Short-term functional decline of older adults admitted for suspected sepsis

2011 ◽  
Vol 29 (8) ◽  
pp. 936-942 ◽  
Author(s):  
William J. Meurer ◽  
Eve D. Losman ◽  
Barbara L. Smith ◽  
Preeti N. Malani ◽  
John G. Younger
Keyword(s):  
Older Adults ◽  
Functional Decline ◽  
Short Term ◽  
Suspected Sepsis

scholarly journals Benefits of a Short-Term Obesity Reduction Intervention Among Obese Older Adults with Prediabetes: Preliminary Evidence by Race (Black/White) from the EGGSPDITe Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1662-1662
Author(s):  
Marshall Miller ◽  
Michael Borack ◽  
Jamie Rincker ◽  
Shelley McDonald ◽  
Kathryn Porter Starr ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Functional Decline ◽  
Group Analysis ◽  
Preliminary Evidence ◽  
The Body ◽  
Physical And Mental Health ◽  
Short Term ◽  
Black And White ◽  
Time Interaction

Abstract Objectives Obesity rates in older adults are rapidly climbing, especially in older African Americans, for whom it hastens functional decline and intensifies chronic health conditions like Type 2 diabetes more so than in their white counterparts. Emerging evidence suggest that increased protein intake can enhance the benefits of intentional weight loss but it is not yet known whether these effects are consistent across race. Methods The ongoing EGGSPDITe trial assess the effects of combining generous intakes of high quality animal protein (≥30 g/meal; primarily from eggs) with calorie restriction, relative to calorie restricted alone, on insulin resistance and weight loss among black and white older adults with prediabetes who are participating in this 4-month obesity reduction intervention. Results Preliminary combined-group analysis reveals significant reductions in body weight (–9.7 ± 7.6 kg), body fat (–8.1 ± 7.6 kg), and HbA1c (–0.2 ± 0.3%) and significant improvement in SF-36 physical and mental health composites (+10.8 and + 4.8, respectively; Ps < 0.01) at 4 months, relative to baseline. Significant improvements in 6-minute walk distance and 8-foot up and go (Ps ≤ 0.05) at 4 months; however, a significant race x time interaction (P < 0.05) reveals that improvements in 30-second chair stands improved among white but not black participants (+2.4 vs 0.4 stands, respectively). No other significant differences were observed between older black and white pre-diabetics. Conclusions These preliminary findings suggest that even short-term obesity reduction intervention can improve the body composition, metabolism, and self-reported health of obese older adults with prediabetes but responses may vary by race for some outcomes. Funding Sources This study was funded by the National Institute on Aging and the Egg Nutrition Council.

Predictors of Short-term Functional Decline in Older Adults with Blunt Injuries

2006 ◽  
Vol 13 (5Supplement 1) ◽  
pp. S67-S67
Author(s):  
S. T. Wilber
Keyword(s):  
Older Adults ◽  
Functional Decline ◽  
Short Term ◽  
Blunt Injuries

scholarly journals Allostatic Load Following Short-Term Intervention: Cognition in Older Hypertensive Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1032-1033
Author(s):  
Anthony Cirilo ◽  
Jordan Kohn ◽  
Gavrila Ang ◽  
Meredith Pung ◽  
Emily Troyer ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Performance ◽  
Behavioral Interventions ◽  
Allostatic Load ◽  
Healthy Aging ◽  
Functional Decline ◽  
Cumulative Effect ◽  
Short Term ◽  
Post Intervention

Abstract Allostatic load (AL), a measure of cumulative effect of prolonged stressors across physiological systems, is consistently associated with adverse health outcomes. Greater AL is correlated with functional decline in aging, but effects of behavioral interventions, such as Tai Chi (TC), on AL in older adults in a short-term is unknown. To investigate the effects of TC practice on AL and cognitive function and an AL-cognition relationship, older adults (60-95 years) with hypertension were recruited and randomly assigned to 12-week TC or Healthy Aging Practice-centered Education (HAP-E) classes. The AL index (ALI) included: SBP and DBP; urinary epinephrine and norepinephrine; plasma inflammatory biomarkers (CRP, IL-6); metabolic biomarkers (HDL, total cholesterol, triglycerides, HbA1c); and BMI. The Montreal Cognitive Assessment (MoCA) was administered to assess cognitive function. Generalized linear mixed-effects models, adjusted for age, race, education, and intervention attendance, was used. Pre- and post-intervention ALI did not change significantly in TC (2.61 (1.48) to 2.76 (1.62)) or HAP-E (2.84 (1.61) to 2.66 (1.86)). High ALI was associated with lower MoCA scores, indicating poorer cognitive performance (IRR=0.96; 95% CI: 0.93-0.98; p=0.002) across the time points. Of note, the MoCA scores did not significantly change across time (25.4 (3.2) to 26.0 (3.0)). 12-week TC or HAP-E interventions did not lead to a significant change in ALI or cognitive performance in our population. However, our findings show greater AL theoretically attributed to chronic stress is associated with cognitive functioning in older adults consistently over about 4 months.

