scholarly journals Quality of Life and Mental Health in Older Adults with Obesity and Frailty: Associations with a Weight Loss Intervention

2018 ◽  
Vol 22 (10) ◽  
pp. 1259-1265 ◽  
Author(s):  
M. E. Payne ◽  
K. N. Porter Starr ◽  
M. Orenduff ◽  
H. S. Mulder ◽  
S. R. McDonald ◽  
...  
2019 ◽  
pp. 145749691988381 ◽  
Author(s):  
A. Liljensøe ◽  
J. O. Laursen ◽  
H. Bliddal ◽  
K. Søballe ◽  
I. Mechlenburg

Background and Aims: Obesity is an increasing problem in patients after total knee replacement. The aim of this study was to investigate whether a weight loss intervention before primary total knee replacement would improve quality of life, knee function, mobility, and body composition 1 year after surgery. Material and Methods: Patients scheduled for total knee replacement due to osteoarthritis of the knee and obesity were randomized to a control group receiving standard care or to an intervention group receiving 8-week low-energy diet before total knee replacement. Patient-reported quality of life, 6-Min Walk Test, and body composition by dual-energy X-ray absorptiometry were assessed before intervention for the diet group, and within 1 week preoperatively for both groups, and the changes in outcome from baseline to 1 year after total knee replacement were compared between groups. The number of participants was lower than planned, which might introduce a type-2 error and underestimate the trend for a better outcome after weight loss. Results: The analyses are based on a total of 76 patients, 38 in each group. This study showed major improvement in both study groups in quality of life and knee function, though no statistically significant differences between the groups were observed 1 year after total knee replacement. The average weight loss after 8-week preoperative intervention was 10.7 kg and consisted of a 6.7 kg reduction in fat mass. One year after total knee replacement, the participants in the diet group managed to maintain the weight reduction, whereas there was no change in the control group. Conclusion: The results suggest that it is feasible and safe to implement an intensive weight loss program shortly before total knee replacement. The preoperative intervention resulted in a 10% body weight loss, improved body composition, lower cardiovascular risk factors, and sustained s-leptin.


2016 ◽  
Vol 39 (9) ◽  
pp. 991-1012 ◽  
Author(s):  
Hyun-Jun Kim ◽  
Karen I. Fredriksen-Goldsen

We assessed factors contributing to ethnic and racial disparities in mental health quality of life (MHQOL) among lesbian, gay, and bisexual (LGB) midlife and older adults. We utilized cross-sectional survey data from a sample of non-Hispanic White and Hispanic LGB adults aged 50 and older. Structural equation modeling was used to test the indirect effect of ethnicity/race on MHQOL via explanatory factors including social connectedness, lifetime discrimination, socioeconomic status (SES), and perceived stress. Hispanics reported significantly lower levels of MHQOL, compared to non-Hispanic Whites. In the final model, the association between ethnicity/race and MHQOL was explained by higher levels of perceived stress related to lower SES, higher frequency of lifetime discrimination, and lack of social connectedness among Hispanic LGB adults. This study suggests that perceived stress related to social disadvantage and marginalization plays an important role in MHQOL disparities among Hispanic LGB midlife and older adults.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S515-S516
Author(s):  
Lan Doan ◽  
Yumie Takata ◽  
Karen Hooker ◽  
Carolyn Mendez-Luck ◽  
and Veronica L Irvin

Abstract Cardiovascular disease (CVD) is the leading cause of death for Asian American (AA), Native Hawaiian, and Pacific Islander (NHPI) older adults, and AAs/NHPIs have not enjoyed decreases in CVD mortality rates, as have non-Hispanic whites (NHWs). Heterogeneity exists in the prevalence of traditional CVD risk factors for AAs/NHPIs. Health-related quality of life (HRQOL) reflect physical and mental burdens beyond clinical burdens, which may help explain discrepant CVD rates and risk factors in AAs/NHPIs. We examined HRQOL among NHW and AA/NHPI Medicare Advantage enrollees with and without a CVD (i.e., coronary artery disease, congestive heart failure, myocardial infarction, and stroke) using the Medicare Health Outcomes Survey. The sample included 655,914 older adults who were 65 years or older, self-reported as AA/NHPI or NHW, and were enrolled in Medicare Advantage plans in 2011-2015. HRQOL was measured using the Veterans RAND 12-item survey and is composed of a physical component score (PCS) and mental component score (MCS), where higher scores reflect better physical and mental health, respectively. Multivariable linear regression was used to explore HRQOL and CVD prevalence. Asian Indian, Filipino, Vietnamese, Other Asian, and NHPI subgroups had lower overall PCS, and all AA/NHPI subgroups had lower overall MCS, compared to NHWs. Among those reporting having any CVD, PCS varied by CVD outcomes and subgroups, whereas MCS was lower for all CVD outcomes and for all but one AA/NHPI subgroups (Japanese), compared to NHWs. Attention to mental health for AA/NHPI older adults could be important for the equitable realization of healthy aging.


