive organ impairment. Moreover, age, knee pain, anxiety about falling in daily life, and difficulty with simple tasks were identified as factors significantly associated with exacerbated locomotive organ impairment (p < 0.05). Appropriate interventions such as guidance or follow-up and recommendations for exercises are needed to prevent locomotive organ impairment and improve treatment.
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Ono R, Murata S, Uchida K, Endo T, Otani K. Reciprocal relationship between locomotive syndrome and social frailty in older adults. Geriatr Gerontol Int 2021; 21:981-984. [PMID: 34505337 DOI: 10.1111/ggi.14273] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/05/2021] [Accepted: 08/21/2021] [Indexed: 11/29/2022]
Abstract
AIM States of vulnerability are multidimensional and become more prevalent with advancing age. These states and the causal relationships between them, merit thorough investigation. This study aimed to understand the reciprocal relationship between the constructs of the locomotive syndrome and social frailty among a community of older adults. METHODS This 2-year cohort study examined a community of older adults (≥75 years) consisting of 1177 members. Using Makizako's method, social frailty was deemed to be present if more than two out of five questions were answered negatively. Locomotive syndrome was measured with the Geriatric Locomotive Function Scale-25, which consists of 25 items measuring an individual's risk of developing locomotive syndrome; a total score of ≥16 identified the presence of locomotive syndrome. Possible reciprocal associations between locomotive syndrome and social frailty were assessed using Cox proportional hazards analyses. RESULTS A total of 748 older adults were analyzed in the following subgroups. Among 574 participants without social frailty at the baseline, the presence of locomotive syndrome at the baseline was associated with new-onset social frailty during the next 2 years, after adjusting for confounding factors (hazard ratio 1.76, 95% confidence interval 1.17-2.65). Conversely, the presence of social frailty among participants without locomotive syndrome in the baseline was not associated with new-onset locomotive syndrome. CONCLUSION The presence of locomotive syndrome was determined to be a risk factor for the onset of social frailty. Therefore, interventions that address the negative impact of locomotive syndrome are a first step toward addressing these vulnerable conditions. Geriatr Gerontol Int 2021; 21: 981-984.
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Affiliation(s)
- Rei Ono
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Shunsuke Murata
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan.,Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan.,Japan Society for the Promotion of Science, Kojimachi Business Center Building, Tokyo, Japan
| | - Kazuaki Uchida
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan.,Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Tatsuya Endo
- Department of Rehabilitation, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Japan
| | - Koji Otani
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
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11
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Ikezoe T, Tsuboyama T, Tabara Y, Matsuda F, Ichihashi N. Weak hip flexor strength predicts progression of functional capacity decline due to locomotor system dysfunction in community-dwelling older adults: A longitudinal cohort study. Arch Gerontol Geriatr 2021; 97:104499. [PMID: 34375940 DOI: 10.1016/j.archger.2021.104499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/26/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE It is critical to determine the risk factors for activities of daily living (ADL) disability caused by locomotor dysfunction. However, no longitudinal study has investigated the association between disability due to locomotive dysfunction and multidimensional factors. Therefore, we investigated the relationship between the progression of functional capacity decline due to locomotive dysfunction and multiple physical functions among older adults in a longitudinal study. METHODS The participants comprised of 433 community-dwelling older adults. Physical function was assessed at baseline, which included handgrip strength, maximal isometric strength of hip flexion, hip extension, hip abduction, knee extension, toe flexion (index for muscle strength), the 5-time chair-stand test (index for muscle power), the one-legged stance and timed ''Up & Go'' tests (index for balance function), the 30-s stair test (index for muscle endurance), and range of motion (ROM) (an index of joint condition). Functional capacity decline due to locomotive dysfunction was assessed using the 25-question Geriatric Locomotive Function Scale (GLFS-25) before and after a 12-month period. Based on changes in the GLFS-25 score compared with baseline, the non-decline and decline groups were operationally defined. Logistic regression analyses with the groups as the dependent variable and physical function as independent variables were performed. RESULTS Of the 433 participants, 189 (43.6%) were included in the decline group. Logistic regression analysis revealed hip flexor strength as a primary determinant in the progression of functional capacity decline. CONCLUSION These results suggest that among physical functions, hip flexor strength influences the progression of disability resulting from locomotive dysfunction in older adults.
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Affiliation(s)
- Tome Ikezoe
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; Faculty of Rehabilitation, Kansai Medical University, Osaka 573-1136, Japan.
| | - Tadao Tsuboyama
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; School of Health Sciences, Bukkyo University, Kyoto 604-8418, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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12
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Kitabayashi K, Yamamoto S, Katano Y, Giustini K, Ei I, Ishii Y, Narita I. Locomotive syndrome in hemodialysis patients and its association with quality of life—a cross-sectional study. RENAL REPLACEMENT THERAPY 2021. [DOI: 10.1186/s41100-021-00352-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
Locomotive syndrome (LS) is defined as impairment of mobility function.