scholarly journals Spontaneous Eye Blinks Predict Executive Functioning in Seniors

2021 ◽  
Author(s):  
Jessika I. V. Buitenweg ◽  
Jaap M. J. Murre ◽  
K. Richard Ridderinkhof
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Executive Functioning ◽  
Cognitive Training ◽  
Functional Decline ◽  
Future Research ◽  
Blink Rate ◽  
Memory Updating ◽  
Age Related ◽  
Working Memory Updating

AbstractAs the world’s population is aging rapidly, cognitive training is an extensively used approach to attempt improvement of age-related cognitive functioning. With increasing numbers of older adults required to remain in the workforce, it is important to be able to reliably predict future functional decline, as well as the individual advantages of cognitive training. Given the correlation between age-related decline and striatal dopaminergic function, we investigated whether eye blink rate (EBR), a non-invasive, indirect indicator of dopaminergic activity, could predict executive functioning (response inhibition, switching and working memory updating) as well as trainability of executive functioning in older adults. EBR was collected before and after a cognitive flexibility training, cognitive training without flexibility, or a mock training. EBR predicted working memory updating performance on two measures of updating, as well as trainability of working memory updating, whereas performance and trainability in inhibition and switching tasks could not be predicted by EBR. Our findings tentatively indicate that EBR permits prediction of working memory performance in older adults. To fully interpret the relationship with executive functioning, we suggest future research should assess both EBR and dopamine receptor availability among seniors.

scholarly journals Frailty and hospitalization-associated disability after pneumonia: A prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chan Mi Park ◽  
Wonsock Kim ◽  
Hye Chang Rhim ◽  
Eun Sik Lee ◽  
Jong Hun Kim ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Outcome ◽  
Long Term Care ◽  
Functional Decline ◽  
Tube Feeding ◽  
Term Care ◽  
Pneumonia Severity ◽  
Frailty Assessment ◽  
Nasogastric Tube Feeding

Abstract Background Pneumonia is a major cause of morbidity and mortality in older adults. The role of frailty assessment in older adults with pneumonia is not well defined. Our purpose of the study was to investigate 30-day clinical course and functional outcomes of pneumonia in older adults with different levels of frailty. Methods A prospective cohort was conducted at a university hospital in Seoul, Korea with 176 patients who were 65 years or older and hospitalized with pneumonia. A 50-item deficit-accumulation frailty index (FI) (range: 0–1; robust < 0.15, pre-frail 0.15–0.24, mild-to-moderately frail 0.25–0.44, and severely frail ≥ 0.45) and the pneumonia severity CURB-65 score (range: 0–5) were measured. Primary outcome was death or functional decline, defined as worsening dependencies in 21 daily activities and physical tasks in 30 days. Secondary outcomes were intensive care unit admission, psychoactive drug use, nasogastric tube feeding, prolonged hospitalization (length of stay > 15 days), and discharge to a long-term care institution. Results The population had a median age 79 (interquartile range, 75–84) years, 68 (38.6 %) female, and 45 (25.5 %) robust, 36 (47.4 %) pre-frail, 37 (21.0 %) mild-to-moderately frail, and 58 (33.0 %) severely frail patients. After adjusting for age, sex, and CURB-65, the risk of primary outcome for increasing frailty categories was 46.7 %, 61.1 %, 83.8 %, and 86.2 %, respectively (p = 0.014). The risk was higher in patients with frailty (FI ≥ 0.25) than without (FI < 0.25) among those with CURB-65 0–2 points (75 % vs. 52 %; p = 0.022) and among those with CURB-65 3–5 points (93 % vs. 65 %; p = 0.007). In addition, patients with greater frailty were more likely to require nasogastric tube feeding (robust vs. severe frailty: 13.9 % vs. 60.3 %) and prolonged hospitalization (18.2 % vs. 50.9 %) and discharge to a long-term care institution (4.4 % vs. 59.3 %) (p < 0.05 for all). Rates of intensive care unit admission and psychoactive drug use were similar. Conclusions Older adults with frailty experience high rates of death or functional decline in 30 days of pneumonia hospitalization, regardless of the pneumonia severity. These results underscore the importance of frailty assessment in the acute care setting.

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