scholarly journals Patterns of multimorbidity and risk of disability in community-dwelling older persons

2021 ◽  
Author(s):  
Alessandra Marengoni ◽  
Roselyne Akugizibwe ◽  
Davide L. Vetrano ◽  
Albert Roso-Llorach ◽  
Graziano Onder ◽  
...  
Keyword(s):  
Daily Living ◽  
Older Persons ◽  
Healthcare Resource ◽  
Resource Planning ◽  
Total Sample ◽  
Community Dwelling ◽  
National Study ◽  
Sensory Impairment ◽  
Multinomial Models

AbstractThe aim was to analyze the association between specific patterns of multimorbidity and risk of disability in older persons. Data were gathered from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K); 2066 60 + year-old participants living in the community and free from disability at baseline were grouped according to their multimorbidity patterns and followed-up for six years. The association between multimorbidity patterns and disability in basic (ADL) and instrumental (IADL) activities of daily living was examined through multinomial models. Throughout the follow-up, 434 (21.0%) participants developed at least one ADL and 310 (15.0%) at least one IADL. Compared to the unspecific pattern, which included diseases not exceeding their expected prevalence in the total sample, belonging to the cardiovascular/anemia/dementia, the sensory impairment/cancer and the musculoskeletal/respiratory/gastrointestinal patterns was associated with a higher risk of developing both ADL and IADL, whereas subjects in the metabolic/sleep disorders pattern showed a higher risk of developing only IADL. Multimorbidity patterns are differentially associated with incident disability, which is important for the design of future prevention strategies aimed at delaying functional impairment in old age, and for a better healthcare resource planning.

Increasing Life-Space Mobility in Community-Dwelling Older Persons With Cognitive Impairment Following Rehabilitation: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Phoebe Ullrich ◽  
Christian Werner ◽  
Martin Bongartz ◽  
Tobias Eckert ◽  
Bastian Abel ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Older Persons ◽  
Controlled Trial ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Life Space ◽  
Home Based ◽  
Independent Life

Abstract Background Community-dwelling older persons with cognitive impairment (CI) following discharge from geriatric rehabilitation are at high risk of losing life-space mobility (LSM). Interventions to improve their LSM are, however, still lacking. The aim of this study was to evaluate the effects of a CI-specific, home-based physical training and activity promotion program on LSM. Methods Older persons with mild-to-moderate CI (Mini-Mental State Examination: 17–26 points) discharged home from rehabilitation were included in this double-blinded, randomized, placebo-controlled trial with a 12-week intervention period and 12-week follow-up period. The intervention group received a CI-specific, home-based strength, balance, and walking training supported by tailored motivational strategies. The control group received a placebo activity. LSM was evaluated by the Life-Space Assessment in Persons with Cognitive Impairment, including a composite score for LSM and 3 subscores for maximal, equipment-assisted, and independent life space. Mixed-model repeated-measures analyses were used. Results One hundred eighteen participants (82.3 ± 6.0 years) with CI (Mini-Mental State Examination: 23.3 ± 2.4) were randomized. After the intervention, the home-based training program resulted in a significant benefit in the Life-Space Assessment in Persons with Cognitive Impairment composite scores (b = 8.15; 95% confidence interval: 2.89–13.41; p = .003) and independent life-space subscores (b = 0.39; 95% confidence interval: 0.00–0.78; p = .048) in the intervention group (n = 63) compared to control group (n = 55). Other subscores and follow-up results were not significantly different. Conclusions The home-based training program improved LSM and independent life space significantly in this vulnerable population. Effects were not sustained over the follow-up. The program may represent a model for improved transition from rehabilitation to the community to prevent high risk of LSM restriction.

scholarly journals Incidence and multidimensional predictors of occasional and recurrent falls among Malaysian community‐dwelling older persons

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Theng Choon Ooi ◽  
Devinder Kaur Ajit Singh ◽  
Suzana Shahar ◽  
Nor Fadilah Rajab ◽  
Divya Vanoh ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Older Persons ◽  
Test Score ◽  
Community Dwelling ◽  
Chair Stand ◽  
Stand Test ◽  
Chair Stand Test ◽  
Recurrent Falls ◽  
History Of