This study aimed to clarify LS and its association with quality of life in hemodialysis patients.
Methods
This is a cross-sectional study. The subjects were chronic kidney disease patients undergoing maintenance hemodialysis treatment. LS was assessed using two physical tests (two-step test, stand-up test) and one self-reported test (Geriatric Locomotive Function Scale-25). LS has two stages of severity; the beginning of the decline in mobility function is known as Locomo stage 1, and the progression of the decline of mobility function is known as Locomo stage 2. We used SF-36 to assess quality of life and examined their relationships with the Locomo stages. Chi-square test, Kruskal-Wallis test, Jonckheere-Terpstra test, and Mantel-Haenszel test were used for analysis. Multiple linear regression was used to model the cross-sectional association of Locomo stages with each component and summary score of SF-36.
Results
A total of 76 hemodialysis patients were included. The number of subjects with Locomo stage 1 and stage 2 were 19 (25%) and 53 (70%), respectively, while only four (5%) subjects did not have mobility dysfunction. Each component and summary score of the SF-36 for physical function, role emotional, physical component summary, and mental component summary were significantly associated with Locomo stages.
Conclusion
A high prevalence and severity of LS in hemodialysis patients was found, and the severity was associated with quality of life.
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Kota M, Uezono S, Ishibashi Y, Kitakaze S, Arakawa H. Factors predicting discharge after two years for inpatients in the psychiatric long-term care wards who can walk independently. J Phys Ther Sci 2021; 33:362-368. [PMID: 33935362 PMCID: PMC8079895 DOI: 10.1589/jpts.33.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 01/21/2021] [Indexed: 12/02/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the factors that affected the
discharge of walkable patients admitted to psychiatric long-term care wards. [Participants
and Methods] The participants were walkable patients admitted to psychiatric long-term
care wards at three different hospitals in Japan. The baseline assessments of all 73
patients were conducted between September and December 2018. During the 2 year follow-up
period, five patients died, while 68 were included in the analysis. The baseline
assessment includes the basic information of the participants and the risk of locomotive
syndrome. [Results] In the comparisons between the discharged (n=12) and hospitalizing
groups (n=56), the age, length of stay, and two-step and stand-up test scores at the
baseline assessment were significantly different. The multiple logistic regression
analysis, which discriminates between the two groups, adopted age as a significant
variable in the baseline assessment as a predictor of dischargeability (odds ratio: 1.08;
95% confidence interval: 1.01, 1.16). [Conclusion] Age was considered to be a discharge
likelihood predictor, as it affects the decline in motor function, such as locomotive
syndrome, as well as the social resources that would be needed after discharge, such as
family support.
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Affiliation(s)
- Munetsugu Kota
- Hiroshima Cosmopolitan University: 3-2-1 Otsuka-Higashi, Asaminami-ku, Hiroshima City, Hiroshima 731-3166, Japan
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Functional difficulties and toileting among older adults in Ghana: evidence from the World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 1. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000453] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Ghana's older population is projected to increase in coming decades and as a result will see increasing care needs. Understanding the functional difficulties older adults experience, and the associated factors, will help identify relevant intervention to assist older adults in meeting their care needs. This study aimed to analyse the prevalence of functional difficulties among older adults in Ghana, and examine how the World Health Organization International Classification of Functioning, Disability and Health (WHO-ICF) conceptual framework can relate to toileting difficulty to understand the factors that increase older adults’ care needs. Data were for 5,096 adults aged ⩾50 years from the WHO Study on global AGEing and adult health (SAGE) Ghana Wave 1. Difficulties were assessed using self-reported difficulty on 22 functional items, including toileting. Multivariate logistic regression tested associations between toileting and other factors as related to the WHO-ICF conceptual framework. Older adults reported climbing one flight of stairs without resting as a common functional difficulty. Difficulty eating was the item least identified. Toileting difficulty was ranked second among five total activities of daily living difficulties. Age, marital status, self-reported health, memory, bodily pain, short- and far-distance vision, obesity, stroke, chronic lung disease, trust at individual and neighbourhood level, toilet facility type, socialising with co-workers, and public and religious meeting attendance were statistically significantly associated with toileting difficulty in the final parsimonious model. Post-hoc analysis testing interaction revealed that interaction existed between female sex and never married marital status (p = 0.04), and obesity and widowed marital status (p = 0.01), with toileting as the outcome. A significant level of functional difficulty existed among Ghanaian older adults in this sample. Toileting difficulty was associated with factors across different components in the WHO-ICF, emphasising functional, social and environmental factors related to this fundamental human activity.
