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Suchy Y, Simpson A, Mora MG, DesRuisseaux LA, Brothers SL, Mullen CM. Test of Practical Judgment (TOP-J): Construct, Criterion, and Incremental Validity in a Community Sample of Older Adults. Arch Clin Neuropsychol 2024; 39:355-366. [PMID: 38097261 DOI: 10.1093/arclin/acad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE The Test of Practical Judgment (TOP-J) is a stand-alone judgment measure that is considered to tap into aspects of executive functioning (EF) and inform clinical predictions of daily functioning in older adults. Past validation research is variable and has some limitations. The present study sought to examine the reliability and construct, criterion, and incremental validities of scores on TOP-J 9-item version (TOP-J/9). METHOD Participants were 95 community-dwelling older adults aged 60 to 85. Participants completed TOP-J/9, measures of EF and global cognition, and three different modalities of instrumental activities of daily living (IADLs) (self-report, performance-based tasks conducted in the laboratory, and performance-based tasks completed at home over 3 weeks). RESULTS TOP-J/9 scores showed adequate internal consistency (α = 0.73) after correcting for the low number of items. TOP-J/9 was correlated with global cognition and EF, although EF did not survive correction for lower-order processes. Finally, although TOP-J/9 scores were associated with home-based IADL tasks (but not with self-report and laboratory-based IADLs), providing some evidence of criterion validity, they did not incrementally contribute to home-based IADL performance beyond other cognitive measures. However, when two items pertaining to social/ethical judgment were removed, this modified version of TOP-J did relate to EF beyond lower-order processes and contributed uniquely to prediction of home-based IADLs beyond other measures. CONCLUSION Results suggest that TOP-J/9 taps into global cognitive status (but not necessarily EF) and predicts "real-world" functioning (but not above and beyond other cognitive measures). TOP-J psychometrics may be improved by removing two social/ethical items.
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Affiliation(s)
- Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Austin Simpson
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | | | | | | | - Christine M Mullen
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Utah, Salt Lake City, UT, USA
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Hoang AT, Tran TH, Vu HM, Do HT, Vu TMT, Vu LG, Nguyen CT, Do HP, Latkin CA, Ho RCM, Ho CSH. Evaluation of activities and instrumental activities of daily living and correlated factors of traumatic brain injury patients in Vietnam. Sci Rep 2024; 14:8267. [PMID: 38594552 PMCID: PMC11003974 DOI: 10.1038/s41598-024-58472-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 03/29/2024] [Indexed: 04/11/2024] Open
Abstract
Traumatic brain injury (TBI) is among the leading causes of death in Vietnam. Survivors of TBI suffer from functional and cognitive deficits. Understanding that Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) are crucial in measuring the treatment and health-related quality of life among patients with TBI. This study aims to evaluate ADLs and IADLs among the TBI population in Vietnam and determine the correlated factors to these two indices. A cross-sectional study was conducted on 212 patients with TBI in Vietnam from February to September 2020. ADLs and IADLs scales were applied. Depression, quality of sleep, and social support scales were used. Multivariate Tobit regression was adopted to identify factors associated with ADLs and IADLs. Patients who received first aid had higher ADLs scores than those who had not, by a statistical difference with a p value = 0.04. The mean ADLs score was 5.4 (SD = 1.4). The mean score of IADLs was 7.3 (SD = 1.7). Female patients (Mean = 7.6, SD = 1.1) performed better in IADLs than male patients (Mean = 7.1, SD = 1.9). Both ADLs and IADLs were affected strongly by depression and Injury Severity scores (p < 0.01), whereas IADLs were significantly correlated to caregiver types and quality of sleep (p < 0.01). Family support was observed as a negatively correlated factor to IADLs. Findings from the study provided evidence for authorities to adjust the health strategies among patients with TBI. Proper prehospital care, a basic low-cost hospital care model, and mental health counseling services should be considered when developing health interventions in Vietnam.
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Affiliation(s)
- Anh Thuy Hoang
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 100000, Vietnam
| | - Tung Hoang Tran
- Institute of Orthopedic and Trauma Surgery, Vietnam - Germany Hospital, Hanoi, Vietnam
| | - Hai Minh Vu
- Department of Trauma, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam
| | - Hoa Thi Do
- Institute of Health Economics and Technology (iHEAT), Hanoi, 100000, Vietnam
| | - Thuc Minh Thi Vu
- Institute of Health Economics and Technology (iHEAT), Hanoi, 100000, Vietnam
| | - Linh Gia Vu
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam.
- Faculty of Medicine, Duy Tan University, Da Nang, 550000, Vietnam.
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, 550000, Vietnam
| | - Huyen Phuc Do
- Institute of Health Economics and Technology (iHEAT), Hanoi, 100000, Vietnam
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, 119077, Singapore
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
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Goldstein A, Commissariat PV, Sullivan KL, Hallowell ES, Davis JD, Margolis SA. Compensatory Strategy Intervention: What Older Patients Want and Why. Arch Clin Neuropsychol 2024:acae023. [PMID: 38520386 DOI: 10.1093/arclin/acae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/30/2024] [Accepted: 03/01/2024] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVE Compensatory strategies can improve performance of instrumental activities of daily living in people with cognitive impairment. This study investigated patient interest in compensatory strategy interventions and preference for various intervention formats. METHODS Semi-structured qualitative interviews with 38 older adults with cognitive impairment queried motivation to improve strategy use and interest in intervention formats/delivery methods. Two coders used thematic analysis to determine rates of interest in each intervention type and explore patient-reported barriers and facilitators to motivation and intervention models. RESULTS Most of the samples reported motivation to enhance compensatory strategy use. Degree of motivation was driven by current experiences with strategy use, perceived benefit of potential changes, intrinsic desire to improve life and self, and current perceived need. The vast majority were interested in hour-long, multi-session, instructor-led interventions. Just over half of the sample was interested in a self-directed virtual program, and just under half was interested in involving family/friends. Facilitators and barriers to interest in intervention formats and delivery methods varied based on participants' previous experiences, preferred learning style, content, and time commitment of the intervention, and perceived current need for intervention. One-fifth of the sample expressed no interest in any intervention type, though they expressed openness to assistance in the future as needed. CONCLUSIONS Older adults with cognitive impairment are generally motivated to enhance their compensatory strategy use. Clinicians/researchers designing compensatory strategy interventions should consider instructor-led formats, present individualized benefits of interventions, and demonstrate the benefits of both preventative and remedial intervention to optimize patient engagement.
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Affiliation(s)
- Allyson Goldstein
- Department of Adult Psychiatry and Behavioral Health, Rhode Island Hospital, Providence, RI, USA
| | - Persis V Commissariat
- Section on Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - Kelli L Sullivan
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Adult Psychiatry and Behavioral Health, Miriam Hospital, Providence, RI, USA
| | - Emily S Hallowell
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Mental Health and Behavioral Sciences, Providence Veterans Administration Medical Center, Providence, RI, USA
| | - Jennifer D Davis
- Department of Adult Psychiatry and Behavioral Health, Rhode Island Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Seth A Margolis
- Department of Adult Psychiatry and Behavioral Health, Rhode Island Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Li Y, Jiang M, Ren X, Han L, Zheng X, Wu W. Hypertension combined with limitations in activities of daily living and the risk for cardiovascular disease. BMC Geriatr 2024; 24:225. [PMID: 38439007 PMCID: PMC10913420 DOI: 10.1186/s12877-024-04832-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVE The aim of present study was to evaluate the combined effect of hypertension and activities of daily living (ADL)/instrumental activities of daily living (IADL) with the risk of CVD, stroke and cardiac events. METHODS A total of 14,083 participants aged 45 years or older from the China Health and Retirement longitudinal study were included in current study. Participants were divided into 4 groups according to hypertension and ADL/IADL status. Cox proportional hazards regression model was used to explore the associations between hypertension, ADL/IADL and new-onset CVD, stroke and cardiac events. RESULTS During the 7-year follow-up, a total of 2,324 respondents experienced CVD (including 783 stroke and 1,740 cardiac events). Individuals with limitations in ADL alone, or with hypertension alone, or with both limitations in ADL and hypertension were associated with increased risk of CVD, with the adjusted hazard ratios (95% confidence intervals) were 1.17(1.00-1.35), 1.36(1.24-1.49) and 1.44(1.23-1.68), respectively. Those with limitations in ADL and hypertension also had higher risk of stroke (hazard ratios = 1.64; 1.26-2.14) and cardiac events (hazard ratios = 1.37; 1.14-1.64). Similarly, individuals with both limitations in IADL and hypertension were associated with increased risk of CVD (hazard ratios = 1.34; 1.15-1.57), stroke (hazard ratios = 1.50; 1.17-1.95) and cardiac events (hazard ratios = 1.27; 1.06-1.53). CONCLUSION Hypertension and limitations in ADL/IADL jointly increased the risk of CVD, stroke and cardiac events.
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Affiliation(s)
- Yiqun Li
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, 214122, Wuxi, Jiangsu Province, China
| | - Minglan Jiang
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, 214122, Wuxi, Jiangsu Province, China
| | - Xiao Ren
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, 214122, Wuxi, Jiangsu Province, China
| | - Longyang Han
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, 214122, Wuxi, Jiangsu Province, China
| | - Xiaowei Zheng
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, 214122, Wuxi, Jiangsu Province, China.
| | - Wenyan Wu
- Center of Clinical Laboratory, The Fifth People's Hospital of Wuxi, Affiliated Hospital of Jiangnan University, Jiangnan University , 214011, Wuxi, Jiangsu, China.
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Kong LL, Xie W, Dong ZY, Liu YT, Zhao HM, Fan JY, Qi XJ, Li J. Cognitive frailty and its association with disability among Chinese community-dwelling older adults: a cross-sectional study. BMC Geriatr 2024; 24:189. [PMID: 38409011 PMCID: PMC10895716 DOI: 10.1186/s12877-024-04773-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/02/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND There are a variety of determinants that are key to functional disability of older adults. However, little is known regarding the relationship between cognitive frailty and disability among older people. The aims of this study were to examine the associations between cognitive frailty and its six components with instrumental activities of daily living (IADL) functioning in community-dwelling older adults. METHODS A total of 313 community-dwelling older adults (aged ≥ 65 years) were recruited from eight community centers in central China. Cognitive frailty was operationalized using the Mini-Mental State Examination for the evaluation of cognitive status and the Fried criteria for the evaluation of physical frailty. The outcome was functional disability assessed by the IADL scale. The association between cognitive frailty, as well as its components, and IADL limitations was identified by conducting binary logistic regression analysis. RESULTS The prevalence of cognitive frailty was 8.9% in this study. The results showed that cognitive frailty (OR = 22.86) and frailty without cognitive impairment (OR = 8.15) were associated with IADL limitations. Subdimensions of cognitive frailty, exhaustion, weakness, low physical activity and cognitive impairment components were independently associated with IADL limitations. CONCLUSION Cognitive frailty was associated with a higher prevalence of disability. Interventions for improving cognitive frailty should be developed to prevent IADL disability among community-dwelling older adults in China.
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Affiliation(s)
- Ling-Lin Kong
- School of Public Health and Nursing, Hubei University of Science and Technology, Xianning, China
| | - Wen Xie
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zi-Yan Dong
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue-Ting Liu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui-Min Zhao
- College of Nursing, Shanxi University of Chinese Medicine, Jinzhong, China
| | - Jun-Yao Fan
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-Jing Qi
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jie Li
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Shoji T, Kogure K, Toda N, Hakoshima M, Katsuyama H, Yanai H, Tokunaga S, Tateoka K, Tsuji T, Okura T. Association between comorbidities associated with diabetes and higher-level functional status in older patients with type 2 diabetes mellitus: a cross sectional study. Eur Geriatr Med 2024:10.1007/s41999-024-00937-8. [PMID: 38340284 DOI: 10.1007/s41999-024-00937-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/04/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE To investigate the association between comorbidities associated with diabetes and higher-level functional status as well as the relationship between comorbidities associated with diabetes and higher-level functional status in older patients with type 2 diabetes mellitus who have better social networks. METHODS Participants were outpatients with type 2 diabetes aged ≥ 65 years, excluding individuals with severe cardiovascular or respiratory illness, hyperglycaemic crisis, type 1 diabetes, or diabetic foot. The Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) was used to evaluate the higher-level functional status. A TMIG-IC score of ≤ 9, instrumental activities of daily living (IADL) ≤ 4, intellectual activity or social role ≤ 3 were defined as decline in higher-level functional status. The comorbidities investigated included peripheral neuropathy, retinopathy, nephropathy, cognitive impairment, depression, frailty, sarcopenia, low muscle strength, stroke, heart disease, and arthritis. RESULTS The analysis included 198 patients (mean age 75.9 ± 5.7 years, male 60.1%). After adjusting for potential confounders, depression was associated with TMIG-IC (Prevalence ratio (PR) 2.34, 95% confidence interval (CI) 1.44-3.82), low muscle strength was associated with IADL (PR 2.85, 95% CI 1.30-6.27), and frailty was associated with intellectual activity (PR 1.38, 95% CI 1.10-1.74). In the model with social networks added as a confounder, the relationship between depression or low muscle strength and higher-level functional status was not statistically significant. CONCLUSION Comorbidities of depression and low muscle strength for older patients with type 2 diabetes mellitus increase the risk of malfunctioning of higher-level functional status. Increased interactions with family, friends and neighbours may reduce this event.
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Affiliation(s)
- Takuro Shoji
- Department of Rehabilitation Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Kohnodai 1-7-1, Ichikawa, Chiba, 272-8516, Japan.