Abstract Background Falls incidence rate and comprehensive data on factors that predict occasional and repeated falls from large population-based studies are scarce. In this study, we aimed to determine the incidence of falls and identify predictors of occasional and recurrent falls. This was done in the social, medical, physical, nutritional, biochemical, cognitive dimensions among community-dwelling older Malaysians. Methods Data from 1,763 Malaysian community-dwelling older persons aged ≥ 60 years were obtained from the LRGS-TUA longitudinal study. Participants were categorized into three groups according to the presence of a single fall (occasional fallers), ≥two falls (recurrent fallers), or absence of falls (non-fallers) at an 18-month follow-up. Results Three hundred and nine (17.53 %) participants reported fall occurrences at an 18-month follow-up, of whom 85 (27.51 %) had two or more falls. The incidence rate for occasional and recurrent falls was 8.47 and 3.21 per 100 person-years, respectively. Following multifactorial adjustments, being female (OR: 1.57; 95 % CI: 1.04–2.36), being single (OR: 5.31; 95 % CI: 3.36–37.48), having history of fall (OR: 1.86; 95 % CI: 1.19–2.92) higher depression scale score (OR: 1.10; 95 % CI: 1.02–1.20), lower hemoglobin levels (OR: 0.90; 95 % CI: 0.81-1.00) and lower chair stand test score (OR: 0.93; 95 % CI: 0.87-1.00) remained independent predictors of occasional falls. While, having history of falls (OR: 2.74; 95 % CI: 1.45–5.19), being a stroke survivor (OR: 8.57; 95 % CI: 2.12–34.65), higher percentage of body fat (OR: 1.04; 95 % CI: 1.01–1.08) and lower chair stand test score (OR: 0.87; 95 % CI: 0.77–0.97) appeared as recurrent falls predictors. Conclusions Having history of falls and lower muscle strength were predictors for both occasional and recurrent falls among Malaysian community-dwelling older persons. Modifying these predictors may be beneficial in falls prevention and management strategies among older persons.

GAIT SPEED AND HANDGRIP STRENGTH AS PREDICTORS OF INCIDENT DISABILITY IN MEXICAN OLDER ADULTS

2014 ◽  
pp. 1-4
Author(s):  
T. LOPEZ-TEROS ◽  
L.M. GUTIERREZ-ROBLEDO ◽  
M.U. PEREZ-ZEPEDA
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Daily Living ◽  
Handgrip Strength ◽  
Statistical Significance ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Performance Tests ◽  
One Year

Physical performance tests are associated with different adverse outcomes in older people. Theobjective of this study was to test the association between handgrip strength and gait speed with incidentdisability in community-dwelling, well-functioning, Mexican older adults (age ≥70 years). Incident disability wasdefined as the onset of any difficulty in basic or instrumental activities of daily living. Of a total of 133participants, 52.6% (n=70) experienced incident disability during one year of follow-up. Significant associationsof handgrip strength (odds ratio [OR] 0.96, 95% confidence interval [95%CI] 0.93-0.99) and gait speed (OR0.27, 95%CI 0.07-0.99) with incident disability were reported. The inclusion of covariates in the models reducedthe statistical significance of the associations without substantially modifying the magnitude of them. Handgripstrength and gait speed are independently associated with incident disability in Mexican older adults.

scholarly journals A Prospective Study on Risk Factors for Olfactory Dysfunction in Aging

2019 ◽  
Vol 75 (3) ◽  
pp. 603-610 ◽  
Author(s):  
Eva Palmquist ◽  
Maria Larsson ◽  
Jonas K Olofsson ◽  
Janina Seubert ◽  
Lars Bäckman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Healthy Lifestyle ◽  
Total Sample ◽  
Olfactory Dysfunction ◽  
National Study ◽  
Current Smoking ◽  
Ε4 Allele ◽  
A Prospective Study

Abstract Background Olfactory dysfunction (OD) refers to a reduced or absent ability to smell. OD negatively impacts health and quality of life and its prevalence increases with advancing age. Since OD may be an early marker of dementia and impending death, more knowledge regarding risk factors of OD in aging is warranted. The objective was therefore to explore longitudinally which demographic, genetic, clinical, lifestyle, and cognitive factors predict the development of OD. Methods The study included participants aged 60–90 years from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), who did not have OD at baseline and were reassessed with an odor identification task at a 6-year follow-up (n = 1,004). Risk factors of OD were assessed with multivariable logistic regression analyses. Results The percentage of incident OD cases was 14.2% over 6 years in the total sample and this number increased monotonically with age. Increasing age, carrying the ε4 allele of the APOE gene, atrial fibrillation, cerebrovascular disease, and current smoking were found to be risk factors for the development of OD, whereas better olfactory identification and verbal episodic memory proficiency at baseline were identified as protective factors. Conclusions In addition to nonmodifiable factors (age and genetic risk), several modifiable risk factors of OD were identified. This suggests that it might be possible to reduce OD incidence through the management of vascular risk factors and maintenance of a healthy lifestyle.