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15
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Shen S, Suzuki K, Kohmura Y, Fuku N, Someya Y, Naito H. Association of physical fitness and motor ability at young age with locomotive syndrome risk in middle-aged and older men: J-Fit + Study. BMC Geriatr 2021; 21:89. [PMID: 33516172 PMCID: PMC7847559 DOI: 10.1186/s12877-021-02047-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 01/21/2021] [Indexed: 12/17/2022] Open
Abstract
Background Physical fitness and motor ability are associated with the incidence of locomotive syndrome (LS) in older adults. The relationships between physical fitness and motor ability at a young age to LS risk in later life remain unclear. This study examined the association between physical fitness and motor ability among university students and their risk of LS in middle and old age. Methods The participants were 231 male alumni aged 48–65 years from the Department of Physical Education of a university in Japan. Physical fitness and motor ability test results during their fourth year at the university were used. Physical fitness tests included the side-step test, vertical jump test, back muscle, grip strength, trunk lift, standing trunk flexion, and step-test. Motor ability was tested using the 50-m and 1500-m run, running long jump, hand-ball throw, and pull-up test. LS risk was assessed using a seven-question standardized self-administered Loco-check questionnaire. Participants were divided into three groups (low, medium, and high) based on physical fitness and motor ability test results at young age, and LS risk was assessed at an older age across the three groups using Cox proportional hazards models. Results From the 2017 follow-up survey, the median follow-up period was 37 years (interquartile range, 33–41), and LS risk was suspected for 31 (13.4%) participants. Better performance on the side-step test was associated with the reduced risk of LS (hazard ratio 0.32; 95% confidence interval, 0.101–0.983, P = 0.047). Conclusions Good agility (side-step test) at a young age may reduce the future risk of LS among middle-aged and older men. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02047-7.
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Affiliation(s)
- Shaoshuai Shen
- Institute of Health and Sports Science & Medicine, Juntendo University, 1-1 Hiraka-gakuendai, Inzai, Chiba, 270-1695, Japan.
| | - Koya Suzuki
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hiraka-gakuendai, Inzai, Chiba, 270-1695, Japan.
| | - Yoshimitsu Kohmura
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hiraka-gakuendai, Inzai, Chiba, 270-1695, Japan
| | - Noriyuki Fuku
- Institute of Health and Sports Science & Medicine, Juntendo University, 1-1 Hiraka-gakuendai, Inzai, Chiba, 270-1695, Japan.,Graduate School of Health and Sports Science, Juntendo University, 1-1 Hiraka-gakuendai, Inzai, Chiba, 270-1695, Japan
| | - Yuki Someya
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hiraka-gakuendai, Inzai, Chiba, 270-1695, Japan.,Sportology Center, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hisashi Naito
- Institute of Health and Sports Science & Medicine, Juntendo University, 1-1 Hiraka-gakuendai, Inzai, Chiba, 270-1695, Japan.,Graduate School of Health and Sports Science, Juntendo University, 1-1 Hiraka-gakuendai, Inzai, Chiba, 270-1695, Japan
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16
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Kota M, Uezono S, Ishibashi Y, Kitakaze S, Arakawa H. Relationship between whether the planned discharge destination is decided and locomotive syndrome for admitted patients in psychiatric long-term care wards. Phys Ther Res 2021; 23:180-187. [PMID: 33489657 DOI: 10.1298/ptr.e10016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 05/16/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We focused on locomotive syndrome as a low physical function factor that may prevent patients with psychiatric disease from being discharged. The purpose of this study is to clarify the factors, including locomotive syndrome, that prevent discharge from psychiatric long-term care wards. METHOD We enrolled 74 patients who were admitted to psychiatric long-term care wards at three different hospitals in Japan. Nurses or medical social workers in the ward were asked whether the planned discharge destination had been decided, and patients were categorized into a decided group and an undecided group. Outcome measures were age, sex, F code in the ICD-10 Classification of Mental and Behavioral Disorders, length of stay, chlorpromazine equivalent dose of antipsychotics, locomotive syndrome test scores (25-question GLFS, two-step test, stand-up test), and Barthel Index. RESULTS Based on the multivariate logistic regression analysis results, the length of stay and the two-step test score significantly explained the difference between the two groups. The odds ratio of a length of stay greater than 10 years was 8.42 times that of a length of stay less than 2 years (P=0.012, 95% CI=1.59, 44.53). Regarding the twostep test, the odds ratio for obtaining stage 2 was 10.62 times that for obtaining stage 0 (P=0.013, 95% CI=1.65, 68.23). CONCLUSION Those who with longer length of stays and lower two-step test scores tended not to be decided the planned discharge destination.