- Graduate School of Comprehensive Human Sciences, Doctoral Program in Public Health, University of Tsukuba, Tsukuba, Ibaraki, Japan.
| | - Kenta Kogure
- Department of Rehabilitation Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Kohnodai 1-7-1, Ichikawa, Chiba, 272-8516, Japan
| | - Nagisa Toda
- Department of Rehabilitation Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Kohnodai 1-7-1, Ichikawa, Chiba, 272-8516, Japan
| | - Mariko Hakoshima
- Department of Diabetes, Endocrinology, and Metabolism, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan
| | - Hisayuki Katsuyama
- Department of Diabetes, Endocrinology, and Metabolism, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan
| | - Hidekatsu Yanai
- Department of Diabetes, Endocrinology, and Metabolism, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan
| | - Satoshi Tokunaga
- Graduate School of Comprehensive Human Sciences, Doctoral Program in Public Health, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Korin Tateoka
- Graduate School of Comprehensive Human Sciences, Doctoral Program in Physical Education, Health and Sport Sciences, University of Tsukuba, Tuskuba, Ibaraki, Japan
| | - Taishi Tsuji
- Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tomohiro Okura
- Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Ding H, Wang K, Li Y, Zhao X. Trends in disability in activities of daily living and instrumental activities of daily living among Chinese older adults from 2011 to 2018. Aging Clin Exp Res 2024; 36:27. [PMID: 38326510 PMCID: PMC10850014 DOI: 10.1007/s40520-023-02690-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/28/2023] [Indexed: 02/09/2024]
Abstract
AIM This study aimed to assess the trends in disabilities in activities of daily living (ADL) and instrumental activities of daily living (IADL) among older Chinese adults and explore the influence of multimorbidity and unhealthy behaviors on ADL/IADL disability over time. METHODS Data were obtained from four waves (2011-2018) of the China Health and Retirement Longitudinal Study. Disability in ADL/IADL was defined as inability to perform any ADL/IADL task. Latent class analysis was used to identify multimorbidity patterns. The generalized estimating equation was used to test disability trends. Logistic regression was used to investigate the factors influencing disability. RESULTS The prevalence of IADL and ADL disability showed significant increasing trends among older Chinese adults from 2011 to 2018 (ptrend < 0.001). The negative association between alcohol intake more than once per month and IADL disability strengthened over time (ptrend < 0.05). The influence of the "arthritis/digestive diseases" pattern, "cardiometabolic disease" pattern and "high multimorbidity" pattern on ADL disability weakened over time (ptrend < 0.05). CONCLUSIONS The prevalence of IADL and ADL disability among Chinese older adults increased over time. The "arthritis/digestive diseases" pattern, "cardiometabolic disease" pattern and "high multimorbidity" pattern appeared to be less disabling in ADL over time. Improving the prevention and treatment of multimorbidity and developing age-friendly living conditions could be helpful to reduce the risks of disability.
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Affiliation(s)
- Hua Ding
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Kun Wang
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Yanan Li
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Xinyi Zhao
- School of Health Humanities, Peking University, Beijing, China.
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Wang Y, Xu X, Liu J, Lv Q, Chang H, He Y, Zhao Y, Zhang X, Zang X. Latent transition analysis of instrumental activities of daily living in Chinese elderly: based on the 2014-2018 wave of the Chinese Longitudinal Healthy Longevity Survey. BMC Geriatr 2024; 24:83. [PMID: 38254009 PMCID: PMC10804623 DOI: 10.1186/s12877-023-04631-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND The instrumental activities of daily living (IADL) among the elderly have been found to be heterogeneous, with different trajectories. However, the transition of the IADL over time remains unclear. We aimed to explore the transition probabilities and the predictors of IADL among the elderly. METHODS Longitudinal data from the 2014 (T1) and 2018 (T2) waves of the Chinese Longitudinal Healthy Longevity Survey were extracted. A sample of 2,944 participants aged 65 years or older, with complete responses to the IADL scale, was included. Latent profile analysis (LPA) and latent transition analysis (LTA) were employed to identify latent profiles of IADL and investigate the transition probabilities between profiles from T1 to T2. The predictors of latent profiles and transition probabilities were examined using multinomial regression analysis. RESULTS The results of LPA at both T1 and T2 supported a 4-profile model solution. They were labeled as the "Normal function profile," "Mildly impaired profile," "Moderately impaired profile," and "Highly impaired profile". The Normal function profile and Highly impaired profile were characterized by maintaining stability rather than transitioning over time, with transition probabilities of 0.71 and 0.68, respectively, for maintaining stability. The Mildly impaired profile and Moderately impaired profile were characterized by a stronger tendency towards transition rather than stability, with transition probabilities of 0.29 and 0.45, respectively, of transitioning to the Highly impaired profile. The transition probabilities from the three impaired function profiles to the Normal function profile ranged from 0.05 to 0.19. Age, gender, place of residence, and social participation were significant predictors of profile attribution at T1 and transition probabilities over time. CONCLUSIONS This study employed the LTA to examine the transition probability of IADL among the Chinese elderly. By recognizing the different profiles of IADL and understanding the factors associated with transitions among the elderly, interventions can be tailored to improve their functional independence and successful reintegration into families and society.
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Affiliation(s)
- Yaqi Wang
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Xueying Xu
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Jingwen Liu
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Qingyun Lv
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Hairong Chang
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Yuan He
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Xiaonan Zhang
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China.
| | - Xiaoying Zang
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China.
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Tai LA, Tsai LY, Lin CH, Chiu YC. Depressive symptoms and daily living dependence in older adults with type 2 diabetes mellitus: the mediating role of positive and negative perceived stress. BMC Psychiatry 2024; 24:14. [PMID: 38166717 PMCID: PMC10762910 DOI: 10.1186/s12888-023-05273-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/11/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Higher stress is associated with higher levels of depression and instrumental-activities-of-daily-living (IADL) dependence, and depression is strongly associated with specific IADL disabilities. Accordingly, the aim of this study was to investigate the mediating effect of perceived stress on the association between depression and IADL dependence among older adults with diabetes mellitus (DM). METHODS We examined baseline data collected from a longitudinal study that recruited 110 patients with DM aged ≥ 65 years from the endocrinology outpatient clinic of a district hospital. The instruments used for our measurement processes comprised a demographic data sheet and Chinese versions of the Perceived Stress Scale (PSS), the short form of the Geriatric Depression Scale (GDS-S), and the Lawton IADL Scale. We assessed the mediating effects of positive perceived stress (PPS) and negative perceived stress (NPS) after controlling for five covariates by using a regression-based model run through the SPSS macro PROCESS. RESULTS We observed negative correlations between GDS-S scores and PPS and between PPS and IADL dependence; we noted positive correlations between GDS-S scores and NPS and between NPS and IADL dependence (all P < 0.01). The indirect effect is coefficient = 0.12, [95% confidence interval = (0.0, 0.33)], suggesting that PPS achieves a mediating effect between depressive symptoms and IADL dependence. However, the NPS does not achieve a mediating effect in the relationship between depressive symptoms and IADL dependence (coefficient = 0.06, 95% CI = - 0.03, 0.15). CONCLUSIONS Personal PPS mediates the association between depression and IADL dependence in older adults with DM. This finding suggests that providing patients with psychological education to promote their PPS may help prevent their functional decline.
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Affiliation(s)
- Li Ai Tai
- Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, New Taipei, Taiwan
| | - Le Yu Tsai
- Department of Endocrinology and Metabolism, Yonghe Cardinal Tien Hospital, New Taipei, Taiwan
| | - Chia Hung Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi Chen Chiu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Abstract
OBJECTIVES Hospitalization is a stressful event that may lead to deterioration in older adults' mental health. Drawing on the stress-buffering hypothesis, we examined whether family support during hospitalization would moderate the relations between level of independence and in-hospital depressive symptoms. METHOD This research was a secondary analysis of a cohort study conducted with a sample of 370 hospitalized older adults. Acutely ill older adults reported their level of independence at time of hospitalization and their level of depressive symptoms three days into the hospital stay. Family support was estimated by a daily report of hours family members stayed with the hospitalized older adult. RESULTS Independent older adults whose family members stayed longer hours in the hospital had fewer depressive symptoms than independent older adults with shorter family visits. Relations between depressive symptoms and family support were not apparent for dependent older adults, even though their family members stayed more hours. CONCLUSIONS This study partially supports the stress-buffering hypothesis, in that social support ameliorated depressive symptoms among hospitalized independent older adults. CLINICAL IMPLICATIONS Assessing depressive symptoms and functional ability and creating an environment conducive to family support for older adults may be beneficial to hospitalized older adults' mental health.
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Affiliation(s)
- Ksenya Shulyaev
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Science, University of Haifa, Haifa, Israel
- The Minerva Centre on Intersectionality in Aging (MCIA), Faculty of Social Welfare and Health Science, University of Haifa, Haifa, Israel
| | - Yochy Spielberg
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Science, University of Haifa, Haifa, Israel
| | - Nurit Gur-Yaish
- The Faculty of Graduate Studies, Oranim Academic College of Education, Kiryat Tiv'on, Israel
| | - Anna Zisberg
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Science, University of Haifa, Haifa, Israel
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11
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Giles GM, Marks TS, Edwards DF. Loss-of-Set and Strategy Application on the Menu Task: An Exploratory Study. Can J Occup Ther 2023; 90:413-422. [PMID: 37218122 DOI: 10.1177/00084174231175018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Background. The Menu Task (MT) is an occupational therapy screening measure designed to identify people in need of functional cognitive (FC) assessment. Purpose. To explore whether test-taker strategy selection on the MT is clinically informative. Methods. Using a cross-sectional design we administered assessments of FC including the MT and the After MT interview, cognitive screening measures, and self-report instrumental activities of daily living assessment to a convenience sample of 55 community-dwelling adults. After MT interviews responses were qualitatively characterized as (a) loss of set (e.g., not recognizing that food preferences are irrelevant to task performance), (b) calorie counting, or (c) planning. Findings. Loss of set was associated with poorer performance on most study measures, calorie counting was associated with superior performance on most study measures, and no differences were observed relating to planning. Implications. Determining the test-takers approach to the MT adds information to that provided by the MT itself.
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12
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Mora MG, Suchy Y. Know thyself: Executive functioning and sex predict self-appraisal of functional abilities in community-dwelling older adults. Clin Neuropsychol 2023; 37:1686-1709. [PMID: 36779583 DOI: 10.1080/13854046.2023.2167738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/06/2023] [Indexed: 02/14/2023]
Abstract
Objective: The capacity for accurate self-appraisals of age-related changes in cognitive and functional abilities is integral to the maintenance of independence in later life, yet there is little understanding of the factors that place nondemented older adults at risk for poor self-awareness. This study examined the potential contributions of executive functioning (EF), crystallized intelligence (IQ-Cr), and sex in predicting congruence between performance and self-appraisals of instrumental activities of daily living (IADL) in a group of community-dwelling older adults. Method: A group of 150 nondemented, community-dwelling older adults (White and majority highly educated) completed measures of EF and IQ-Cr. Participants also completed five timed IADL tasks and self-appraised their performance relative to others of similar age. Results: Sex [F(1,148) = 7.75, p = .006, ηp2 = .05] and EF [(F(1,147) = 5.30, p = .02, ηp2 = .04)], but not IQ-Cr, predicted the relationship between performance and self-appraisals, such that those with lower EF and those of male sex overestimated their performance more than those with higher EF and females. Conclusions: Findings indicate that having average to below average EF abilities and being of male sex are risk factors for less accurate self-report of IADL abilities and as such might represent important considerations when assessing IADL abilities via self-report among largely independent, community-dwelling older adults.
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Affiliation(s)
| | - Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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13
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Danesh V, McDonald AD, McPeake J, Eaton TL, Potter K, Su H, Jackson JC, Boehm LM. Driving decisions after critical illness: Qualitative analysis of patient-provider reviews during ICU recovery clinic assessments. Int J Nurs Stud 2023; 146:104560. [PMID: 37531701 PMCID: PMC10528726 DOI: 10.1016/j.ijnurstu.2023.104560] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/18/2023] [Accepted: 06/27/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Driving a vehicle is a functional task requiring a threshold of physical, behavioral and cognitive skills. OBJECTIVE To report patient-provider evaluations of driving status and driving safety assessments after critical illness. DESIGN Qualitative secondary analysis of driving-related dialog drawn from a two-arm pilot study evaluating telemedicine delivery of Intensive Care Unit Recovery Clinic assessments. Multidisciplinary providers assessed physical, psychological, and cognitive recovery during one-hour telemedicine ICU-RC assessments. Qualitative secondary analysis of patient-provider dialog specific to driving practices after critical illness. SETTING AND PATIENTS Multidisciplinary Intensive Care Unit Recovery clinic assessment dialog between 17 patients and their providers during 3-week and/or 12-week follow-up assessments at a tertiary academic medical center in the Southeastern United States. MAIN MEASURES AND KEY RESULTS Thematic content analysis was performed to describe and classify driving safety discussion, driving status and driving practices after critical illness. Driving-related discussions occurred with 15 of 17 participants and were clinician-initiated. When assessed, driving status varied with participants reporting independent decisions to resume driving, delay driving and cease driving after critical illness. Patient-reported driving practices after critical illness included modifications to limit driving to medical appointments, self-assessments of trip durations, and inclusion of care partners as a safety measure for new onset fatigue while driving. CONCLUSION We found that patients are largely self-navigating this stage of recovery, making subjective decisions on driving resumption and overall driving status. These results highlight that driving status changes are an often underrecognized yet salient social cost of critical illness. TRIAL REGISTRATION Clinicaltrials.gov: NCT03926533.
