[Factors associated with activities of daily living (ADL) in independently living elderly persons in a community: a baseline examination of a large scale cohort study, Fujiwara-kyo study]

Older Community Residents Who Participate in Group Activities Have Higher Daily Physical Activity Levels and Lower Medical Costs

Participation in a group activity improves levels of activities of daily living and self-rated health in community-dwelling older adults. However, whether the group activity is associated with daily physical activity (PA) levels and medical costs has not yet been explored. The author administered a questionnaire to participants of group activities for community-dwelling older adults. Levels of daily PA were greater in those who participated once a month (n = 1147), twice a month (n = 1432), and 4 times a month (n = 635) compared with nonparticipating counterparts (n = 570). In the stepwise regression, group activity participation rate was identified as an independent predictor of daily PA levels. Before group activities began, there were no differences in medical costs between participants (n = 721) and nonparticipants (n = 1124). However, after group activities were established, medical costs were lower in participants than in nonparticipants. These results suggest that older community residents who participate in group activities have higher daily PA levels and lower medical costs.

Multimorbidity associated with functional independence among community-dwelling older people: a cross-sectional study in Southern China

Background

Multimorbidity, the coexistence of two or more chronic diseases, is common in older adults. And it may lead to many adverse health outcomes, such as disability. However, data on multimorbidity and its relationship with functional independence are scarce in Asian countries. Therefore, this study aims to investigate the relationship between multimorbidity and functional status among older people in China.

Methods

Based on a cross-sectional survey, the information regarding 2705 older adults, who were of at least 60 years of age, was collected through interviews and analyzed. To assess functional status, we used the Functional Independence Measure (FIM). Exploratory factor analysis was performed to assess correlations among chronic diseases. Several logistic regression models were run in the study.

Results

The presence of two or more chronic conditions and the number of multimorbidity group overlaps were independent risk factors for the loss of functional independence in older adults. Hypertension and chronic pain, emerged as the most prevalent multimorbidity pair, was significantly associated with functional independence (OR = 1.64, 95% CI = 1.25–2.16), followed by the co-occurrence of hypertension and heart diseases with a lower prevalence but a higher OR compared with the former pair (OR = 1.72, 95% CI = 1.15–2.58). Of the five multimorbidity groups used for factor analysis, the bones and pain group (OR = 1.47, 95% CI = 1.23–1.77) and the cardiometabolic group (OR = 1.34, 95% CI = 1.13–1.59) were both found to be significantly correlated with lower functional independence.

Conclusions

Multimorbidity was common among older people in Southern China. Studying the relationship between multimorbidity and functional status could be useful to find potential correlations among chronic diseases. Additionally, it may also be meaningful to identify multimorbidity combinations, posing an increased risk of loss of functional independence, and further improve functional status in older adults with comorbidities.

A structured physical activity and fitness programme for older adults with intellectual disabilities: results of a cluster-randomised clinical trial

BACKGROUND

The physical activity level of older adults with intellectual disabilities (ID) is extremely low, and their fitness levels are far beneath accepted norms for older people with normal intelligence and comparable with frail older people. A physical activity programme, including an education programme, was developed for older adults with ID using behaviour change techniques. The programme aimed at improving or maintaining adequate levels of physical activity (primary outcome measure) and motor fitness, cardio respiratory fitness, morphologic and metabolic fitness, activities of daily living, cognitive functioning and depressive symptoms (secondary outcome measures).

METHOD

The programme's efficacy was evaluated in a cluster-randomised clinical trial among people aged 43 years and over with mild-moderate levels of ID. Five day-activity centres were randomised to the participation group. In these centres, 81 older adults participated in groups of 8 to 10 in the programme, three times a week during 8 months. The programme was executed by physical activity instructors and staff of day-activity centres. Five other day-activity centres were randomised to the control group; 70 older adults in these centres received care as usual. The generalised linear model with mixed effects was used to test the programme's effectiveness.

RESULTS

Significant effects were found on physical activity, muscle strength, systolic and diastolic blood pressure, serum cholesterol level and cognitive functioning, in favour of the programme's participants. No significant improvements were found on balance, serum glucose, weight, waist circumference, walking speed, mobility, depression or instrumental activities of daily living.

CONCLUSIONS

The physical activity and fitness programme has established small but significant effects in this sample, but generalising the findings to other settings is difficult due to significant participant dropout. Implementation of evidence-based physical activity programmes among older adults with ID is recommended. Further research is needed to investigate the effectiveness of physical activity on daily life functioning and the development on chronic diseases in the long run.