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Srivastava S, Muhammad T. Violence and associated health outcomes among older adults in India: A gendered perspective. SSM Popul Health 2020; 12:100702. [PMID: 33304986 PMCID: PMC7708932 DOI: 10.1016/j.ssmph.2020.100702] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Since older population in India continue to rely on family and social networks for care and support, understanding the health outcomes associated with violence within and outside family may direct the development of policies and measures to aid the victims of violence. The present paper examines the health consequences of violence against older adults and its gender differentials in India. METHODS Using data from Building Knowledge Base on Population Ageing in India (BKPAI), we employed bivariate and logistic regressions on a sample of 9181 older adults to fulfil the aims and objective of the paper. RESULTS About 10.7% and 11.3% of men and women faced violence after turning 60 years respectively. Older adults who ever faced violence after turning age 60 years had 60%, 41% and 33% higher likelihood to have poor-SRH, low ADL and low IADL respectively in comparison to their counterparts. Further, it was found that older adults who ever faced violence after turning age 60 years had 97% and 62% higher likelihood to have lower psychological health and low subjective well-being. Additionally, it was found that women who faced violence had higher odds of having low psychological health [OR: 1.18, CI: 1.06, 1.63], low subjective well-being [OR: 1.70, CI: 1.24, 2.33] and low cognitive ability [OR: 1.32, CI: 1.04, 1.79] in comparison to men who faced violence. CONCLUSION Violence against older adults must be recognized as a key public health issue for older adults in India. Study findings indicate the immediate need for assessing victim health outcomes following any type of violence in later years to determine related policies and programs to protect the victims. Reducing violence will have a positive impact on physical and mental health outcomes late in life as well as the functional abilities of older adults, especially older women.
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Affiliation(s)
- Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - T. Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
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18
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Wang C, Ikemoto T, Hirasawa A, Arai YC, Kikuchi S, Deie M. Assessment of locomotive syndrome among older individuals: a confirmatory factor analysis of the 25-question Geriatric Locomotive Function Scale. PeerJ 2020; 8:e9026. [PMID: 32328357 PMCID: PMC7164427 DOI: 10.7717/peerj.9026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 03/30/2020] [Indexed: 11/20/2022] Open
Abstract
Background The 25-question Geriatric Locomotive Function Scale (GLFS-25) is widely used in daily clinical practice in evaluating locomotive syndrome (LS). The questionnaire contains 25 questions aiming to describe 6 aspects, including body pain, movement-related difficulty, usual care, social activities, cognitive status, and daily activities. However, its potential underlying latent factor structure of the questionnaire has not been fully examined so far. Methods Five hundred participants who were 60 years or older and were able to walk independently with or without a cane but had complaints of musculoskeletal disorders were recruited face to face at the out-patient ward of Aichi Medical University Hospital between April 2018 and June 2019. All participants completed the GLFS-25. Confirmatory factor analysis (CFA) models (single-factor model, 6-factor model as designed by the developers of the GLFS-25) were fitted and compared using Mplus 8.3 with a maximum likelihood minimization function. Modification indices, standardized expected parameter change were used, a standard strategy for scale development was followed in the search for an alternative and simpler model that could well fit the collected data. Cronbach’s α and its 95% confidence interval (CI) were also calculated. Results Mean (standard deviation) participants age was 72.6 (7.4) years old; 63.6% of them were women. Under the current criteria, 132 (26.4%) and 262 (52.4%) of the study subjects would be classified as LS stage 1 and stage 2, respectively. Overall, the Cronbach’s α (95% CI) for GLFS-25 evaluated using these data was 0.959 (0.953, 0.964). The single- and 6-factor models were rejected due to poor fit. The alternative models with either full 25 questions or a shortened GLFS-16 were found to fit the data better. These alternative models included three latent factors (body pain, movement-related difficulty, and psycho-social complication) and allowed for cross-loading and residual correlations. Discussion The findings of the CFA models provided evidence that the factor structure of the GLFS-25 might be simpler than the 6-factor model as suggested by the designers. The complex relationships between the latent factors and the observed items may also indicate that individual sub-scale use or simply combining the raw scores for evaluation is likely to be inadequate or unsatisfactory. Thus, future revisions of the scoring algorithm or questions of the GLFS-25 may be required.
