Multimorbidity and functional status in community-dwelling older adults

2014 ◽  
Vol 25 (7) ◽  
pp. 610-616 ◽  
Author(s):  
Stefano Marventano ◽  
Alba Ayala ◽  
Nerea Gonzalez ◽  
Carmen Rodríguez–Blázquez ◽  
Susana Garcia-Gutierrez ◽  
...  
2005 ◽  
Vol 8 (8) ◽  
pp. 1275-1285 ◽  
Author(s):  
Jodi Dunmeyer Stookey ◽  
Carl F Pieper ◽  
Harvey Jay Cohen

AbstractObjectiveThe fluid recommendation for adults aged 70+ years has been criticised on the basis of a low prevalence of dehydration in community-dwelling older adults. This study explores whether the low prevalence might reflect limitations of individual dehydration indices.DesignCross-sectional data on plasma sodium, blood urea nitrogen (BUN), creatinine, glucose and potassium were used to classify 1737 participants of the 1992 Established Populations for Epidemiologic Studies of the Elderly (EPESE) (70+ years) according to multiple dehydration indices. Associations between dehydration indices, health and functional status were evaluated.ResultsDepending on the indicator used, the prevalence of dehydration ranged from 0.5% for hypotonic hypovolaemia only (plasma tonicity <285 mOsm l−1 with orthostatic hypotension) to 60% with dehydration defined as either plasma sodium ≥145 mEq l−1, BUN/creatinine ratio ≥20, tonicity ≥295 mOsm l−1, or hypotonic hypovolaemia. Elevated tonicity and BUN/creatinine ratio were respectively associated with chronic disease and functional impairment.ConclusionsThe true prevalence of dehydration among community-dwelling adults may be low or high, depending on the indicator(s) used to define dehydration. Before we can pinpoint a generalisable prevalence of dehydration for community-dwelling seniors and draw conclusions about fluid recommendations, validation studies of dehydration indices and longitudinal studies of dehydration, health and functional status are needed.


2016 ◽  
Vol 24 (2) ◽  
pp. 214-222 ◽  
Author(s):  
Addie Middleton ◽  
George D. Fulk ◽  
Michael W. Beets ◽  
Troy M. Herter ◽  
Stacy L. Fritz

Daily ambulatory activity is associated with health and functional status in older adults; however, assessment requires multiple days of activity monitoring. The objective of this study was to determine the relative capabilities of self-selected walking speed (SSWS), maximal walking speed (MWS), and walking speed reserve (WSR) to provide insight into daily ambulatory activity (steps per day) in community-dwelling older adults. Sixty-seven older adults completed testing and activity monitoring (age 80.39 [6.73] years). SSWS (R2 = .51), MWS (R2 = .35), and WSR calculated as a ratio (R2 = .06) were significant predictors of daily ambulatory activity in unadjusted linear regression. Cutpoints for participants achieving < 8,000 steps/day were identified for SSWS (≤ 0.97 m/s, 44.2% sensitivity, 95.7% specificity, 10.28 +LR, 0.58 −LR) and MWS (≤ 1.39 m/s, 60.5% sensitivity, 78.3% specificity, 2.79 +LR, 0.50 −LR). SSWS may be a feasible proxy for assessing and monitoring daily ambulatory activity in older adults.


2005 ◽  
Vol 85 (7) ◽  
pp. 648-655 ◽  
Author(s):  
Anne Shumway-Cook ◽  
Marcia A Ciol ◽  
William Gruber ◽  
Cynthia Robinson

Abstract Background and Purpose. Hip fracture is a major medical problem among older adults, leading to impaired balance and gait and loss of functional independence. The purpose of this study was to determine the incidence of and risk factors for falls 6 months following hospital discharge for a fall-related hip fracture in older adults. Subjects. Ninety of 100 community-dwelling older adults (≥65 years of age) hospitalized for a fall-related hip fracture provided data for this study. Methods. An observational cohort study used interviews and medical records to obtain information on demographics, prefracture health, falls, and functional status. Self-report of falls and performance-based measures of balance and mobility were completed 6 months after discharge. Results. A total of 53.3% of patients (48/90) reported 1 or more falls in the 6 months after hospitalization. Older adults who fell following discharge had greater declines in independence in activities of daily living and lower performance on balance and mobility measures. Prefracture fall history and use of a gait device predicted postdischarge falls. Discussion and Conclusion. Falls following hip fracture can be predicted by premorbid functional status.


2021 ◽  
Author(s):  
Penney H. Deratnay

This secondary data analysis examined the extent to which fatigue mediates the relationship between insomnia and the physical, social, and psychological domains of functional status in community-dwelling older adults. Data were obtained from 209 older adults with insomnia. Regression analysis was used to test the proposed mediating role of fatigue. Findings identified insomnia of moderate severity in community-dwelling older adults. Insomnia was directly associated with social function and indirectly associated with physical and psychological function. Fatigue mediated the relationship between insomnia and all three domains of functional status. The findings highlight the importance of successfully managing insomnia and fatigue to promote functioning in older adults.


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