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Affiliation(s)
- Valerie Danesh
- Center for Applied Health Research, Baylor Scott & White Research Institute, Dallas, TX, USA; School of Nursing, University of Texas at Austin, Austin, TX, USA.
| | - Anthony D McDonald
- College of Engineering, University of Wisconsin at Madison, Madison, WI, USA. https://twitter.com/hfml_lab
| | - Joanne McPeake
- Intensive Care Unit, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom; The Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK. https://twitter.com/Jomcpeake22
| | - Tammy L Eaton
- National Clinician Scholars Program (NCSP), VA HSR&D Center for the Study of Healthcare Innovation, Implementation, & Policy, University of Michigan, Ann Arbor, MI, USA; Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, MI, USA. https://twitter.com/tammyeaton17
| | - Kelly Potter
- Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA. https://twitter.com/KP_ICURN
| | - Han Su
- School of Nursing, Vanderbilt University, Nashville, TN, USA. https://twitter.com/HanSu_hs
| | - James C Jackson
- Critical Illness, Brain dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA; VA Tennessee Valley Geriatric Research Education and Clinical Center (GRECC), Nashville, TN, USA; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. https://twitter.com/jcjackson68
| | - Leanne M Boehm
- School of Nursing, Vanderbilt University, Nashville, TN, USA; Critical Illness, Brain dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA. https://twitter.com/boehmleanne
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14
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Peng Y, Bu J, Dai N, Huang C, Liu Y, Yang H, Lin R, Qin G, Yu Y, Chen J. Association of nocturnal sleep duration and nocturnal sleep changes with instrumental activities of daily living disability among middle-aged and elderly Chinese. Sleep Med 2023; 109:90-97. [PMID: 37423024 DOI: 10.1016/j.sleep.2023.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/04/2023] [Accepted: 06/17/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVE To investigate the association of baseline nocturnal sleep duration and sleep changes with functional disability in middle-aged and elderly Chinese. METHODS Data for this study were collected from the China Health and Retirement Longitudinal Study (CHARLS) from baseline (2011) to the Wave 3 follow-up (2018). 8361 participants free of IADL disability in 2011 and aged ≥ 45 years old were recruited and prospectively followed till 2018 to analyze the association between baseline nocturnal sleep duration and IADL disability. Of these 8361 participants, a total of 6948 participants had no IADL disability at the first three follow-up visits and completed the 2018 follow-up to analyze the association between nocturnal sleep changes and IADL disability. Nocturnal sleep duration (hours) was self-reported at baseline. The coefficient of variation (CV) of nocturnal sleep duration at baseline and three follow-up visits was used to calculate sleep changes and classified into mild, moderate, and severe degrees by the quantiles. Cox proportional hazards regression model was used to analyze the association of baseline nocturnal sleep duration with IADL disability, and the binary logistic regression model was used to analyze the association of nocturnal sleep changes with IADL disability. RESULTS Among the 8361 participants of 50237.5 person-years follow-up with a median follow-up of 7 years, 2158 (25.81%) participants developed IADL disabilities. Higher risks of IADL disability were observed among participants with sleep duration <7 h [HR(95%): 1.23(1.09-1.38)], 8∼<9 h [HR(95%): 1.05(1.00-1.32)] and ≥9 h [HR(95%): 1.21(1.01-1.45)] compared to those with 7∼<8 h. Among the 6948 participants, a total of 745 (10.72%) participants finally developed IADL disabilities. Compared with mild nocturnal sleep changes, moderate [OR(95%): 1.48(1.19-1.84)] and severe [OR(95%): 2.43(1.98-3.00)] sleep changes increased the probability of IADL disability. The restricted cubic spline model showed that a higher degree of nocturnal sleep changes was associated with a greater probability of IADL disability. CONCLUSION Both insufficient and excessive nocturnal sleep duration were associated with higher risk of IADL disability in middle-aged and elderly adults, independent of the participants' gender, age, and napping habits. Higher nocturnal sleep changes were associated with a higher probability of disability in IADL. These findings highlight the importance of appropriate and stable nocturnal sleep, and the need to pay attention to population differences in the impact of nocturnal sleep duration on health.
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Affiliation(s)
- Yuwei Peng
- Department of Biostatistics, Key Laboratory for Health Technology Assessment, National Commission of Health, Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Jianchen Bu
- Department of Health Management, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Neng Dai
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China; National Clinical Research Center for Interventional Medicine, China
| | - Chen Huang
- Department of Biostatistics, Key Laboratory for Health Technology Assessment, National Commission of Health, Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Yahang Liu
- Department of Biostatistics, Key Laboratory for Health Technology Assessment, National Commission of Health, Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Hui Yang
- Department of Biostatistics, Key Laboratory for Health Technology Assessment, National Commission of Health, Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Ruilang Lin
- Department of Biostatistics, Key Laboratory for Health Technology Assessment, National Commission of Health, Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Guoyou Qin
- Department of Biostatistics, Key Laboratory for Health Technology Assessment, National Commission of Health, Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China.
| | - Yongfu Yu
- Department of Biostatistics, Key Laboratory for Health Technology Assessment, National Commission of Health, Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China.
| | - Jiaohua Chen
- Department of Health Management, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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15
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Allen DD, Jaffe L. A Survey of Medication Management in Occupational Therapy Practice. Occup Ther Health Care 2023:1-14. [PMID: 37548574 DOI: 10.1080/07380577.2023.2243516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 07/28/2023] [Indexed: 08/08/2023]
Abstract
A descriptive study was conducted through the use of an online survey to gain understanding of the current occupational therapy practices of medication management. Although most respondents felt this topic is important, 24% of those surveyed reported not including medication management in their practice. Results suggest cognition was an important consideration when addressing medication management as well as the need to increase occupational therapy practitioners' knowledge and use of medication management.
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Affiliation(s)
- Denise D Allen
- Department of Rehabilitation Sciences, FL Gulf Coast University 10501 FGCU Boulevard South, Fort Myers, FL, USA
| | - Lynn Jaffe
- Emeritus of Department of Rehabilitation Sciences, Emeritus at Florida Gulf Coast University, Fort Myers, FL, USA
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16
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Harada T, Tsuji T, Tanaka M, Konishi N, Yanagisawa T, Koishihara Y, Ueno J, Mizutani T, Nishiyama N, Soeda R, Hijikata N, Ishikawa A, Hayashi R. Priority of the basic and instrumental activities of daily living in older patients with cancer prescribed rehabilitation: a cross-sectional survey. Support Care Cancer 2023; 31:503. [PMID: 37526784 DOI: 10.1007/s00520-023-07975-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 07/27/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND There is no information on whether vulnerable older patients with cancer consider basic activities of daily living (BADL) and instrumental activities of daily living (IADL) important outcomes. Our survey aimed to investigate the priority of BADL and IADL in outcomes among vulnerable older patients with cancer. METHODS This was a single-center survey in a Japanese cancer center. Eligible patients were ≥ 65 years of age and were prescribed in-hospital rehabilitation while under cancer treatment. Using original self-administered ranking questionnaires, patients were asked to rank outcomes and subdomain of BADL and IADL. High-priority domains were defined as the highest, second-highest, and third-highest priority domains in individuals. RESULTS A total of 169 patients were analyzed. The mean age was 74.0 years (standard deviation, 5.1 years) and the number of males was 107 (63%). The order of ranking of high-priority outcomes was BADL and IADL (n = 155), cognitive function (n = 91), mental function (n = 82), nutrition (n = 61), social function (n = 51), comorbidity (n = 39), and life span (n = 28). The top three high-priority independence subdomains of BADL and IADL were toilet use (n = 140), feeding (n = 134), and mobility (n = 69) among the BADL and shopping (n = 93), food preparation (n = 88), and ability to handle finances (n = 85) among the IADL. CONCLUSIONS BADL and IADL can be considered the most important health outcomes in clinical trials and in practice among older patients with cancer and physical vulnerabilities.
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Affiliation(s)
- Tsuyoshi Harada
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
- Department of Rehabilitation Medicine, Keio University Graduate School, Shinjuku, Tokyo, Japan.
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
- Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Motoki Tanaka
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Nobuko Konishi
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Takumi Yanagisawa
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Yu Koishihara
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Junya Ueno
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Tomonori Mizutani
- Department of Medical Oncology, Faculty of Medicine, Kyorin University, Mitaka, Tokyo, Japan
| | - Nanako Nishiyama
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, Habikino, Osaka, Japan
| | - Ryo Soeda
- Department of Rehabilitation Medicine, Keio University Graduate School, Shinjuku, Tokyo, Japan
- Department of Rehabilitation, Tsurumaki Onsen Hospital, Hadano, Kanagawa, Japan
| | - Nanako Hijikata
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Aiko Ishikawa
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
- Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Ryuichi Hayashi
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
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17
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Dubbelman MA, Mimmack KJ, Sprague EH, Amariglio RE, Vannini P, Marshall GA. Regional cerebral tau predicts decline in everyday functioning across the Alzheimer's disease spectrum. Alzheimers Res Ther 2023; 15:120. [PMID: 37408004 PMCID: PMC10320884 DOI: 10.1186/s13195-023-01267-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/29/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Emerging difficulty performing cognitively complex everyday tasks, or 'instrumental activities of daily living' (IADL) may be an early clinical sign of Alzheimer's disease (AD). We aimed to investigate how changes over time in everyday functioning relate to cerebral tau burden across the AD clinical spectrum. METHODS We included 581 participants (73.9 ± 7.6 years old; 52% female) from the Alzheimer's Disease Neuroimaging Initiative who underwent tau positron emission tomography (PET) and completed at least two assessments of the Functional Activities Questionnaire (FAQ). Participants were classified as cognitively normal (n = 334) or symptomatic (n = 247). We analyzed the association between longitudinal FAQ scores and baseline tau in six temporal, parietal, and frontal brain regions in mixed-effects models. Models were run in the entire sample, as well as stratified by diagnostic group (cognitively normal or symptomatic). We additionally investigated tau-PET adjusted for, as well as interacting with, amyloid-β. RESULTS Greater tau burden in several frontal, temporal, and parietal regions was associated with steeper decline over time in everyday functioning. These findings remained when adjusting for baseline global cortical amyloid-β; amyloid-β itself was only associated with change over time in FAQ scores when tau was not included in the model. When stratifying by diagnostic group, most associations between tau and everyday functioning, adjusted for amyloid-β, were present only in the symptomatic group. CONCLUSIONS The rate of change in everyday functioning is related to baseline tau burden in various brain regions, more strongly so than global cortical amyloid-β, specifically in cognitively symptomatic individuals. Longitudinal studies in incident dementia populations are needed to better understand functional changes in response to AD pathology across the disease.
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Affiliation(s)
- Mark A Dubbelman
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA, 02115, USA.
| | - Kayden J Mimmack
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Emily H Sprague
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA, 02115, USA
| | - Rebecca E Amariglio
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA, 02115, USA
| | - Patrizia Vannini
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA, 02115, USA
| | - Gad A Marshall
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA, 02115, USA
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18
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Huang Z, Xu T, Zhang R, Zhang X, Wang S, Zhang J, Yang Q, Fu Y, Gui J, Zhang X, Chen C. The relationship between home and community-based healthcare services utilization and depressive symptoms in older adults in rural China: a moderated mediation model. BMC Public Health 2023; 23:1014. [PMID: 37254084 DOI: 10.1186/s12889-023-15590-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/03/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Studies have shown a close association between home and community-based healthcare services (HCBHS) utilization and depressive symptoms in older adults. However, no studies have explored the underlying mechanism of this relationship in rural China. This study was designed to evaluate the roles of instrumental activities of daily living (IADL) and marital status in the association between HCBHS utilization and depressive symptoms in Chinese rural older adults. METHODS Data were obtained from the 2018 China Health and Retirement Longitudinal Study, and 5,981 rural respondents (≥ 60 years old) were included. Depression scores were calculated using the ten-item Center for Epidemiological Studies Depression Scale. Moderated mediation analysis was carried out applying Hayes' PROCESS macro (Model 7). RESULTS HCBHS utilization had a direct and negative effect on depressive symptoms. Furthermore, marital status moderated the association between HCBHS utilization and IADL, which belonged to the indirect influence of the first half on the association between HCBHS utilization and depressive symptoms. HCBHS utilization was associated with IADL in single but not in married respondents. CONCLUSION The results demonstrated that marital status moderated the indirect relationship between HCBHS utilization and depressive symptoms, with HCBHS utilization being negatively associated with IADL among single but not married respondents. The government should focus on rural older adults, especially those who are single and have poor IADL function, and improve the provision of HCBHS to alleviate depressive symptoms.
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Affiliation(s)
- Zishuo Huang
- School of Innovation and Entrepreneurship, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
| | - Tingke Xu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
| | - Rujia Zhang
- School of Innovation and Entrepreneurship, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
| | - Xinxin Zhang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
| | - Shanshan Wang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
| | - Jiayun Zhang
- The 2 nd School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
| | - Qingren Yang
- School of Innovation and Entrepreneurship, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
| | - Yating Fu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
| | - Jia Gui
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
| | - Xiangyang Zhang
- First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, 325000, Zhejiang, China.
| | - Chun Chen
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China.
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Kito K, Mori Y, Watanabe D, Onoda H, Fujiyama K, Toda M, Kato M. Relationship between instrumental activities of daily living decline during hospitalization and one-year mortality in elderly patients with heart failure: A multi-center prospective cohort study. Arch Gerontol Geriatr 2023; 110:104985. [PMID: 36948093 DOI: 10.1016/j.archger.2023.104985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/18/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND It remains unclear whether instrumental activities of daily living (IADL) decline during hospitalization is related to mortality rates. This study examined the relationship between IADL decline during hospitalization and the one-year mortality rate in elderly heart failure (HF) patients. METHODS Five hundred seventy-six consecutive patients who were hospitalized for acute decompensated HF and underwent rehabilitation were divided into groups based on changes in IADL during hospitalization: IADL maintained and IADL decline. IADL was assessed by the National Center for Geriatrics and Gerontology-Activities of Daily Living Scale (NCGG-ADL). IADL decline was defined as Δ NCGG-ADL ≤ -1 point. The primary outcome was one-year all-cause mortality rate after discharge. Outcomes were examined using the Kaplan-Meier method with the log-rank test and Cox proportional hazards models using the existing prognostic risk factors for HF. RESULTS Of 576 patients, 20% (n = 113) had IADL decline during hospitalization, and 9.2% (n = 35) and 6.0% (n = 18) died of all-cause and cardiovascular disease within one year after discharge, respectively. The IADL-decline group had significantly higher one-year all-cause mortality rates after adjusting for risk factors (hazard ratio: 1.923, 95% confidence interval 1.085-3.409; P = 0.023). Among the IADL subcategories, outdoor activity items such as "go out by oneself," "take a bus or train," and "shop for necessities" were more likely to change from independent to dependent during hospitalization. CONCLUSION IADL decline during hospitalization was associated with an increased all-cause mortality rate at one-year after discharge in elderly HF patients.