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Affiliation(s)
- Chaochen Wang
- Department of Public Health, Aichi Medical University, Nagakute, Aichi, Japan
| | - Tatsunori Ikemoto
- Department of Orthopedic Surgery, Aichi Medical University, Nagakute, Aichi, Japan
| | - Atsuhiko Hirasawa
- Department of Orthopedic Surgery, Aichi Medical University, Nagakute, Aichi, Japan
| | - Young-Chang Arai
- Institute of Physical Fitness, Sports Medicine and Rehabilitation, Aichi Medical University, Nagakute, Aichi, Japan
| | - Shogo Kikuchi
- Department of Public Health, Aichi Medical University, Nagakute, Aichi, Japan
| | - Masataka Deie
- Department of Orthopedic Surgery, Aichi Medical University, Nagakute, Aichi, Japan
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Chen YC, Lin KC, Chen CJ, Wang CH. Effects of leisure-time physical activity interventions on frailty-related characteristics of frail older adults in long-term care: a systematic review. Contemp Nurse 2020; 56:34-48. [PMID: 32124658 DOI: 10.1080/10376178.2020.1737555] [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: 10/24/2022]
Abstract
Background: The proportion of frailty in older adults is increasing in many countries. Demand for institutional long-term care followed by an increasing globally. Aims: The effects of leisure-time physical activity (LTPA) interventions on frail older adults in long-term care facilities (LTCFs) of randomized controlled trials. Design: A literature searches of the published articles indexed in CINAHL, MEDLINE, PsycINFO, ProQuest, and Google Scholar between 2000 and 2017 was conducted. Methods: The inclusion criteria were divided into four sections: (1) design: randomized controlled trials; (2) sample population: LTCF adults aged 60 years or over with frailty; (3) intervention: LTPA; and (4) body composition: physical, functional or neuropsychological tests as either the primary or the secondary outcomes. Results: Three main themes were identified (the particular monitor, intervention duration and outcome measurement dimensions). Impact statement and conclusions: LTPA interventions effectively improved the physical performance and body composition of frail older adults in LTCFs. Nevertheless, an optimal combination of intensity, duration and frequency is crucial.
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Affiliation(s)
- Yi-Chang Chen
- School of Occupational Therapy, National Taiwan University, 3F.-3, No.20-3, Ln. 128, Sec. 3, Taichung Port Rd., Situn Dist., Taichung, Taipei 40764, Taiwan
| | - Keh-Chung Lin
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Chen-Jung Chen
- Department of Nursing, Mackay Medical College, 46, Sec. 3, Zhongzheng Rd., Sanzhi Dist., Taipei 252, Taiwan
| | - Chih-Hung Wang
- Graduate Institute of Education, National Changhua University of Education, Zhang Hua, Taiwan
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Hasegawa J, Suzuki H, Yamauchi T. Effect of a lower limb strength training programme on physical activity during the snowy season among community-dwelling elderly individuals. Ann Hum Biol 2019; 46:323-329. [PMID: 31284765 DOI: 10.1080/03014460.2019.1641222] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background: Promoting continued physical activity during winter in snowy-cold regions would be of benefit as a health promotion strategy among elderly individuals. Aim: To evaluate the effect of a lower limb strength training programme for elderly individuals on the daily step counts during the snowy season. Subjects and methods: Fourteen community-dwelling elderly individuals were recruited from a snowy-cold region of northern Japan. Methods: Daily step counts were measured during the snowy season in 2018 (with no exercise intervention) and 2019 (after the exercise intervention). Physical function was measured before and after the intervention, including body mass index, 30-s chair test, grip strength, normal gait speed, short-test battery for locomotive syndrome, Kihon checklist and 25-question geriatric locomotive function scale. Results: The study group included 11 women and three men (78.6 ± 5.2 years old). The exercise intervention improved physical function, with a significant increase in step count among individuals with lower baseline strength. Improved lower limb strength positively correlated with an increase in step count. Conclusion: Lower limb muscle strengthening is an effective intervention to improve physical activity during the snowy season among community-dwelling elderly.
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Affiliation(s)
- Junko Hasegawa
- School of Rehabilitation Sciences, Health Sciences University of Hokkaido , Ishikari-tobetsu , Japan
| | - Hideki Suzuki
- Graduate School of Rehabilitation Sciences, Health Sciences University of Hokkaido , Ishikari-tobetsu , Japan
| | - Taro Yamauchi
- Faculty of Health Sciences, Hokkaido University , Sapporo , Japan
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Disability for basic and instrumental activities of daily living in older individuals. PLoS One 2019; 14:e0220157. [PMID: 31348797 PMCID: PMC6660130 DOI: 10.1371/journal.pone.0220157] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 07/09/2019] [Indexed: 01/10/2023] Open
Abstract
AIMS To know the prevalence, associated factors and temporal trends of disabilities for basic and instrumental activities of daily living in older people in Spain from 2009 to 2017. BACKGROUND Disability in older people is associated with health problems, increased health costs and low quality of life. There are no updated data in Spain with a representative sample about disability. METHODS Cross-sectional study with 25,465 non-institutionalized older people who participated in the European Health Survey in 2009 and 2014 and the National Health Survey in 2011/12 and 2017 in Spain. The prevalence rates of disability were evaluated using the Katz Scale and Lawton and Brody Scale. Logistic regression was used to determine if there was an association between basic and instrumental activities of daily living and sociodemographic characteristics. RESULTS More individuals had disability for instrumental activities of daily living (31.9%) than disability for basic activities of daily living (11.1%). The most predominant disability for instrumental activities of daily living was performing severe housework (34%). The prevalence of disabilities decreased from 2009 to 2017. In general, disability was associated with female gender, advanced age, lower education, restricted daily activity, being bedridden and higher pain levels. CONCLUSION There is a considerable prevalence of disabilities for basic and instrumental activities of daily living in older people in Spain. Although the disability prevalence has decreased slowly from 2009 to 2017, it continues to remain a health problem. Gender may influence the disabilities for basic and instrumental activities of daily living. Health policymakers should establish prevention strategies and effective interventions (e.g., physical exercise) for prevention and reduction of the disabilities for basic and instrumental activities of daily living, particularly in older females.