2021 ◽  
Vol 9 ◽  
Author(s):  
Christine E. Gould ◽  
Chalise Carlson ◽  
Ana Jessica Alfaro ◽  
Christina F. Chick ◽  
Martha L. Bruce ◽  
...  

Background: This study aimed to examine the effects of a 12-week multicomponent mobile app-delivered intervention, the Meru Health Program (MHP), on mental health quality of life (QoL) and loneliness among the middle-aged and older adults with depression symptoms.Methods: The eligible participants (M age = 57.06, SD = 11.26 years) were enrolled in the MHP, a therapist-supported mobile intervention. Using a non-randomized pre-post design, change in mental health QoL [WHO QoL Brief (WHOQOL-BREF) psychological health] and loneliness (UCLA Loneliness Scale) from baseline to post-treatment were examined. Time of enrollment [pre- vs. post-coronavirus disease 2019 (COVID-19)] was included as a between-subjects factor in the repeated measures analyses.Results: Forty-two participants enrolled prior to the COVID-19 pandemic; eight enrolled after the pandemic began. Among the pre-COVID-19 enrollees, increase in mental health QoL, F(1, 38) = 12.61, p = 0.001, η2 = 0.25 and decreases in loneliness emerged, F(1, 38) = 5.42, p = 0.025, η2 = 0.13. The changes in mental health QoL, but not loneliness, held for the combined sample, such as post-COVID-19 enrollees, F(1, 44) = 6.02, p = 0.018, η2 = 0.12. The regression analyses showed that increases in mindfulness were associated with the increased mental health QoL and decreased loneliness.Conclusion: Therapist-supported digital mental health interventions, such as the MHP, have the potential to improve mental health QoL and decrease loneliness among the middle-aged and older adults. The findings for loneliness may not hold during the periods of mandated isolation. Instead, therapists supporting digital interventions may need to tailor their approach to target loneliness.


2020 ◽  
Author(s):  
Antonio Miguel-Cruz ◽  
Anna-Maria Ladurner ◽  
Megan Kohls-Wiebe ◽  
David Rawani ◽  
Fiona Jaffray

BACKGROUND Mental health is a prevalent condition amongst Canadians. Mental health conditions are the leading cause of disability, as each year 1 in 5 Canadians experiences a mental health issue. Five percent of people aged 65 years and older perceive their mental health as fair or poor, and 6.3% of them have mood disorders. Regarding older adults with cognitive impairments such as dementias, up to 40 to 50 per cent of them experience depression at some point. We believe that older adults can benefit significantly from information and telecommunication technologies (ICTs) as a strategy for improving mental health conditions such as depression and anxiety, while at the same time improving their quality of life. 3Scape Systems Inc. is an Albertan-based private company that has produced a series of specialized 3D videos that have been designed to simulate real-life events and engage individuals living with mental health disorders and cognitive impairments such as dementia. OBJECTIVE The purpose of this study is to explore the trial design and effects of 3Scape videos on older adults’ symptoms of depression, anxiety, and quality of life, as well as the efficacy of this technology in reducing the caregiver burden on the START Psychiatry Day Hospital program at Glenrose Rehabilitation Hospital (GRH), and to provide data in order to estimate the parameters required to design a definitive Randomized Controlled Trial (RCT). METHODS The trial will use a randomized controlled design comprising 15 intervention participants and 15 control group participants. The participants will be adults aged 65 years and older who are cognitively intact or who have a minimal cognitive impairment, i.e. Montreal Cognitive Assessment (MOCA) ≥18), and clients from the START Psychiatry Day Hospital program at GRH. This study’s primary outcome variables are related to the clients’ depressive and anxiety symptoms, and their quality of life. The control group will receive the standard of care (i.e. the START Psychiatry Day Hospital program at GRH). The intervention group will receive the same standard of care as the control group at each facility and will use the 3Scape Systems videos for the therapeutic activities. RESULTS Our study is currently on hold due to the Covid-19 global pandemic. The recruitment process is expected to resume by November 2020 and the primary impact analysis is expected to be conducted by February 2021. CONCLUSIONS This study will provide valuable information such as the measurement of comparative intervention effects, perception of older adults and hand therapists about the 3Scape Systems, the associated costs of treatment, and product costings. This will contribute to the evidence planning process, which will be crucial for the future adoption of the 3Scape Systems. CLINICALTRIAL International Registered Report Identifier (IRRID): ISRCTN: 93685907 (available at https://doi.org/10.1186/ISRCTN93685907)