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Affiliation(s)
- Kazuya Kito
- Department of Rehabilitation, Shizuoka Medical Center, Shizuoka, Japan
| | - Yuji Mori
- Department of Rehabilitation, Shizuoka Medical Center, Shizuoka, Japan
| | - Daisuke Watanabe
- Department of Rehabilitation, Juntendo University Shizuoka Hospital, Shizuoka, Japan
| | - Hiroshige Onoda
- Department of Rehabilitation, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - Keita Fujiyama
- Department of Rehabilitation, Fujinomiya City General Hospital, Shizuoka, Japan
| | - Masahiro Toda
- Department of Rehabilitation, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Michitaka Kato
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Shizuoka, Japan.
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20
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Singhal S, Walter LC, Smith AK, Loh KP, Cohen HJ, Zeng S, Shi Y, Boscardin WJ, Presley CJ, Williams GR, Magnuson A, Mohile SG, Wong ML. Change in four measures of physical function among older adults during lung cancer treatment: A mixed methods cohort study. J Geriatr Oncol 2023; 14:101366. [PMID: 36058839 PMCID: PMC9974579 DOI: 10.1016/j.jgo.2022.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Functional outcomes during non-small cell lung cancer (NSCLC) treatment are critically important to older adults. Yet, data on physical function and which measures best capture functional change remain limited. MATERIALS AND METHODS This multisite, mixed methods cohort study recruited adults ≥65 years with advanced NSCLC starting systemic treatment (i.e., chemotherapy, immunotherapy, and/or targeted therapy) with non-curative intent. Participants underwent serial geriatric assessments prior to starting treatment and at one, two, four, and six months, which included the Karnofsky Performance Scale (KPS, range: 0-100%), instrumental activities of daily living (IADL, range: 0-14), European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Physical Functioning subscale (EORTC QLQ-C30 PF, range: 0-100), and Life-Space Assessment (LSA, range: 0-120). For all measures, higher scores represent better functioning. In a qualitative substudy, 20 patients completed semi-structured interviews prior to starting treatment and at two and six months to explore how treatment affected their daily functioning. We created joint displays for each interview participant that integrated their longitudinal KPS, IADL, EORTC QLQ-C30 PF, and LSA scores with patient quotes describing their function. RESULTS Among 87 patients, median age was 73 years (range 65-96). Mean pretreatment KPS score was 79% (standard deviation [SD] 13), EORTC QLQ-C30 PF was 69 (SD 23), and LSA was 67 (SD 28); median IADL was 13 (interquartile range [IQR] 10-14). At two months after treatment initiation, 70% of patients experienced functional decline on at least one measure, with only 13% of these patients recovering at six months. At two and six months, decline in LSA was the most common (48% and 35%, respectively). Joint displays revealed heterogeneity in how well each quantitative measure of physical function captured the qualitative patient experience. DISCUSSION Functional decline during NSCLC treatment is common among older adults. LSA is a useful measure to detect subtle functional decline that may be missed by other measures. Given heterogeneity in how well each quantitative measure captures changes in physical function, there is value to including more than one functional measure in geriatric oncology research studies.
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Affiliation(s)
- Surbhi Singhal
- Division of Medical Oncology, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Louise C Walter
- Division of Geriatrics, University of California, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Alexander K Smith
- Division of Geriatrics, University of California, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Kah Poh Loh
- James P. Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Harvey Jay Cohen
- Center for the Study of Aging & Human Development and Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Sandra Zeng
- Division of Hematology/Oncology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Ying Shi
- Division of Geriatrics, University of California, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - W John Boscardin
- Division of Geriatrics, University of California, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Carolyn J Presley
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Grant R Williams
- Divisions of Hematology/Oncology and Gerontology, Geriatrics, and Palliative Care, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allison Magnuson
- James P. Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Supriya G Mohile
- James P. Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Melisa L Wong
- Division of Geriatrics, University of California, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Division of Hematology/Oncology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA.
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21
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Spalding K, Gustafsson L, Di Tommaso A. Evaluation of an inpatient occupation-based group program using a process evaluation framework. Aust Occup Ther J 2023; 70:32-42. [PMID: 35854625 PMCID: PMC10083955 DOI: 10.1111/1440-1630.12829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/25/2022] [Accepted: 06/28/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Occupation-based groups are used in inpatient rehabilitation to enhance delivery and intensity of intervention; however, little research is available to understand their effectiveness. The aim of this study was to examine the process of an occupation-based group to understand mechanisms and success factors. METHODS A mixed methods process evaluation using an evidence-based framework guided implementation and analysis. Participants were those involved in the 'LifeSkills' group run daily in an adult inpatient general rehabilitation ward. Quantitative administrative data, goal achievement outcome measures, group observations and qualitative semistructured interviews were conducted. RESULTS Thirty participants were recruited. Factors for success included consistency in group structure and support, using meaningful practise opportunities and facilitating a real-world experience. There was no significant relationship between patient outcomes and dose of training or patient demographics. CONCLUSION This evaluation contributes to a growing body of evidence for incorporating occupation-based approaches into rehabilitation and offers insights into practice implementation.
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Affiliation(s)
- Kaitlyn Spalding
- Discipline of Occupational Therapy, School of Health Sciences and Social WorkGriffith UniversityNathanQueenslandAustralia
- Occupational Therapy Department, Surgical Treatment and Rehabilitation ServiceBrisbaneQueenslandAustralia
- Occupational Therapy DepartmentRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social WorkGriffith UniversityNathanQueenslandAustralia
| | - Amelia Di Tommaso
- Discipline of Occupational Therapy, School of Health Sciences and Social WorkGriffith UniversityNathanQueenslandAustralia
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22
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Tamura M, Tomoki I, Matsumoto K, Hattori S. Association between choices of transportation means and instrumental activities of daily living: observational cohort study of community-dwelling older adults. BMC Public Health 2023; 23:175. [PMID: 36698162 PMCID: PMC9878886 DOI: 10.1186/s12889-022-14671-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 11/18/2022] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION The association between the physical health of older people and the frequency of going out has been reported, and in recent years, local governments have developed transportation support programs for older people. Although previous studies show an association between the frequency of going out and functional health status, little has been reported on the impact of the choice of means of transport on instrumental activities of daily living (IADL). OBJECTIVE To evaluate the association between choice of transportation means and the risk of decline in IADL among older adults. METHODS We conducted an observational, population (community-dwelling)-based cohort study using data from the Resident Health Status Survey, and longitudinal panel data at 2-time points in 2016 and 2019. In addition, we combined this panel data and a database on people who were certified as requiring long-term care to identify participants' IADL. The propensity score matching method was used to classify the respondents into two groups, "active means of transportation" and "passive means of transportation," and determine the risk of a decline in means-tested independence after 3 years. RESULTS Active means were used by 6,280 (76.2%) and passive means were used by 1,865 (22.6%). 999 (12.1%) individuals declined in IADL in 2019. The results of the comparison by balancing the attributes of "active means of transportation" and "passive means of transportation," with propensity score matching, showed that "passive means of transportation" were more likely to be "active" than "passive means of transportation," and "active" was more likely to be "passive" The risk of IADL decline was significantly higher than that of "active means of transportation" with an RR of 1.93 (95% CI: 1.62-2.30). CONCLUSION Passive means of transportation in older adults could be a possible risk for decreasing IADL 3 years later. Increasing the number of opportunities and places in the community for older adults to use active means of transportation may be effective in encouraging socially independent living among older adults.
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Affiliation(s)
- Motoki Tamura
- grid.488900.dInstitute for Health Economics and Policy, Tokyu Toranomon Bldg, 1-21-19 Toranomon, Minato-ku, Tokyo 105-0001 Japan ,grid.136304.30000 0004 0370 1101Chiba University Center for Preventive Medicine, 1-33, Yayoicho, Inage-ku, Chiba Prefecture Chiba, 263-8522 Japan
| | - Ishikawa Tomoki
- grid.488900.dInstitute for Health Economics and Policy, Tokyu Toranomon Bldg, 1-21-19 Toranomon, Minato-ku, Tokyo 105-0001 Japan
| | - Komaki Matsumoto
- grid.488900.dInstitute for Health Economics and Policy, Tokyu Toranomon Bldg, 1-21-19 Toranomon, Minato-ku, Tokyo 105-0001 Japan ,Toyoake City Office, Citizens Collaboration Div., 1-1 Komochimatsu, Shindencho, Toyoake, Aichi Prefecture 470-1195 Japan
| | - Shinji Hattori
- Institute for Health Economics and Policy, Tokyu Toranomon Bldg, 1-21-19 Toranomon, Minato-ku, Tokyo, 105-0001, Japan. .,Chiba University Center for Preventive Medicine, 1-33, Yayoicho, Inage-ku, Chiba Prefecture, Chiba, 263-8522, Japan.
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23
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Kariya H, Yamaoka-Tojo M, Hamazaki N, Obara S, Kitasato L, Matsunaga A, Ako J. Association between instrumental activities of daily living frequency and clinical outcomes in older patients with cardiovascular disease. Eur J Cardiovasc Nurs 2023; 22:64-72. [PMID: 35670158 DOI: 10.1093/eurjcn/zvac043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 05/11/2022] [Accepted: 05/15/2022] [Indexed: 01/14/2023]
Abstract
AIMS Impairment in activities of daily living (ADL) is an independent predictor of poor prognosis in older patients. Nevertheless, the effects of instrumental ADL (IADL) frequency on prognosis in older patients with cardiovascular disease (CVD) are unclear. We investigate the associations between IADL frequency and all-cause mortality and hospital readmission due to cardiovascular events in older patients with CVD. METHODS AND RESULTS A total of 638 consecutive outpatients ≥65 years old with CVD were enrolled. A questionnaire, including Frenchay Activities Index (FAI) parameters, was used to determine IADL frequency at the start of the study as the baseline observation. The primary endpoint was all-cause mortality, and the secondary endpoint was readmission for cardiovascular events. We examined the relationship between IADL frequency and each endpoint. Among the 632 patients evaluated {median age 74.0 [interquartile range (IQR) 70.0-78.0] years; 439 males}, there were 39 deaths and 105 cardiovascular events during the median follow-up period of 4.0 (IQR, 2.3-4.0) years. After adjusting for clinical confounding factors, the hazard ratios for all-cause mortality and cardiovascular events in the FAI points were 0.957 [95% confidence interval (CI), 0.920-0.996] and 0.973 (95% CI, 0.950-0.997), respectively. CONCLUSION A higher IADL frequency was independently associated with better outcomes in older patients with CVD, suggesting that the preservation of instrumental activities should be focused on as the components of cardiovascular rehabilitation.
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Affiliation(s)
- Hidenori Kariya
- Department of Rehabilitation, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Minako Yamaoka-Tojo
- Kitasato University Regenerative Medicine and Cell Design Research Facility, Sagamihara, Japan.,Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan
| | - Nobuaki Hamazaki
- Department of Rehabilitation, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Shinichi Obara
- Department of Rehabilitation, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Lisa Kitasato
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Atsuhiko Matsunaga
- Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
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24
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Lu X, Yao Y, Jin Y. Digital exclusion and functional dependence in older people: Findings from five longitudinal cohort studies. EClinicalMedicine 2022; 54:101708. [PMID: 36353265 PMCID: PMC9637559 DOI: 10.1016/j.eclinm.2022.101708] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022] Open
Abstract
Background Older people are more likely to be excluded from the digital world, and this has been linked to poor health outcomes. The extent and direction of the influence of digital exclusion on functional dependency is, however, not well understood. We aimed to investigate the association between digital exclusion and functional dependency among older adults from high-income countries (HICs) and low- and middle-income countries (LMICs). Methods In this multicohort study, we pooled individual-level data from five longitudinal cohort studies that included nationally representative samples of older adults across 23 countries, including the Health and Retirement Study (HRS), the English Longitudinal Study of Aging (ELSA), the Survey of Health, Ageing and Retirement in Europe (SHARE), the China Health and Retirement Longitudinal Study (CHARLS), and the Mexican Health and Aging Study (MHAS). The digital exclusion was recorded as an absence from internet use by self-reported. We assessed basic activities of daily living (BADL) and instrumental activities of daily living (IADL), and we used interval-of-need methods to categorize the functional dependency. We applied generalized estimating equations models fitting Poisson model to investigate the association of digital exclusion with difficulties in BADL or IADL and functional dependency, adjusting for the causal-directed-acyclic-graph (DAG) minimal sufficient adjustment set (MSAS), including gender, age level, labour force status, education, household wealth level, marital status, and co-residence with children. Findings We included 108,621 participants recruited between 2010 and 2018 with a median follow-up of 3 phrases. Digital exclusion in older adults varied across countries, ranging from 23.8% in Denmark (SHARE) to 96.9% in China (CHARLS). According to the crude model, digital exclusion was significantly associated with functional dependency. In the MSAS-adjusted model, those associations remained statistically significant: HRS (incidence rate ratio [IRR] = 1.40, 95% confidence interval [CI] 1.34-1.48 for BADL; 1.71 [1.61-1.82] for IADL), ELSA (1.31 [1.22-1.40] in BADL and 1.37 [1.28-1.46] in IADL), SHARE (1.69 [1.61-1.78] in BADL and 1.70 [1.63-1.78] in IADL), CHARLS (2.15 [1.73-2.67] in BADL and 2.59 [2.06-3.25] in IADL), and MHAS (1.15 [1.09-1.21] in BADL and 1.17 [1.09-1.25] in IADL). In the subgroup analyses, the associations were more pronounced in the oldest-old (aged ≥ 80 years old). Interpretation There is a substantial proportion of older adults who are excluded from the Internet, especially those in LMIC. Older people excluded from the Internet regardless of whether they live in HICs or LMICs are more likely to develop functional dependency. It should be made a priority to remove barriers to Internet access in order to assist older people in maintaining their independence and, consequently, to reduce the care burden associated with the ageing population worldwide. Funding The National Natural Science Foundation of China (No. 71904004).