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Influence of hip joint dysfunction on motor disorders in Japanese patients with osteoarthritis of the hip: Assessment of the JHEQ and GLFS-25 scores and hip muscle strength. Arch Gerontol Geriatr 2019; 82:45-49. [DOI: 10.1016/j.archger.2019.01.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 01/15/2019] [Accepted: 01/26/2019] [Indexed: 11/21/2022]
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Chen YC, Lin KC, Wu CY, Chen CJ, Hsieh YW. Determinants of quality of life in the older residents of long-term care facilities using the World Health Organization International Classification of Functioning, Disability and Health framework in Taiwan. Disabil Rehabil 2019; 42:2325-2333. [PMID: 30741036 DOI: 10.1080/09638288.2018.1559888] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: The purpose of this study was to identify determinants within the International Classification of Functioning, Disability and Health as a conceptual framework regarding the quality of life of older long-term care facility residents.Methods: A questionnaire-based cross-sectional design was conducted. All participants (n = 210) completed a questionnaire that included the Sheltered Care Environmental Scale, the Beck Depression Inventory, the Short Physical Performance Battery, the Mini-Mental State Examination, the World Health Organization Disability Assessment Schedule, and the World Health Organization Quality of Life Scale. The outcome was assessed using mixed-design multiple regression with a covariance model and hierarchical regression.Results: Personal factors, environmental factors, body function and structures, and activity and participation explained 35.9%, 18.5%, 25.2%, and 52.1% of the variability in quality of life, respectively. The hierarchical model included 10 variables and explained 84.3% of the total variability in quality of life.Conclusions: Activity and participation showed high explanatory power for the quality of life of older long-term care facility residents. The influence of activity and participation in the older population is an important issue, although these factors remain relatively unexplored. This exploratory study used the International Classification of Functioning, Disability and Health as a conceptual framework to provide a more sophisticated understanding of quality of life.Implications for rehabilitationAlthough the viewpoint of quality of life involves many more factors than an understanding of an individual disease or disability condition, activity and participation were found to be the most important factors.Simple clinical measures, such as activity limitations and participation restrictions, can be used as clinical markers of quality of life, thus enabling rehabilitation professionals to determine the quality of life of older people in institutions.The conceptual framework of determinants of quality of life that this study reports may be helpful for rehabilitation professionals to explore with patients to implement interventions.
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Affiliation(s)
- Yi-Chang Chen
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Keh-Chung Lin
- Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Yi Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Chen-Jung Chen
- Department of Nursing, Mackay Medical College, New Taipei, Taiwan
| | - Yu-Wei Hsieh
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan
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24
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Maezawa K, Nozawa M, Yuasa T, Sato H, Gomi M, Kaneko K. Early clinical results of total hip arthroplasty assessed with the 25-question Geriatric Locomotive Function Scale and muscle strength testing. J Orthop Sci 2018. [PMID: 29525200 DOI: 10.1016/j.jos.2018.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND We think that it is necessary to evaluate whether the patient after total hip arthroplasty has achieved age-appropriate locomotor ability by improvement in hip joint function. The 25-question Geriatric Locomotive Function Scale (GLFS-25) have been determined age-specific standard values for the general population. The aim of this study was to compare postoperative hip muscle strength and functional performance at 3 months after THA with preoperative levels, and to compare the outcomes at 3 months after THA with the function of age-matched adults without hip disease. METHODS The GLFS-25 scores and muscle strength were investigated before THA and 3 months after surgery in 12 men and 75 women who underwent total hip arthroplasty. RESULTS The mean preoperative and postoperative GLFS-25 score was 55.4 and 19.1, respectively. With regard to the influence of age, the mean scores before and after THA were respectively 52.0 versus 18.2 for patients aged 60-69 years and 61.2 versus 17.3 for those aged 70-79 years in the normal/mild OA group. When female patients from the normal/mild OA group and the implant group classified into levels 4-7 after THA were combined (n = 15), their mean preoperative and postoperative straight leg raising (SLR) strength was 0.56 Nm/kg and 0.75 Nm/kg, respectively. On the other hand, the mean preoperative and postoperative SLR strength was respectively 0.54 Nm/kg and 0.86 Nm/kg for patients classified into levels 1-3 after THA (n = 45). CONCLUSION Before THA, 90% of the patients who has severe hip disturbance were in need of nursing care (levels 4-7), while the percentage decreased to 30% after surgery. There was a difference of SLR muscle strength between the patients in levels 4-7 and those in levels 1-3 after THA, suggesting that achieving levels 1-3 postoperatively might depend on whether SLR muscle strength shows improvement.