Predictors of functional status in Japanese community-dwelling older persons during a 2-year follow up

2006 ◽  
Vol 6 (2) ◽  
pp. 116-123 ◽  
Author(s):  
Ryuichi Kawamoto ◽  
Hitomi Tomita ◽  
Yuichiro Oka ◽  
Nobuyuki Ohtsuka
Keyword(s):  
Functional Status ◽  
Older Persons ◽  
Community Dwelling

scholarly journals Decline in Literacy and Incident AD Dementia Among Community-Dwelling Older Persons

2017 ◽  
Vol 30 (9) ◽  
pp. 1389-1405 ◽  
Author(s):  
Lei Yu ◽  
Robert S. Wilson ◽  
S. Duke Han ◽  
Sue Leurgans ◽  
David A. Bennett ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Older Persons ◽  
Hazard Ratio ◽  
Community Dwelling ◽  
Cognitive Outcomes ◽  
Longitudinal Change ◽  
Time To Event ◽  
Time To Event Data ◽  
Clinical Diagnoses

Objective: To quantify longitudinal change in financial and health literacy and examine the associations of declining literacy with incident Alzheimer’s disease (AD) dementia and mild cognitive impairment (MCI). Method: Data came from 799 participants of an ongoing cohort study. Literacy was measured using a battery of 32 questions. Clinical diagnoses were made annually following uniform structured procedures. The associations of declining literacy with incident AD dementia and MCI were tested using a joint model for longitudinal and time-to-event data. Results: We observed an overall decline in total literacy score over up to 6 years of follow-up ( p < .001). Faster decline in literacy was associated with higher risks for incident AD dementia (hazard ratio = 4.526, 95% confidence interval = [2.993, 6.843], p < .001) and incident MCI (hazard ratio = 2.971, 95% confidence interval = [1.509, 5.849], p = .002). Discussion: Declining literacy among community-dwelling older persons predicts adverse cognitive outcomes and serves as an early indicator of impending dementia.

scholarly journals The Impact Of Frailty On Admission To Home Care Services And Nursing Homes: Eight-Year Follow-Up Of A Community-Dwelling, Older Adult, Spanish Cohort

2020 ◽  
Author(s):  
Francisco Cegri ◽  
Francesc Orfila ◽  
Rosa M Abellana ◽  
María Pastor-Valero
Keyword(s):  
Older Adults ◽  
Nursing Homes ◽  
Home Care ◽  
Primary Healthcare ◽  
Daily Living ◽  
Community Dwelling ◽  
Older Age ◽  
Age Dependence ◽  
Primary Healthcare Centers

Abstract Background The aim of this study is to identify the factors that anticipate the future inclusion of community-dwelling individuals aged ≥ 70 years in home care programmes (HC) and nursing homes (NH), and to develop the corresponding prediction models. Methods Study design: prospective, multicenter, cohort study in 23 primary healthcare centers located in Catalonia, Spain, with an eight-year follow-up (2005-2013). Participants: the cohort was made up of 616 individuals. Data collection: baseline interview included a multidimensional assessment carried out by primary health care professionals. Outcome variables were collected during follow-up by consulting electronic healthcare records, telephone contacts, and the Central Registry of Catalonia for mortality. Statistical analysis: a prognostic index for a HC and NH at eight years was estimated for each patient. Death prior to these events was considered a competing risk event, and Fine–Gray regression models were used. The internal validity of the predictive models was tested for 150 bootstrap re-samples. Results At baseline, mean age was 76.4 years, 55.5% were women, and 22% lived alone. During follow-up, 19.2% entered a HC program, 8.2% a NH, and 15.4% died without presenting an event. Of those who entered a NH, 31.5% had previously been in a HC program. Multivariate competitive risk models for a HC and NH showed that the risk of a HC entry was associated with older age, dependence on the Instrumental Activities of the Daily Living, and slow gait measured by Timed-up-and-go test. An increased risk of being admitted to a NH was associated with older age, dependence on the Instrumental Activities of the Daily Living, augmented number of prescriptions, and the presence of social risk. Conclusions Prognostic models based on comprehensive geriatric assessments can predict the need for the commencement of HC and NH admission in community-dwelling older adults. Our findings underline the necessity to measure functional capacity, mobility, number of prescriptions, and social aspects of older adults in primary healthcare centers. In such a setting they can be offered longitudinal holistic assessments so as to benefit from preventive actions in order to remain independent in the community for as long as possible.