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Affiliation(s)
- Xinran Lu
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
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25
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Yuan J, Wang Y, Liu Z. Chronic disease and depression among the elderly in China: the mediating role of instrumental activities of daily living and the moderating role of area of residence. Curr Psychol 2022; 42:1-8. [PMID: 36258891 PMCID: PMC9561327 DOI: 10.1007/s12144-022-03782-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 09/08/2022] [Accepted: 09/15/2022] [Indexed: 12/02/2022]
Abstract
Chronic diseases are associated with depressive symptoms in older adults. However, the mechanism of this relation is not clear. In this study, we explored the mediating role of instrumental activities of daily living and the moderating role of area of residence in the relationship between chronic diseases and depression. The data was from the Chinese Longitudinal Healthy Longevity Study. Results showed that chronic diseases were positively correlated with depression, and negatively associated with instrumental activities of daily living (IADLs). Moreover, IADLs mediated the relationship between chronic diseases and depression. In addition, area of residence (rural/urban) moderated the relation between IADLs and depression, such that this negative relation was stronger for old adults lived in rural area than for urban area. These results have important significance for prevention and intervention of depression in the elderly.
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Affiliation(s)
- Jing Yuan
- School of Nursing, Hebei University, Baoding, Hebei China
| | - Yan Wang
- School of Nursing, Hebei University, Baoding, Hebei China
| | - Zejun Liu
- Department of Psychology, Educational College, Shanghai Normal University, Shanghai, China
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Câmara J, Ferreira L, Faria AL, Vilar M, Bermúdez I Badia S. Feasibility, Acceptability, and Preliminary Impact of Full-Body Interaction on Computerized Cognitive Training Based on Instrumental Activities of Daily Living: A Pilot Randomized Controlled Trial with Chronic Psychiatric Inpatients. Games Health J 2022; 11:435-446. [PMID: 36251861 DOI: 10.1089/g4h.2021.0228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Objective: To conduct a pilot randomized control trial to assess the feasibility and acceptability of full-body interaction cognitive training (FBI-CT) inspired by instrumental activities of daily living in chronic psychiatric inpatients and to explore its preliminary impact on cognitive and noncognitive outcomes. Materials and Methods: Twenty psychiatric inpatients met the inclusion criteria and were randomly allocated to the FBI-CT group (n = 10) or the tablet-based CT group (T-CT) (n = 10). Neuropsychological assessments were performed at baseline, postintervention, and 3-month follow-up. Results: Both groups presented high completion rates at postintervention and follow-up. Participants reported high satisfaction following the interventions, with the FBI-CT group exhibiting slightly higher satisfaction. A within-group analysis showed significant improvements in the FBI-CT group for processing speed and sustained attention for short periods (P = 0.012), verbal memory (P = 0.008), semantic fluency (P = 0.027), depressive symptoms (P = 0.008), and quality of life (P = 0.008) at postintervention. At 3-month follow-up, this group maintained verbal memory improvements (P = 0.047) and depressive symptoms amelioration (P = 0.026). The T-CT group revealed significant improvements in sustained attention for long periods (P = 0.020), verbal memory (P = 0.014), and executive functions (P = 0.047) postintervention. A between-group analysis demonstrated that the FBI-CT group exhibited greater improvements in depressive symptoms (P = 0.042). Conclusions: Overall, we found support for the feasibility and acceptability of both training approaches. Our findings show promise regarding the preliminary impact of the FBI-CT intervention, but due to study limitations such as the small sample size, we cannot conclude that FBI-CT is a more effective approach than T-CT for enhancing cognitive and noncognitive outcomes of chronic psychiatric inpatients. Clinical trials (number: NCT05100849).
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Affiliation(s)
- Joana Câmara
- Faculdade de Psicologia e de Ciências de Educação, Universidade de Coimbra, Coimbra, Portugal
- NOVA Laboratory for Computer Science and Informatics, Universidade da Madeira, Funchal, Portugal
| | - Luís Ferreira
- NOVA Laboratory for Computer Science and Informatics, Universidade da Madeira, Funchal, Portugal
- Faculdade de Ciências Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal
| | - Ana Lúcia Faria
- NOVA Laboratory for Computer Science and Informatics, Universidade da Madeira, Funchal, Portugal
- Escola Superior de Saúde, Universidade da Madeira, Funchal, Portugal
| | - Manuela Vilar
- Faculdade de Psicologia e de Ciências de Educação, Universidade de Coimbra, Coimbra, Portugal
| | - Sergi Bermúdez I Badia
- NOVA Laboratory for Computer Science and Informatics, Universidade da Madeira, Funchal, Portugal
- Faculdade de Ciências Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal
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Bruderer-Hofstetter M, Gorus E, Cornelis E, Meichtry A, De Vriendt P. Influencing factors on instrumental activities of daily living functioning in people with mild cognitive disorder - a secondary investigation of cross-sectional data. BMC Geriatr 2022; 22:791. [PMID: 36217106 PMCID: PMC9552428 DOI: 10.1186/s12877-022-03476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Finding a strategy to reduce the impact of cognitive decline on everyday functioning in persons suffering from cognitive impairment is a public health priority. Instrumental activities of daily living (IADL) are key to everyday functioning. Hence, it is essential to understand the influencing factors on IADL to develop specific interventions to improve everyday functioning in persons with mild cognitive disorder. Therefore, this study aimed to 1) explore different influencing factors on IADL functioning considering all domains of the International Classification of Functioning, disability, and health and 2) rank these factors. METHODS We performed a secondary analysis of a cohort including participants with amnestic mild cognitive impairment (a-MCI) or mild Alzheimer's Dementia (mild AD). The IADL functioning model was used as a starting point to estimate the effects of cognitive and physical function factors and personal and environmental factors on IADL functioning using multiple linear regression analysis, including subgroup analysis in persons with a-MCI. We used standardized coefficient estimates to relate the size of the predictor effects in the final model. RESULTS We included 105 participants (64 a-MCI, 41 mild AD); the mean age was 81.9 years (SD 4.9), with 70% females. Based on a multi-step approach and model fit, the final model included IADL functioning as the response variable and memory, attention, executive function, vision and hearing, mobility, balance, education, and social support as predictors. The final model explained 75% of the variability. The significant predictors in the model were mobility, balance, attention, and education, and were the predictors with the most considerable effects based on standardized coefficient estimates. The subgroup analysis, including only a-MCI participants, revealed a similar pattern. CONCLUSION Our results confirm that IADL functioning in people with mild cognitive disorder is influenced by cognitive and physical function and personal factors. The study provides further insight into understanding IADL functioning impairments in persons with mild impaired cognition and may be used to develop specific non-pharmacological interventions.
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Affiliation(s)
- Marina Bruderer-Hofstetter
- School of Health Professions, Institute of Physiotherapy, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland.
| | - Ellen Gorus
- Department Gerontology and Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Elise Cornelis
- Department of Occupational Therapy and Research & Development in Health & Care, Artevelde University of Applied Sciences, Ghent, Belgium
| | - André Meichtry
- School of Health Professions, Institute of Physiotherapy, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland
| | - Patricia De Vriendt
- Department Gerontology and Frailty in Ageing (FRIA) Research Group, Mental Health and Wellbeing (MENT) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Occupational Therapy, Artevelde University of Applied Sciences, Ghent, Belgium.,Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Occupational Therapy Programme, Ghent University, Ghent, Belgium
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Brothers SL, Suchy Y. Daily Assessment of Executive Functioning and Expressive Suppression Predict Daily Functioning among Community-Dwelling Older Adults. J Int Neuropsychol Soc 2022; 28:974-83. [PMID: 34666858 DOI: 10.1017/S1355617721001156] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Executive functioning (EF) is known to be associated with performance of instrumental activities of daily living (IADLs). However, prior research has found that the degree to which EF fluctuates was more predictive of self-reported cognitive and IADL lapses than was average EF performance. One source of such EF fluctuations is engagement in an emotion regulation strategy known as expressive suppression (ES). Importantly, ES has also been shown to relate to IADL performance, presumably due to its impact on EF. However, past research is limited due to assessing IADLs only in the laboratory or via self-report. The present study examined (a) the association of daily EF and ES fluctuations with performance of actual IADL tasks in participants' homes, and (b) whether any significant association between ES fluctuations and daily IADLs would be mediated by daily EF variability. METHOD Participants were 52 older adults aged 60 to 95. Over the course of 18 days while at home, participants completed daily IADL tasks as well as daily measures of EF and ES via ecological momentary assessment. RESULTS Contrary to our hypothesis, average EF across days predicted at-home IADLs above and beyond daily EF variability, which itself was also predictive. ES variability also predicted daily IADLs, and this association was fully mediated by average daily EF. CONCLUSIONS Daily fluctuations in ES appear to have a deleterious impact on performance of IADLs at home, likely due to the impact of such fluctuations on EF, although the average level of EF capacity is also important.
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29
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Arola A, Levänen T, Laakso HM, Pitkänen J, Koikkalainen J, Lötjönen J, Korvenoja A, Erkinjuntti T, Melkas S, Jokinen H. Neuropsychiatric symptoms are associated with exacerbated cognitive impairment in covert cerebral small vessel disease. J Int Neuropsychol Soc 2022;:1-8. [PMID: 36039945 DOI: 10.1017/S1355617722000480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Neuropsychiatric symptoms are related to disease progression and cognitive decline over time in cerebral small vessel disease (SVD) but their significance is poorly understood in covert SVD. We investigated neuropsychiatric symptoms and their relationships between cognitive and functional abilities in subjects with varying degrees of white matter hyperintensities (WMH), but without clinical diagnosis of stroke, dementia or significant disability. METHODS The Helsinki Small Vessel Disease Study consisted of 152 subjects, who underwent brain magnetic resonance imaging (MRI) and comprehensive neuropsychological evaluation of global cognition, processing speed, executive functions, and memory. Neuropsychiatric symptoms were evaluated with the Neuropsychiatric Inventory Questionnaire (NPI-Q, n = 134) and functional abilities with the Amsterdam Instrumental Activities of Daily Living questionnaire (A-IADL, n = 132), both filled in by a close informant. RESULTS NPI-Q total score correlated significantly with WMH volume (rs = 0.20, p = 0.019) and inversely with A-IADL score (rs = -0.41, p < 0.001). In total, 38% of the subjects had one or more informant-evaluated neuropsychiatric symptom. Linear regressions adjusted for age, sex, and education revealed no direct associations between neuropsychiatric symptoms and cognitive performance. However, there were significant synergistic interactions between neuropsychiatric symptoms and WMH volume on cognitive outcomes. Neuropsychiatric symptoms were also associated with A-IADL score irrespective of WMH volume. CONCLUSIONS Neuropsychiatric symptoms are associated with an accelerated relationship between WMH and cognitive impairment. Furthermore, the presence of neuropsychiatric symptoms is related to worse functional abilities. Neuropsychiatric symptoms should be routinely assessed in covert SVD as they are related to worse cognitive and functional outcomes.
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Abstract
Objective The aim of this study was to investigate the effect of skeletal sarcopenia on the prognosis of intertrochanteric fracture in the elderly. Methods We collected information on 144 patients with femoral intertrochanteric fracture (FIF). The influence of sarcopenia on the chance of death was determined using binary Probit regression analysis. For additional analysis, the Chow test was utilized to select the best distinguishing node in the instrumental activities of daily living (IADL) score. We looked for characteristics that were linked to a higher probability of death and a poor IADL outcome within 1 year. The data collected above were analyzed using logistic regression analysis. The internal calibration degree and model validity were assessed by GiViTI calibration. Results Sarcopenia, EuroQol-5D 1 month score, age, gender, and hypertension were identified as risk factors for death in older patients with FIF within a year by logistic regression analysis. Sarcopenia, psychotropics, BMI, and length of hospital stay were all found to be risk factors for poor IADL outcomes (P < 0.1). The calibration curves indicated that the anticipated and actual probabilities of these two models were very close. The study's reliability coefficient was 0.671, showing a satisfactory level of reliability. Conclusion In elderly patients with FIF, sarcopenia, EuroQol-5D score, age, gender, and hypertension were risk factors for death; sarcopenia, hospital stay length, BMI were risk factors for poor quality of life.
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Affiliation(s)
- Shunli Jiang
- The Affiliated Lianyungang Oriental Hospital, Kangda College of Nanjng Medical University, Lianyungang, Jiangsu Province, China,The Affiliated Lianyungang Oriental Hospital, Xuzhou Medical University, Lianyungang, Jiangsu Province, China
| | - Yu Ding
- Wafangdian Central Hospital, Dalian, Liaoning province, China
| | - Lixing Kang
- Department of Orthopedics, Langfang People’s Hospital, Langfang, Hebei Province, China
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Juniper AR, Connor LT. Self-Perceived ADL/IADL Function is Influenced by Residual Neurological Impairment, Aphasia, and Anxiety. Can J Occup Ther 2022; 89:307-314. [PMID: 35532902 DOI: 10.1177/00084174221098876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND. Self-perceptions of performance of activities of daily living (ADL) and instrumental activities of daily living (IADL) are reduced following stroke. Research investigating contributing factors is lacking. PURPOSE. We examined the extent to which aphasia status, neurological impairment and poststroke depression, and anxiety contribute to self-perceived ADL/IADL function. METHOD. Seventy-six community-dwelling individuals at least 6 months poststroke, 44 with and 32 without aphasia, participated in the cross-sectional study. The Stroke Impact Scale (SIS) ADL/IADL domain was the primary outcome measure with aphasia status, residual neurological impairment, depressive symptoms, and anxiety as predictor variables. FINDINGS Aphasia status, residual neurological impairment, and anxiety were independent predictors of self-perceived ADL/IADL function, together accounting for more than half the variance. Depression was not associated with ADL/IADL. IMPLICATIONS. Clinician awareness of the influence of anxiety on self-perceived ADL/IADL function, particularly for people with aphasia, may lead to future interventions that improve self-perceived ADL/IADL function.