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Affiliation(s)
- Katsuhiko Maezawa
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu City, Chiba, 279-0021, Japan.
| | - Masahiko Nozawa
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Takahito Yuasa
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu City, Chiba, 279-0021, Japan
| | - Hironobu Sato
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu City, Chiba, 279-0021, Japan
| | - Motosi Gomi
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu City, Chiba, 279-0021, Japan
| | - Kazuo Kaneko
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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25
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Abstract
The deterioration of locomotive components, which comprise bones, joints, and intervertebral discs, and muscles and nerves, can lead to symptoms such as pain, limitations in the range of joint mobility, malalignment, impaired balance, and difficulty walking. Locomotive syndrome (LoS) was proposed by the Japanese Orthopedic Association in 2007 as a concept for people who are at a high risk of developing a musculoskeletal ambulation disability attributed to locomotor organs. Although many international articles related to LoS have been published, an international consensus of this concept seems to be lacking. This review article on LoS introduces the concept, the related assessment methods, and the condition's prevalence based on the most up-to-date literature, and discusses discrimination from frailty and sarcopenia, relevance to musculoskeletal problems, management plan, and future directions. Familiarity with recent evidence would be useful for the health care providers in an aging society to educate individuals with LoS or pre-LoS and to maintain their well-being and prevent them from requiring long-term care.
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Affiliation(s)
- Tatsunori Ikemoto
- Department of Orthopaedic Surgery, Aichi Medical University, Yazako Karimata, Nagakute, Aichi, Japan
| | - Young-Chang Arai
- Institute of Physical Fitness, Sports Medicine and Rehabilitation, Aichi Medical University, Yazako Karimata, Nagakute, Aichi, Japan
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26
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Kobayashi Y, Ogata T. Association between the gait pattern characteristics of older people and their two-step test scores. BMC Geriatr 2018; 18:101. [PMID: 29699495 PMCID: PMC5921743 DOI: 10.1186/s12877-018-0784-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 04/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Two-Step test is one of three official tests authorized by the Japanese Orthopedic Association to evaluate the risk of locomotive syndrome (a condition of reduced mobility caused by an impairment of the locomotive organs). It has been reported that the Two-Step test score has a good correlation with one's walking ability; however, its association with the gait pattern of older people during normal walking is still unknown. Therefore, this study aims to clarify the associations between the gait patterns of older people observed during normal walking and their Two-Step test scores. METHODS We analyzed the whole waveforms obtained from the lower-extremity joint angles and joint moments of 26 older people in various stages of locomotive syndrome using principal component analysis (PCA). The PCA was conducted using a 260 × 2424 input matrix constructed from the participants' time-normalized pelvic and right-lower-limb-joint angles along three axes (ten trials of 26 participants, 101 time points, 4 angles, 3 axes, and 2 variable types per trial). RESULTS The Pearson product-moment correlation coefficient between the scores of the principal component vectors (PCVs) and the scores of the Two-Step test revealed that only one PCV (PCV 2) among the 61 obtained relevant PCVs is significantly related to the score of the Two-Step test. CONCLUSIONS We therefore concluded that the joint angles and joint moments related to PCV 2-ankle plantar-flexion, ankle plantar-flexor moments during the late stance phase, ranges of motion and moments on the hip, knee, and ankle joints in the sagittal plane during the entire stance phase-are the motions associated with the Two-Step test.
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Affiliation(s)
- Yoshiyuki Kobayashi
- Digital Human Research Group, Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology, 2-3-26 Aomi, Koto-ku, Tokyo, 135-0064, Japan.