The Transition From Informal to Formal Sources of Support With Tasks of Daily Living

1991 ◽  
Vol 10 (2) ◽  
pp. 133-149 ◽  
Author(s):  
Judith G. Chipperfield ◽  
Betty Havens
Keyword(s):  
Social Network ◽  
Daily Living ◽  
Detrimental Effect ◽  
Well Being ◽  
Community Dwelling ◽  
Formal Support ◽  
The Social ◽  
Sources Of Support ◽  
New Community

This study examined two issues related to the transition from informal to formal support sources of support: (a) the link between losses within the social network and a transition in source of support, and (b) the association between transitions toward formal sources of support and changes in wellbeing. Included were a subset of community-dwelling elders who participated in the Aging in Manitoba Studies and who survived over a 12-year follow up (n = 384). Women, but not men, experienced a transition to formal support with the less of a spouse or housemate, or with recent relocation to a new community. Moreover, for some women, the shift toward formal support was associated with declines in well-being, but this was true for only one of several measures of well-being. Thus, little evidence was found to suggest that the transition from informal to formal support has a detrimental effect on elders' levels of well-being.

scholarly journals Behavioral Program and Exercise Training for Older Persons: Effect on Cardiorespiratory Fitness

2017 ◽  
Vol 2 (6) ◽  
pp. 105
Author(s):  
Azliyana Azizan ◽  
Maria Justine ◽  
Noor Amiera Alias
Keyword(s):  
Quality Of Life ◽  
Daily Living ◽  
Older Persons ◽  
Exercise Program ◽  
Community Dwelling ◽  
Behavioral Program ◽  
Significant Difference ◽  
Cardio Respiratory Fitness

Active participation in exercise may help to improve physical and psychological functions for older people. Regretfully, most of them do not engage in long term exercise due to several barriers. This puts them at high risk of may chronic illness that will limit their activities of daily living. The aim of this study is to determine the effectiveness of the behavioral and exercise program on cardio respiratory fitness among 63 community-dwelling olders. At the end of six months, there is a significant difference for cardio respiratory fitness and exercise engagement. Thus, improved their overall quality of life.

scholarly journals Outcomes and interventions in the elderly with and without cognitive impairment: a longitudinal study

2020 ◽  
Vol 14 (4) ◽  
pp. 394-402
Author(s):  
Anne Caroline Soares da Silva ◽  
Juliana Hotta Ansai ◽  
Natália Oiring de Castro Cezar ◽  
Francisco Assis Carvalho Vale ◽  
Julimara Gomes dos Santos ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Older People ◽  
Clinical Outcomes ◽  
Daily Living ◽  
Home Visit ◽  
Geriatric Patients ◽  
The Elderly ◽  
Community Dwelling ◽  
Community Dwelling Older People

ABSTRACT. Background: Clinical follow-up studies are necessary for a better understanding of the evolution of cognitive impairment as well as the development of better assessment and intervention tools. Objective: To investigate whether older people with preserved cognition (PC), mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) show differences in clinical outcomes and interventions after a 32-month period. Methods: One hundred twenty-four community-dwelling older people were included and classified in one of three groups (PC, MCI and mild AD). Information on clinical outcomes (deaths, new diagnoses, falls, need for assistance or changes in routine and hospitalizations) and interventions (increased use of medication, physiotherapeutic intervention, practice of physical exercise, etc.) in the 32-month period were collected by telephone or during a home visit on a single day. Results: Ninety-five participants (35 with PC, 33 with MCI and 27 with AD) were reevaluated after 32 months. The need for assistance/changes in routine was significantly higher in the AD group, especially with regard to basic activities of daily living. Unlike the other groups, the PC group did not show “other diagnoses” (urinary incontinence, prolapse, change in vision or autoimmune disease). No significant differences were found regarding other variables. Conclusions: Older people with and without cognitive impairment exhibited differences in some clinical outcomes after 32 months, such as need for assistance or changes in their routine and new diagnoses of specific diseases. Therefore, the multidimensionality of geriatric patients should be considered when planning assessments and interventions.

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