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Affiliation(s)
- Ashley R Juniper
- Department of Occupational Therapy, 15646MGH Institute of Health Professions, Boston, MA, USA
| | - Lisa Tabor Connor
- Program in Occupational Therapy & Department of Neurology, 12275Washington University School of Medicine, St. Louis, MO, USA
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Abstract
BACKGROUND OF THE STUDY Instrumental activities of daily living (IADL) are activities that are needed to live an independent life. Psychotic disorders are associated with deficits in everyday functioning, causing impairment/disability in activities of daily living. Activities play a crucial role to measure functional health or disability. People with Schizophrenia often present difficulties in social and occupational reintegration that may be associated with problems in performing daily activities, including independent living, education, working, and socializing. Activities of daily living and instrumental activities of daily living (life skills training) including leisure and social skills training intended to reintegrate the patient into the community to lead an everyday life. AIM The aim of this review was to identify the effect of skill-based interventions on independent functioning in persons with Schizophrenia. METHODS The authors conducted database searches of Google Scholar, PubMed, Science Direct, ProQuest, EBSCO from 1st January 1992 to 31st December 2020. The researcher extracted data, and the quality of included studies was rated by two authors independently. We used the Cochrane Risk of Bias (ROB) tool for assessing the quality of selected studies. The search identified nine studies that met the inclusion criteria with 655 participants. The outcome measure was independent functioning skills. RESULTS The interventions in the review were multifaceted with different combinations of psychoeducation, cognitive-behavioral methods, training in social skills, and IADL. The interventions resulted in significant improvement in functioning skills and reduction in relapse rates. CONCLUSION Results of this review have revealed moderate to strong evidence for skills training, either behavioral or social skills to improve social and independent functioning, reduce caregiver burden, and improve negative symptoms. The review also supported that interventions could be generalized across settings.
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Affiliation(s)
- Annie John
- National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Sailaxmi Gandhi
- National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Suzuki Y, Sudo T, Mochizuki H. Awareness of Instrumental Activities of Daily Living Disability: Pilot Study for Elderly Requiring Care and Caregivers. Dement Geriatr Cogn Dis Extra 2022; 12:94-99. [PMID: 35702344 PMCID: PMC9149450 DOI: 10.1159/000524155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 12/02/2022] Open
Abstract
Aim We aimed to investigate differences in the awareness of instrumental activities of daily living (IADL) disability between elderly patients with and without dementia requiring care. Methods We assessed 25 elderly individuals requiring care and their primary caregivers using the Lawton IADL scale, with score differences between the patients and their caregivers representing the level of impaired awareness of IADL disability. Results Among the participants, 80% exhibited impaired awareness of IADL disability. In terms of total score on the Lawton scale, there was no between-group difference in the occurrence of impaired awareness of IADL disability (p = 0.274, φ = 0.31). Contrastingly, regarding the subitems of the Lawton scale, the dementia group had a significantly higher number of participants with impaired awareness of responsibility for their own medications than the nondementia group (p = 0.030, φ = 0.47). Further, there were no significant between-group differences in the ability to use telephone, shopping, mode of transportation, or ability to handle finances. Conclusions It is important for caregivers to notice the emergence of impaired awareness among the elderly as soon as possible to ensure early diagnosis and treatment. The results of this study suggest the need for caregivers to take care of the elderly patients with the perspective that they may develop impaired awareness of responsibility for their own medications.
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Affiliation(s)
- Yukiko Suzuki
- Department of Occupational Therapy, Kyorin University, Tokyo, Japan
| | | | - Hideki Mochizuki
- Department of Occupational Therapy, Kyorin University, Tokyo, Japan
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Lu Y, Matsuyama S, Sugawara Y, Sone T, Tsuji I. Dairy intake and incident functional disability among older Japanese adults: the Ohsaki Cohort 2006 Study. Eur J Nutr 2022; 61:2627-2637. [PMID: 35246747 DOI: 10.1007/s00394-022-02843-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/16/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Previous studies have investigated the association between dairy intake and functional disability, but their results were inconsistent. Our study aimed to investigate whether dairy intake may protect against incident functional disability among Japanese older adults. METHODS We conducted a longitudinal analysis of dairy intake with incident functional disability in a prospective cohort study of 11,911 Japanese individuals aged ≥ 65 years who were followed up for 8.2 years on average. Data on milk, yogurt, and cheese intake were collected using a validated food frequency questionnaire. Total dairy intake was the sum of the daily intake of milk, yogurt, and cheese, which was sex-specifically categorized in quintiles. Data on functional disability were retrieved from the public Long-term Care Insurance database. The Cox proportional hazards model was used to estimate the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (95%CIs) for incident functional disability. RESULTS During 97,234 person-years of follow-up, 4874 persons (40.9%) were ascertained as having functional disability. Our study suggested a null association between total dairy intake and incident risk of functional disability; compared to Q1 (the lowest quintile) group, the multivariable-adjusted HRs (95%CIs) were 0.96 (0.88-1.05) for Q2, 0.93 (0.85-1.02) for Q3, 0.93 (0.85-1.02) for Q4, and 1.01 (0.92-1.10) for Q5 (p-trend = 0.840). We did not find any associations between milk, yogurt, or cheese intake and incident risk of functional disability. CONCLUSION We found no evidence showing that dairy intake was associated with functional disability among Japanese older adults.
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Affiliation(s)
- Yukai Lu
- Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Sanae Matsuyama
- Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Yumi Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Toshimasa Sone
- Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
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Lee YH, Kong D, Lee YTH, Lin CH, Liu CT, Chang YC. Functional disabilities and changes in sleep quality and duration among older adults: results from a longitudinal study in China, 2005-2014. Eur Geriatr Med 2022; 13:967-975. [PMID: 35191012 DOI: 10.1007/s41999-022-00619-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/26/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE We examined the associations of activities of daily living (ADL) and instrumental activities of daily living (IADL) with changes in sleep-related measurements among Chinese older adults from 2005 to 2014. METHODS Four waves of longitudinal data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS; 2005-2014; n = 42,417) were used. Two sleep-related measurements were included: sleep quality and meeting the recommended daily sleep duration (7-8 h). We used Cox two-state regression models to examine the different states of sleep quality and duration. RESULTS Approximately 43.6% of observations were between 81 and 95 years old, and 35.9% were between 65 and 80 years old. Around 54.8% of observations were female. Older adults with more ADL and IADL limitations had a higher risk of experiencing declines in sleep quality and the transition from meeting to not meeting the recommended sleep duration over time (all p < 0.01). CONCLUSION ADL and IADL limitations are significant risk factors for the development of sleep-related issues over time among Chinese older adults. Functional limitations need to be included in intervention strategies focused on sleep hygiene and studies examining changes in sleep patterns over time.
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Affiliation(s)
- Yen-Han Lee
- Department of Public Health and Sports Medicine, McQueary College of Health and Human Services, Missouri State University, Springfield, MO, USA.
| | - Dexia Kong
- Department of Social Work, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yi-Ting Hana Lee
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Chia-Hung Lin
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Ti Liu
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, USA
| | - Yen-Chang Chang
- Center for General Education, National Tsing Hua University, Hsinchu City, Taiwan.
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Van Patten R, Mahmood Z, Nguyen TT, Maye J, Kim HC, Jeste DV, Twamley EW. Rates of Cognitive and Functional Impairments in Older Adults Residing in a Continuing Care Senior Housing Community. J Int Neuropsychol Soc 2022; 28:62-73. [PMID: 33749570 PMCID: PMC8455703 DOI: 10.1017/s1355617721000163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The current cross-sectional study examined cognition and performance-based functional abilities in a continuing care senior housing community (CCSHC) that is comparable to other CCSHCs in the US with respect to residents' demographic characteristics. METHOD Participants were 110 older adult residents of the independent living unit. We assessed sociodemographics, mental health, neurocognitive functioning, and functional capacity. RESULTS Compared to normative samples, participants performed at or above expectations in terms of premorbid functioning, attention span and working memory, processing speed, timed set-shifting, inhibitory control, and confrontation naming. They performed below expectation in verbal fluency and verbal and visual learning and memory, with impairment rates [31.4% (>1 SD below the mean) and 18.49% (>1.5 SD below the mean)] well above the general population (16% and 7%, respectively). Within the cognitive test battery, two tests of delayed memory were most predictive of a global deficit score. Most cognitive test scores correlated with performance-based functional capacity. CONCLUSIONS Overall, results suggest that a subset of older adults in the independent living sector of CCSHCs are cognitively and functionally impaired and are at risk for future dementia. Results also argue for the inclusion of memory tests in abbreviated screening batteries in this population. We suggest that CCSHCs implement regular cognitive screening procedures to identify and triage those older adults who could benefit from interventions and, potentially, a transition to a higher level of care.
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Affiliation(s)
- Ryan Van Patten
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Zanjbeel Mahmood
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Ct, San Diego, CA
| | - Tanya T. Nguyen
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Jacqueline Maye
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Ho-Cheol Kim
- Scalable Knowledge Intelligence, IBM Research – Almaden, San Jose, CA, United States
| | - Dilip V. Jeste
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego
- Department of Neurosciences, University of California San Diego, La Jolla, CA, United States
| | - Elizabeth W. Twamley
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
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Kurniadi NE, Suchy Y, Niermeyer MA. Branching Condition of the Color-Word Interference Test Enhances Prediction of Meta-Tasking in Community-Dwelling Older Adults. J Int Neuropsychol Soc 2021; 27:1004-14. [PMID: 33632370 DOI: 10.1017/S1355617720001381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Meta-tasking (MT) is an aspect of executive functioning (EF) that involves the ability to branch (i.e., to apply "if-then" rules) and to effectively interleave sub-goals of one task with sub-goals of another task. As such, MT is crucial for successful planning, coordination, and execution of multiple complex tasks in daily life. Traditional tests of EF fail to adequately measure MT. This study examined whether Condition 4 of the Color-Word Interference Test (CWIT-4; the inhibition/switching condition that requires branching) predicted MT beyond Condition 3 (CWIT-3; inhibition-only condition) and beyond other subtests from the Delis-Kaplan Executive Function System (D-KEFS) that have a switching condition. METHOD Ninety-eight non-Hispanic white community-dwelling older adults completed the first four subtests of the D-KEFS and an ecologically valid measure of MT. RESULTS Time to completion and total errors on CWIT-4 accounted for variance in MT above and beyond CWIT-3 and beyond the switching conditions of other D-KEFS subtests. Results remained virtually unchanged when controlling for demographics and general cognitive status. CONCLUSIONS Among older adults, CWIT-4 is more strongly associated with MT than other D-KFES tasks. Future research should examine whether CWIT-4 relates to lapses in instrumental activities of daily living among older adults above and beyond other EF tests.
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Saad O, Zysberg L, Heinik J, Ben-Itzhak R, Zisberg A. A conceptual model for achieving well-being in adults with mild cognitive impairment. Geriatr Nurs 2021; 42:1467-1473. [PMID: 34670178 DOI: 10.1016/j.gerinurse.2021.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Low well-being is common among people with Mild Cognitive Impairment (MCI). We propose a model to examine how different types of resources work together to maintain well-being in people with MCI. METHODS Participants included 121 community dwelling adults over the age of 60 who were diagnosed with MCI. Structural equation modeling assessed suggested relationships between resources and well-being. RESULTS Emotional intelligence, general mental ability, morbidity, economic status, basic activities of daily living, and age were correlated to well-being in a triple mediation process through cognitive function, instrumental activities of daily living, and social support. Model fit was excellent (RMSEA-0.04; IFI-.96; CFI-.96; CMIN/DF-1.23), CONCLUSION: Achieving well-being when coping with MCI requires a combination of objective resources and subjective evaluation of the situation. Ultimately, social support determines an individual's level of well-being. Findings suggest the need to understand what kind of social support is required by those coping with MCI.
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Affiliation(s)
- Odelyah Saad
- JCT-Jerusalem College of Technology-Lev Academic Center Israel; The Cheryl Spencer Department of Nursing Faculty of Social Welfare and Health Science, University of Haifa, Israel, Haifa, Israel.
| | | | - Jeremia Heinik
- Academic Center for Continuing Medical Education, Sackler Faculty of Medicine, Tel Aviv University
| | - Ron Ben-Itzhak
- Geriatric Service, Sorasky Medical Center, Ichilov Israel
| | - Anna Zisberg
- The Cheryl Spencer Department of Nursing Faculty of Social Welfare and Health Science, University of Haifa, Israel, Haifa, Israel
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Zhao X, Liang W, Maes JHR. Associations Between Self- and Informant-Reported Abilities of Instrumental Activities of Daily Living and Cognitive Functions in Older Adults With Mild Cognitive Impairment. Arch Clin Neuropsychol 2021; 36:723-733. [PMID: 33200196 PMCID: PMC8296846 DOI: 10.1093/arclin/acaa110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/15/2020] [Accepted: 10/20/2020] [Indexed: 11/30/2022] Open
Abstract
Objective Older adults (OAs) with mild cognitive impairment (MCI) show disabilities in
instrumental activities of daily living (IADLs), which have been linked to
compromised cognitive functioning. However, it is unclear which cognitive
functions are primarily involved. The present study sought to identify the
cognitive function(s) most strongly associated with the IADL limitations in
MCI. Method OAs with MCI (N = 120) completed cognitive tasks measuring
general cognitive processing speed, working memory (WM) maintenance and
updating, inhibition, and shifting ability. IADL abilities were assessed
through both self- and informant reports. Results Self-reported IADL abilities were positively associated with both cognitive
processing speed and WM updating capacity. Informant-reported IADL abilities
were also positively associated with processing speed and WM updating, in
addition to cognitive shifting ability. Conclusion Both general processing speed and WM updating capacity were consistently
predictive of IADL abilities. These results might inform the design of
training programs aimed at maintaining or improving functional independence
in individuals with MCI to focus more on these cognitive functions. However,
the strength of the association between specific cognitive functions and
IADL abilities in OAs with MCI depends on the source of the information
about the IADL abilities, which highlights the need for gathering data from
both the examinee and informants.