| | - Toru Ogata
- National Rehabilitation Center for Persons with Disabilities, 4-1 Namiki, Tokorozawa-shi, Saitama, Japan
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Izawa N, Hirose J, Fujii T, Oka H, Uehara K, Naito M, Matsumoto T, Tanaka S, Tohma S. The utility of 25-question Geriatric Locomotive Function Scale for evaluating functional ability and disease activity in Japanese rheumatoid arthritis patients: A cross-sectional study using NinJa database. Mod Rheumatol 2018; 29:328-334. [PMID: 29575947 DOI: 10.1080/14397595.2018.1457422] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To investigate the distribution of 25-question Geriatric Locomotive Function Scale (GLFS-25) scores in Japanese rheumatoid arthritis (RA) patients and evaluate relationships with clinical variables. METHODS Among 15,115 patients registered in the NinJa database for fiscal year 2015, 1710 with complete GLFS-25 and disease activity score-28 (DAS28) data were analyzed. Correlations between GLFS-25 score and clinical variables were assessed by Spearman coefficients. Mean GLFS-25 scores were compared among DAS28 groups (<2.6, 2.6-3.1, 3.2-5.0, ≥5.1) using the Kruskal-Wallis test. To evaluate the performance of the GLFS-25 and Health Assessment Questionnaire Disability Index (HAQ-DI) for predicting DAS28 ≥ 3.2 (moderate/high disease activity), receiver operator characteristic (ROC) curves were constructed. RESULTS GLFS-25 score was significantly correlated with age, disease duration, DAS28, and HAQ-DI. GLFS-25 score increased in parallel with DAS28. The proportion of patients with locomotive syndrome stage 2 also increased with DAS28. Area under the curve values for HAQ-DI and GLFS-25 score were 0.739 and 0.768, respectively. At a GLFS-25 positive cutoff score ≥16, sensitivity was 0.716 and specificity was 0.661 for predicting DAS28 ≥ 3.2. CONCLUSION This study documents the GLFS-25 score distribution in Japanese RA patients and demonstrates that GLFS-25 is a useful measure for evaluating functional ability in RA.
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Affiliation(s)
- Naohiro Izawa
- a Faculty of Medicine, Department of Orthopaedic Surgery , The University of Tokyo , Tokyo , Japan
| | - Jun Hirose
- a Faculty of Medicine, Department of Orthopaedic Surgery , The University of Tokyo , Tokyo , Japan
| | - Tomoko Fujii
- b Faculty of Medicine, Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center , The University of Tokyo , Tokyo , Japan
| | - Hiroyuki Oka
- b Faculty of Medicine, Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center , The University of Tokyo , Tokyo , Japan
| | - Kosuke Uehara
- a Faculty of Medicine, Department of Orthopaedic Surgery , The University of Tokyo , Tokyo , Japan
| | - Masashi Naito
- a Faculty of Medicine, Department of Orthopaedic Surgery , The University of Tokyo , Tokyo , Japan
| | - Takumi Matsumoto
- a Faculty of Medicine, Department of Orthopaedic Surgery , The University of Tokyo , Tokyo , Japan
| | - Sakae Tanaka
- a Faculty of Medicine, Department of Orthopaedic Surgery , The University of Tokyo , Tokyo , Japan
| | - Shigeto Tohma
- c Clinical Research Center for Allergy and Rheumatology , Sagamihara Hospital, National Hospital Organization , Sagamihara , Japan
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28
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Evandrou M, Falkingham JC, Qin M, Vlachantoni A. Elder abuse as a risk factor for psychological distress among older adults in India: a cross-sectional study. BMJ Open 2017; 7:e017152. [PMID: 29061615 PMCID: PMC5665217 DOI: 10.1136/bmjopen-2017-017152] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study examines the association between elder abuse and psychological distress among older adults in India and explores whether this association varies by the level of psychosocial and material resources. DESIGN The study uses a cross-sectional survey design. SETTING The data are drawn from a representative sample of 9589 adults aged 60 and above in seven Indian states-Himachal Pradesh, Punjab, West Bengal, Odisha, Maharashtra, Kerala and Tamil Nadu-in 2011. STATISTICAL ANALYSES Secondary analysis, using bivariate and multivariate logistic regression models, is conducted using the United Nations Population Fund project Building Knowledge Base on Ageing in India survey. Elder abuse (physical and/or emotional) emanating from family members in the previous month before the survey is examined. Multivariate models are run on the total analytical sample and for men and women separately. RESULTS The overall prevalence of psychological distress among persons aged 60 and over living in the seven Indian States is 40.6%. Among those older persons who experienced some form of physical or emotional abuse or violence in the last month, the prevalence of psychological distress is much higher than that in the general older population, at 61.6% (p<0.001). The results show that the experience of abuse is negatively associated with the mental health of older adults, and this relationship persists even after controlling for demographic and socioeconomic factors (OR=1.60, 95% CI 1.22 to 2.09). The findings also suggest that household wealth has an inverse relationship with mental health, with the association between experiencing elder abuse and reporting poor mental health being strongest among older people in wealthy households. CONCLUSIONS Elder abuse in India is currently a neglected phenomenon, and greater recognition of the link between abuse and mental health is critical to improve the well-being of vulnerable older adults, some of whom may be 'hidden' within well-off households.
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Affiliation(s)
- Maria Evandrou
- Centre for Research on Ageing, ESRC Centre for Population Change, University of Southampton, Southampton, UK
| | - Jane C Falkingham
- Centre for Research on Ageing, ESRC Centre for Population Change, University of Southampton, Southampton, UK
| | - Min Qin
- Centre for Research on Ageing, ESRC Centre for Population Change, University of Southampton, Southampton, UK
| | - Athina Vlachantoni
- Centre for Research on Ageing, ESRC Centre for Population Change, University of Southampton, Southampton, UK
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