2018 ◽  
Vol 4 (2) ◽  
pp. 15-24
Author(s):  
Nidup Dorji ◽  
Michael P. Dunne ◽  
Charrlotte Seib ◽  
Sibnath Dep

Introduction: Health-related quality of life (HRQoL) is a multi-dimensional construct that assesses an individual’s and group’s perceived physical and mental health over time. Measurement of HRQoL is an important medical outcome study and its study among older adults in Bhutan is limited. Methods: This is a cross-sectional study aimed to assess HRQoL and its sociodemographic and health correlates, among older adults in Bhutan. Data for this study was collected from the four major towns of Thimphu, Phuntsholing, Gelephu, and Samdrupjongkhar, Bhutan, from November 2014 - February 2015, using structured questionnaire with face-to-face interview. A total of 337 Bhutanese older adults participated in this study. Statistical analysis was performed using statistical package for social science version 21.0. Results: The overall mean score for the HRQoL among older adults in this study was 0.67 (SD: 0.13) significantly different between the gender (p-value<0.001). A significantly low scores inthe areas of role limitations (p<0.05), pain (p<0.01), mental health (p<0.001), and vitality (p<0.05) of the HRQoL was observed for the female gender. Frequent back pain (67.1%), memory decline (60.5%), depression (46.0%) mobility impairment (45.4%), insomnia (42.1%), and problem affecting breathing (31.8%) were common health problems and were significantly higher among the female gender. Better health conditions was positively related with better HRQoL (p-value<0.001). Conclusions: Low HRQoL was reported higher among female gender and was linked to multiple and cumulative health morbidities. Members of the family, community and healthcare providers could incorporate holistic approach to foster positive health outcomes and HRQoL of the older adults.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S877-S877
Author(s):  
Anjana Muralidharan ◽  
Clayton H Brown ◽  
Richard W Goldberg

Abstract Older adults with serious mental illness (i.e., schizophrenia spectrum disorders and affective psychoses) exhibit marked impairments across medical, cognitive, and psychiatric domains. The present study examined predictors of health-related quality-of-life and mental health recovery in this population. Participants (N=211) were ages 50 and older with a chart diagnosis of serious mental illness and a co-occurring medical condition, engaged in outpatient mental health services at a study site. Participants completed a battery of assessments including subtests from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the 24-Item Behavior and Symptom Identification Scale (BASIS-24), the 12-Item Short-Form Health Survey (SF-12), and the Maryland Assessment of Recovery Scale (MARS). Multiple linear regression analyses, with age, race, gender, and BMI as covariates, examined number of current medical conditions, RBANS, and BASIS as predictors of quality-of-life and recovery. Significant predictors of physical health-related quality-of-life (R-squared=.298, F(9,182)=8.57, p&lt;.0001) were number of medical conditions (β=-1.70, p&lt;.0001), BASIS-Depression/Functioning (β=-4.84, p&lt;.0001), and BASIS-Psychosis (β=2.39, p&lt;.0008). Significant predictors of mental health-related quality-of-life (R-squared=.575, F(9,182)=27.37, p&lt;.0001) were RBANS (β=0.03, p=.05), BASIS-Depression/Functioning (β=-6.49, p&lt;.0001), BASIS-Relationships (β=-3.17, p&lt;.0001), and BASIS-Psychosis (β=-1.30, p=.03). Significant predictors of MARS (R-squared=.434, F(9,183)=15.56, p&lt;.0001) were BASIS-Depression/Functioning (β=-4.68, p=.002) and BASIS-Relationships (β=-9.44, p&lt;.0001). To promote holistic recovery among older adults with serious mental illness, integrated interventions are required. For example, to improve physical health-related quality-of-life, one should target depression and psychotic symptoms as well as medical illness burden. To improve mental health-related quality-of-life, depression symptoms and interpersonal functioning may be key targets, as well as neurocognitive function.


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