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Affiliation(s)
- Xin Zhao
- Behavior Rehabilitation Training Research Institution, School of Psychology, Northwest Normal University, 967 East Anning Road, Lanzhou, 730070, China
| | - Wenjia Liang
- Behavior Rehabilitation Training Research Institution, School of Psychology, Northwest Normal University, 967 East Anning Road, Lanzhou, 730070, China
| | - Joseph H R Maes
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Radboud University, PO. Box 9104, Nijmegen, 6500 HE, The Netherlands
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Guger M, Raschbacher S, Kellermair L, Vosko MR, Eggers C, Forstner T, Leitner K, Fuchs A, Fellner F, Ransmayr G. Caregiver burden in patients with behavioural variant frontotemporal dementia and non-fluent variant and semantic variant primary progressive aphasia. J Neural Transm (Vienna) 2021; 128:1623-1634. [PMID: 34282470 PMCID: PMC8528762 DOI: 10.1007/s00702-021-02378-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 07/01/2021] [Indexed: 11/30/2022]
Abstract
Studies on caregiver burden in patients with frontotemporal lobar degeneration are rare, differ methodologically and show variable results. Single center longitudinal pilot study on caregiver burden and potential risk factors in patients with behavioural variant frontotemporal dementia (bvFTD) and semantic (svPPA) and non-fluent variants (nfvPPA) primary progressive aphasia. Forty-six bvFTD, nine svPPA, and six nfvPPA patients and caring relatives were analysed for up to 2 years using the Mini-Mental State Examination as global measure for cognitive performance, Frontal Assessment Battery (frontal lobe functions), Frontal Behavioural Inventory (personality and behaviour), Neuropsychiatric Inventory (dementia-related neuropsychiatric symptoms), Barthel Index and Lawton IADL Scale (basic and instrumental activities of daily living), the Caregiver Strain Index (CSI), and in most participants also the Zarit Burden Interview (ZBI). CSI baseline sum scores were highest in bvFTD (mean ± SD 5.5 ± 3.4, median 5, IQR 6), intermediate in svPPA (2.9 ± 2.3; 3; 3.5) and low in nfvPPA (1.6 ± 2.1; 1; 2). Similar differences of caregiver burden were found using the ZBI. During follow-up, CSI and ZBI sum scores deteriorated in svPPA, not in bvFTD and nfvPPA, and correlated significantly with personality and behaviour, neuropsychiatric symptoms, caregiver age, and instrumental, but not basic activities of daily living, Mini-Mental State Examination scores or frontal lobe functions. This study reveals differences in caregiver burden in variants of frontotemporal lobar degeneration. Caregivers should be systematically asked for caregiver burden from the time of the diagnosis to provide comprehensive support in time.
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Affiliation(s)
- Michael Guger
- Department of Neurology 2, Med Campus III, Kepler University Hospital GmbH, Krankenhausstr. 9, 4021, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Stefan Raschbacher
- Department of Neurology 2, Med Campus III, Kepler University Hospital GmbH, Krankenhausstr. 9, 4021, Linz, Austria
| | - Lukas Kellermair
- Department of Neurology 2, Med Campus III, Kepler University Hospital GmbH, Krankenhausstr. 9, 4021, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Milan R Vosko
- Department of Neurology 2, Med Campus III, Kepler University Hospital GmbH, Krankenhausstr. 9, 4021, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Christian Eggers
- Department of Neurology 2, Med Campus III, Kepler University Hospital GmbH, Krankenhausstr. 9, 4021, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Thomas Forstner
- Department of Applied Systems Research and Statistics, Johannes Kepler University, Linz, Austria
| | - Karin Leitner
- Clinical and Health Psychology Unit, Med Campus III, Kepler University Hospital GmbH, Linz, Austria
| | - Alexandra Fuchs
- Clinical and Health Psychology Unit, Med Campus III, Kepler University Hospital GmbH, Linz, Austria
| | - Franz Fellner
- Medical Faculty, Johannes Kepler University, Linz, Austria
- Central Radiology Institute, Med Campus III, Kepler University Hospital GmbH, Linz, Austria
| | - Gerhard Ransmayr
- Department of Neurology 2, Med Campus III, Kepler University Hospital GmbH, Krankenhausstr. 9, 4021, Linz, Austria.
- Medical Faculty, Johannes Kepler University, Linz, Austria.
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Yamasaki S, Matsushima T, Minami M, Kadowaki M, Takase K, Iwasaki H. Clinical impact of comprehensive geriatric assessment in patients aged 80 years and older with diffuse large B-cell lymphoma receiving rituximab-mini-CHOP: a single-institute retrospective study. Eur Geriatr Med 2021; 13:195-201. [PMID: 34254266 DOI: 10.1007/s41999-021-00539-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Comprehensive geriatric assessment (CGA) has been used to help identify elderly patients with diffuse large B-cell lymphoma (DLBCL) who were suitable for rituximab combined with CHOP therapy (cyclophosphamide, Adriamycin, vincristine, and prednisolone), but there are few reports of CGA for elderly patients with DLBCL who received R-mini-CHOP. METHODS We retrospectively analyzed the risk factors for outcomes among 142 patients aged 80 years and older (≤ 85 years, n = 102; > 85 years, n = 40) with DLBCL who received R-mini-CHOP at 4-week intervals at our institute between 2008 and 2019. We performed a comparison between CGA and treatment outcomes. RESULTS There were significant differences in progression-free survival between patients with international prognostic index (IPI) scores of > 3 and ≤ 3 at diagnosis and in overall survival between patients with instrumental activities of daily living (IADL) scores of ≥ 5 and IADL < 5 before the initial treatment and patients aged ≤ 85 years and > 85 years. CONCLUSION Strategies that carefully select elderly patients aged 80 years and older with DLBCL using CGA may help to identify individuals suitable for novel therapies.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. .,Department of Internal Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Tsurumi, Beppu, Oita, 874-0838, Japan.
| | - Takumi Matsushima
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Mariko Minami
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Masanori Kadowaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Ken Takase
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hiromi Iwasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
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Mis R, Giovannetti T. Similarities between Cognitive Models of Language Production and Everyday Functioning: Implications for Development of Interventions for Functional Difficulties. Top Cogn Sci 2021; 14:295-310. [PMID: 34128585 DOI: 10.1111/tops.12550] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 05/20/2021] [Accepted: 05/20/2021] [Indexed: 11/29/2022]
Abstract
The loss of the ability to independently complete activities of daily living, such as meal preparation and household chores, is a defining characteristic of clinical dementia; however, minor difficulties in completing everyday activities emerge in the mild cognitive impairment stage, and even healthy older adults exhibit subtle functional difficulties compared to younger adults. These functional difficulties are associated with an array of negative outcomes, including decreased quality of life, higher costs of care, and increased frustration, depression, caregiver burden, and institutionalization. While cognitive models have been proposed to explain the functional deficits seen in dementia and subtler forms of cognitive decline, in contrast to other cognitive disorders such as aphasia, there are essentially no theoretically motivated interventions to address difficulties in everyday functioning. Proposed models of functional impairment share features with cognitive processing models of language, including hierarchical organization of representations and interactive, spreading activation; thus, an examination of aphasia interventions has the potential to inform the development of theoretically motivated interventions for everyday activities. This review first addresses the shared characteristics of cognitive models of everyday function and language, with a focus on linguistic production. Next, we will present aphasia interventions that target single-word production, sentence production, short-term memory, and semantics, and discuss their implications for everyday functioning interventions. We conclude with a discussion of limitations of the language-everyday functioning comparison as well as areas of future research.
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Affiliation(s)
- Rachel Mis
- Department of Psychology, Temple University
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Marincolo JCS, Aprahamian I, Corona LP, Neri AL, Yassuda MS, Borim FSA. Three definitions of probable sarcopenia and associations with falls and functional disability among community-dwelling older adults. Osteoporos Sarcopenia 2021; 7:69-74. [PMID: 34278002 PMCID: PMC8261724 DOI: 10.1016/j.afos.2021.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/18/2021] [Accepted: 05/01/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To assess the prevalence of probable sarcopenia according to 3 different definitions ("strength, assistance with walking, rise from a chair, climb stairs, falls"- SARC-F score, low grip strength, and the guidelines indicated by the European Working Group on Sarcopenia in Older People 2 - EWGSOP2) and assess the association of probable sarcopenia with functional disability and falls among community-dwelling older adults. METHODS Cross-sectional study with 419 older adults. Probable sarcopenia was assessed by 3 definitions: a SARC-F ≥ 4, low grip strength (< 27 kg for men and < 16 kg for women), and the EWGSOP2 criteria. Associations were investigated using Pearson's chi-square test and prevalence ratios were estimated by Poisson regression (P < 0.05). RESULTS Of the total, probable sarcopenia was identified in 23.0% of participants (SARC-F ≥ 4 score), 33.7% (low grip strength), and 10.4% (EWGSOP2) according to each different definition. In adjusted regression models, having at least 1 instrumental activities of daily living (IADL) disability and having fallen in the last 12 months were significantly associated with a SARC-F ≥ 4 (prevalence ratio, PR = 1.60; and PR = 2.50, respectively) and EWGSOP2 (PR = 1.78; and PR = 2.19, respectively). CONCLUSIONS IADL disability and falls were associated with a SARC-F ≥ 4 and the EWGSOP2 criteria (SARC-F ≥ 4 and low grip strength). Probable sarcopenia may be used in clinical practice in order to facilitate the diagnosis of definite sarcopenia and to implement early interventions that could prevent functional decline and falls in older people.
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Affiliation(s)
| | - Ivan Aprahamian
- Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Geriatrics Division, Jundiaí Medical School (FMJ), Jundiaí, Brazil
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
| | - Ligiana Pires Corona
- Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Mônica Sanches Yassuda
- Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
- School of Arts, Sciences and Humanities (EACH) – University of São Paulo (USP), São Paulo, Brazil
| | - Flávia Silva Arbex Borim
- Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
- Department of Collective Health, School of Health Sciences, University of Brasilia – Brasília (DF), Brazil
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Oort Q, Dirven L, Sikkes SAM, Aaronson N, Boele F, Brannan C, Egeter J, Grant R, Klein M, Lips I, Narita Y, Sato H, Sztankay M, Stockhammer G, Talacchi A, Uitdehaag BMJ, Reijneveld JC, Taphoorn MJB. Development of an EORTC questionnaire measuring instrumental activities of daily living (IADL) in patients with brain tumours: phase I-III. Qual Life Res 2021; 30:1491-1502. [PMID: 33496902 PMCID: PMC8068708 DOI: 10.1007/s11136-020-02738-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2020] [Indexed: 04/02/2024]
Abstract
PURPOSE Being able to function independently in society is an important aspect of quality of life. This ability goes beyond self-care, requires higher order cognitive functioning, and is typically measured with instrumental activities of daily living (IADL) questionnaires. Cognitive deficits are frequently observed in brain tumour patients, however, IADL is almost never assessed because no valid and reliable IADL measure is available for this patient group. Therefore, this measure is currently being developed. METHODS This international multicentre study followed European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group module development guidelines. Three out of four phases are completed: phases (I) generation of items, (II) construction of the item list, and (III) pre-testing. This paper reports the item selection procedures and preliminary psychometric properties of the questionnaire. Brain tumour patients (gliomas and brain metastases), their informal caregivers, and health care professionals (HCPs) were included. RESULTS Phase I (n = 44 patient-proxy dyads and 26 HCPs) generated 59 relevant and important activities. In phase II, the activities were converted into items. In phase III (n = 85 dyads), the 59 items were pre-tested. Item selection procedures resulted in 32 items. Exploratory factor analysis revealed a preliminary dimensional structure consisting of five scales with acceptable to excellent internal consistency (α = 0.73-0.94) and two single items. For three scales, patients with cognitive impairments had significantly more IADL problems than patients without impairments. CONCLUSION A phase IV validation study is needed to confirm the psychometric properties of the EORTC IADL-BN32 questionnaire in a larger international sample.
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Affiliation(s)
- Quirien Oort
- Department of Neurology and Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | - Sietske A M Sikkes
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Alzheimer Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Developmental & Clinical Neuropsychology, Faculty of Behavioural and Movement Sciences (FGB), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Neil Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Florien Boele
- Leeds Institute of Medical Research, St James's University Hospital, Leeds, LS9 7TF, UK
- Faculty of Medicine and Health, Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT, UK
| | - Christine Brannan
- East & North Hertfordshire NHS Trust Incorporating Mount Vernon Cancer Centre, Northwood, UK
| | - Jonas Egeter
- Department for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Robin Grant
- Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
| | - Martin Klein
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Irene Lips
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center, Tokyo, Japan
| | - Hitomi Sato
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center, Tokyo, Japan
- Department of Nursing, Teikyo Heisei University, Tokyo, Japan
| | - Monika Sztankay
- Department for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Andrea Talacchi
- Department of Neurosurgery, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
| | - Bernard M J Uitdehaag
- Department of Neurology and Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands
| | - Jaap C Reijneveld
- Department of Neurology and Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Neurology, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
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Nightingale G, Battisti NML, Loh KP, Puts M, Kenis C, Goldberg A, Haase KR, Krok-Schoen J, Liposits G, Sattar S, Stolz-Baskett P, Pergolotti M. Perspectives on functional status in older adults with cancer: An interprofessional report from the International Society of Geriatric Oncology (SIOG) nursing and allied health interest group and young SIOG. J Geriatr Oncol 2021; 12:658-665. [PMID: 33172805 PMCID: PMC8102651 DOI: 10.1016/j.jgo.2020.10.018] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/17/2020] [Accepted: 10/27/2020] [Indexed: 12/18/2022]
Abstract
Most adults with cancer are over 65 years of age, and this cohort is expected to grow exponentially. Older adults have an increased burden of comorbidities and risk of experiencing adverse events on anticancer treatments, including functional decline. Functional impairment is a predictor of increased risk of chemotherapy toxicity and shorter survival in this population. Healthcare professionals caring for older adults with cancer should be familiar with the concept of functional status and its implications because of the significant interplay between function, cancer, anticancer treatments, and patient-reported outcomes. In this narrative review, we provide an overview of functional status among older patients with cancer including predictors, screening, and assessment tools. We also discuss the impact of functional impairment on patient outcomes, and describe the role of individual members of an interprofessional team in addressing functional impairment in this population, including the use of a collaborative approach aiming to preserve function.
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Affiliation(s)
- Ginah Nightingale
- Department of Pharmacy Practice, Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Nicolò Matteo Luca Battisti
- Breast Unit, Department of Medicine, The Royal Marsden NHS Foundation Trust, Sutton, Surrey SM1 2JP, United Kingdom; Breast Cancer Research Division, The Institute of Cancer Research, London SM2 5NG, United Kingdom
| | - Kah Poh Loh
- James P Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
| | - Cindy Kenis
- Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Annette Goldberg
- Department of Nutrition, Dana Farber Cancer Institute, Boston, MA, USA
| | - Kristen R Haase
- School of Nursing, University of British Columbia, Wesbrook Mall, Vancouver, British Columbia, Canada
| | - Jessica Krok-Schoen
- School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Gábor Liposits
- Department of Oncology, Regional Hospital West Jutland, Herning, Denmark
| | - Schroder Sattar
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - Petra Stolz-Baskett
- Oncology Service, Nelson Hospital Nelson Marlborough Health, Nelson 7048, New Zealand
| | - Mackenzi Pergolotti
- ReVital Cancer Rehabilitation, Select Medical; Colorado State University, Fort Collins, CO, USA
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Tremblay M, Muslemani S, Côté I, Gagnon C, Fortin J, Gallais B. Accomplishment of instrumental activities of daily living and its relationship with cognitive functions in adults with myotonic dystrophy type 1 childhood phenotype: an exploratory study. BMC Psychol 2021; 9:56. [PMID: 33865455 PMCID: PMC8052658 DOI: 10.1186/s40359-021-00562-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/06/2021] [Indexed: 11/14/2022] Open
Abstract
Background The childhood phenotype of myotonic dystrophy type 1 (DM1) involves impaired cognitive functioning starting in infancy, which may compromise later on their ability to carry out instrumental activities of daily living (IADLs) necessary for living independently. The current study aims to document the ability to perform IADLs among adults with the childhood phenotype of DM1 and to explore its links to cognitive functioning. Methods This cross-sectional exploratory study was conducted among 11 individuals living with DM1. IADLs related to money management, home management & transportation and health & safety activities were assessed by the Independent Living Scale (ILS). Neuropsychological tests assessed participants’ intellectual abilities and executive functioning. Associations were investigated using Spearman’s rho correlation. Results Important difficulties were found in all three categories of IADLs, mostly in money management in which only 2/11 participants were scored as independent. 8/11 participants showed low to very low intellectual functioning and limit to impaired executive functioning. Apathy was also a common feature as 5/11 participants showed clinical level of apathy. A lower IQ was associated with greater difficulty in the home management & transportation subtest of the ILS. Conclusions Adults with the childhood phenotype of DM1 demonstrate relative dependence in regard to the following IADLs: money management and home management & transportation. Level of dependence is, at least partially, associated with cognitive impairments. The work relates to results from an exploratory study; thus, studies must be pursued to describe in more details difficulties experienced by this population.
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Affiliation(s)
- Marjolaine Tremblay
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires (GRIMN), Centre Intégré Universitaire de Santé Et de Services Sociaux du Saguenay-Lac-St-Jean, Québec, Canada.,Centre de Recherche Charles-Le-Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Université de Sherbrooke, Québec, Canada
| | - Samar Muslemani
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires (GRIMN), Centre Intégré Universitaire de Santé Et de Services Sociaux du Saguenay-Lac-St-Jean, Québec, Canada.,Centre de Recherche Charles-Le-Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Université de Sherbrooke, Québec, Canada
| | - Isabelle Côté
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires (GRIMN), Centre Intégré Universitaire de Santé Et de Services Sociaux du Saguenay-Lac-St-Jean, Québec, Canada
| | - Cynthia Gagnon
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires (GRIMN), Centre Intégré Universitaire de Santé Et de Services Sociaux du Saguenay-Lac-St-Jean, Québec, Canada.,Centre de Recherche Charles-Le-Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Université de Sherbrooke, Québec, Canada
| | - Julie Fortin
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires (GRIMN), Centre Intégré Universitaire de Santé Et de Services Sociaux du Saguenay-Lac-St-Jean, Québec, Canada
| | - Benjamin Gallais
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires (GRIMN), Centre Intégré Universitaire de Santé Et de Services Sociaux du Saguenay-Lac-St-Jean, Québec, Canada. .,Centre de Recherche Charles-Le-Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Université de Sherbrooke, Québec, Canada. .,ÉCOBES - Recherche Et Transfert, Cégep de Jonquière, 2505 rue Saint-Hubert, Jonquière, QC, G7X 7X2, Canada.
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Svensson HK, Karlsson J, Sterner TR, Ahlner F, Skoog I, Erhag HF. Self-perceived functional ability and performance-based testing of physical function in older women with or without long-term back pain - results of the H70 study. BMC Geriatr 2021; 21:229. [PMID: 33827441 PMCID: PMC8028168 DOI: 10.1186/s12877-021-02177-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 03/25/2021] [Indexed: 11/18/2022] Open
Abstract
Background The proportion of older adults is increasing rapidly, and the majority are female. In 2050, the number of persons aged 60 years and over is estimated to reach 2.1 billion worldwide, constituting one-third of the total population of Europe. Long-term back pain is a disabling and common condition, primarily affecting older women. Although standardized functional evaluations are essential in the screening of older adults, self-rated activities of daily living capture a different aspect of the person’s ability in the context of his or her environment and social support system. This study aimed to describe how older women with or without long-term back pain self-rate their activities of daily living (ADL) and instrumental activities of daily living (IADL) in relation to their performance-based testing of physical function, including walking test, leg muscle strength, balance, and endurance. Method This study is part of the Gothenburg H70 Birth Cohort Studies in Sweden (H70 studies) and uses data from the 1944 birth cohort examined in 2015–16 at age 70. In the present study, only female participants were included in the analysis, and all cases of dementia (n = 17) and cases of acute and sub-acute back pain excluded (n = 181), leaving an effective sample of 446 female participants. Results Women with long-term back pain self-perceived their ADL and IADL as being as good as those without back pain, although they performed poorer in all performance-based tests and perceived themselves as less physically fit. Conclusion The discrepancy between self-perceived functional ability (ADL/IADL) and performance-based testing of functioning based on clinical tests calls for further investigation to incentivize person-centered care in older women with long-term back pain in municipal or emergency health-care settings.
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Affiliation(s)
- Hilda Kristin Svensson
- Academy of Health and Welfare and Centre of Research on Welfare, Health and Sport (CVHI), Halmstad University, Box 823, SE-301 18, Halmstad, Sweden. .,Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden.
| | - Jon Karlsson
- Institute of Clinical Sciences and Department of Orthopaedics at Sahlgrenska Academy, University of Gothenburg, Box 426, SE-405 30, Gothenburg, Sweden
| | - Therese Rydberg Sterner
- Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Box 430, SE-405 30, Gothenburg, Sweden.,Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Wallinsgatan 6, SE-431 41, Mölndal, Sweden
| | - Felicia Ahlner
- Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Box 430, SE-405 30, Gothenburg, Sweden.,Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Wallinsgatan 6, SE-431 41, Mölndal, Sweden
| | - Ingmar Skoog
- Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Box 430, SE-405 30, Gothenburg, Sweden.,Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Wallinsgatan 6, SE-431 41, Mölndal, Sweden
| | - Hanna Falk Erhag
- Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Box 430, SE-405 30, Gothenburg, Sweden.,Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Wallinsgatan 6, SE-431 41, Mölndal, Sweden
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Khalagi K, Ansarifar A, Fahimfar N, Sanjari M, Gharibzdeh S, Sharifi F, Shafiee G, Heshmat R, Nabipour I, Larijani B, Ostovar A. Cardio-metabolic and socio-demographic risk factors associated with dependency in basic and instrumental activities of daily living among older Iranian adults: Bushehr elderly health program. BMC Geriatr 2021; 21:172. [PMID: 33750321 PMCID: PMC7941716 DOI: 10.1186/s12877-021-02124-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 03/01/2021] [Indexed: 11/17/2022] Open
Abstract
Background Iran’s population is aging. Disability is a major public health problem for older adults, not only in Iran but all over the world. The purpose of this study was to investigate the relationship between cardio-metabolic and socio-demographic risk factors and disability in people 60 years and older in Iran. Methods The baseline (cross-sectional) data of 2426 samples from the Bushehr Elderly Health (BEH) program was included in the analysis. The participants were selected through multi-stage random sampling in Bushehr, southern Iran. Socio-demographic characteristics, as well as the history of diabetes and other chronic diseases, and smoking were measured using standardized questionnaires. Anthropometric measurements and laboratory tests were performed under standard conditions. Dependency was determined by the questionnaires of basic activities of daily living (BADL) and instrumental activities of daily living (IADL) using Barthel and Lawton scales respectively. Multiple logistic regression was used in the analysis. Results Mean (Standard Deviation) of the participants’ age was 69.3 (6.4) years (range: 60 and 96 years), and 48.1% of the participants were men. After adjusting for potential confounders, being older, being female (OR (95%CI): 2.3 (1.9–2.9)), having a lower education level, a history of diabetes mellitus (OR: 1.4 (1.2–1.7)) and past smoking (OR: 1.3 (1.0–1.6)), and no physical activity (OR: 1.5 (1.2–1.9)) were significantly associated with dependency in IADL. Also, being older and female (OR: 2.4 (1.9–3.0)), having a lower education level, no physical activity (OR: 2.2 (1.6–2.9)) and daily intake of calories (OR: 0.99 (0.99–0.99)) were associated with dependency in BADL. Conclusion Dependency in older adults can be prevented by increasing community literacy, improving physical activity, preventing and controlling diabetes mellitus, avoiding smoking, and reducing daily calorie intake. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02124-x.
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Affiliation(s)
- Kazem Khalagi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Ansarifar
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Sanjari
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Safoora Gharibzdeh
- Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, the Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Liu M, Du X, Sun Y, Zhou A, Sun S, Wu Y. The mediating role of cognition in the relationship between sleep duration and instrumental activities of daily living disability among middle-aged and older Chinese. Arch Gerontol Geriatr 2021; 94:104369. [PMID: 33556636 DOI: 10.1016/j.archger.2021.104369] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/22/2021] [Accepted: 01/29/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To explore the effect of sleep duration at baseline on the incident IADL disability among middle-aged and older Chinese, and test whether cognition mediates this causality. METHODS Data were collected from wave 1 (2011-2012) to wave 3 (2015-2016) of the China Health and Retirement Longitudinal Study (CHARLS). Sleep duration was self-reported at baseline. Cognitive function, including episodic memory and mental intactness were measured via a questionnaire. IADL was assessed at baseline and follow-up. Baron and Kenny's causal steps and Karlson/Holm/Breen (KHB) method were conducted to examine the mediating effect. RESULTS A total of 10,328 participants free of IADL disability at baseline were included in this study. Over 4 years of follow-up, 17.1% of participants developed IADL disability. Compared to 7-8 h sleep duration, both short sleep (OR=1.460; 95% CI: 1.261-1.690 for sleeping ≤5 h; OR= 1.189; 95% CI: 1.011-1.400 for sleeping 5-7 h) and long sleep (OR=1.703; 95% CI: 1.269-2.286 for sleeping >9 h) were linked with incident IADL disability. KHB method identified significant mediating effect of cognition on the relationship between extreme sleep durations (≤5 h or >9 h) and IADL disability and the proportional mediation through cognition was 21.32% and 21.06% for sleeping ≤5 h and >9 h, respectively. CONCLUSION Both short (sleeping ≤5 h) and long sleep duration (sleeping >9 h) predicted incident IADL disability. Cognition partially mediated the effect of extreme sleep durations on IADL disability.
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Shen Y, Hao Q, Liu S, Su L, Sun X, Flaherty JH, Dong B, Cao L. The impact of functional status on LOS and readmission in older patients in geriatrics department: a cohort study. Aging Clin Exp Res 2020; 32:1977-1983. [PMID: 31776857 DOI: 10.1007/s40520-019-01411-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 11/02/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Length of hospital stay (LOS) and readmission are important outcomes for older inpatients. The association between functional status on admission and outcomes has not been well investigated in Chinese elderly. OBJECTIVES To detect the impact of function impairments on LOS and 90-day readmission in a population of Chinese elderly inpatients. METHODS This is a prospective cohort study. All new patients over 60 years in geriatrics department of a university hospital in Western China from June to August 2016 were enrolled. Activities of daily living (ADL) and Instrumental ADL (IADL) on admission were evaluated with Barthel Index and Lawton IADL. Outcomes were LOS and 90-day readmission. LOS was calculated as the total days of hospital stay. Readmission was investigated through telephone interviews after discharge. Pearson Chi-square test was used to detect the associations. Binary logistic regression was used to detect the association of function status on admission with LOS and readmission. RESULTS A total of 225 patients were enrolled. Mean age 82.41 (± 7.316; 63-99), 31.1% were females. Overall, 64.9% of the patients were hospitalized longer than 14 days and 33.30% experienced a 90-day readmission. Following an adjustment for age, gender, marital status, education level, smoking, alcohol, nutrition status, and admission location, the binary logistic regression models showed that both ADL impairment (OR 2.03; 95% CI 1.06-3.87) and IADL impairment (OR 2.54; 95% CI 1.28-5.01) were independent predictors for LOS. ADL impairment was an independent predictor for 90-day readmission (OR 2.26; 95% CI 1.14-4.47), while IADL impairment was not associated with readmission (OR 1.43; 95% CI 0.68-3.02). CONCLUSION Functional status on admission is the predictor of LOS and 90-day readmission in Chinese older inpatients from the geriatric department of a university hospital.
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Affiliation(s)
- Yanjiao Shen
- The Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guoxuexiang, Chengdu, 610041, Sichuan, China
| | - Qiukui Hao
- The Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guoxuexiang, Chengdu, 610041, Sichuan, China
| | - Shuang Liu
- The Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guoxuexiang, Chengdu, 610041, Sichuan, China
| | - Lin Su
- The Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guoxuexiang, Chengdu, 610041, Sichuan, China
| | - Xuelian Sun
- The Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guoxuexiang, Chengdu, 610041, Sichuan, China
| | - Joseph H Flaherty
- Geriatrics, Envision Physician Health Services, and Adjunct in Division of Geriatrics, University of Texas Southwestern, 13737 Noel Rd Suite 1600, Dallas, TX, 75240, United States
| | - Birong Dong
- The Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guoxuexiang, Chengdu, 610041, Sichuan, China
| | - Li Cao
- The Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guoxuexiang, Chengdu, 610041, Sichuan, China.
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