scholarly journals Survival, disabilities in activities of daily living, and physical and cognitive functioning among the oldest-old in China: a cohort study

The Lancet ◽  
2017 ◽  
Vol 389 (10079) ◽  
pp. 1619-1629 ◽  
Author(s):  
Yi Zeng ◽  
Qiushi Feng ◽  
Therese Hesketh ◽  
Kaare Christensen ◽  
James W Vaupel
Keyword(s):  
Cohort Study ◽  
Activities Of Daily Living ◽  
Cognitive Functioning ◽  
Daily Living ◽  
Oldest Old

scholarly journals Impairment in activities of daily living and readmission in older patients with heart failure: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044416
Author(s):  
Tan Van Nguyen ◽  
Huyen Thanh Dang ◽  
Mason Jenner Burns ◽  
Hiep HH Dao ◽  
Tu Ngoc Nguyen
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Tertiary Hospital ◽  
Logistic Regression Models ◽  
Hospitalised Patients ◽  
Patients With Heart Failure ◽  
The Impact

ObjectivesThis study aims to investigate the prevalence of impairment of activities of daily living (ADLs) in older patients with heart failure (HF), and to examine the impact of ADL impairment on readmission after discharge.Design and settingsA prospective cohort study was conducted in patients aged ≥65 years with HF admitted to a tertiary hospital in Vietnam from August 2016 to June 2017. Difficulties with six ADLs were assessed by a questionnaire. Participants were classified into two categories (with and without ADL impairment). The associations of ADL impairment with 3-month readmission were examined using logistic regression models.ResultsThere were 180 participants (mean age 80.6±8.2, 50% female) and 26.1% were classified as having ADL impairment. The most common impaired activity was bathing (21.1%), followed by transferring (20.0%), toileting (12.2%), dressing (8.9%), eating (3.3%), and continence (2.8%). During 3-month follow-up, 32.8% of the participants were readmitted to hospitals (55.3% in participants with ADL impairment, 24.8% in those without ADL impairment, p<0.001). ADL impairment significantly increased the risk of 3-month readmission (adjusted OR 2.75, 95% CI 1.25 to 6.05, p=0.01).ConclusionsIn summary, ADL impairment was common in older hospitalised patients with HF and was associated with increased readmission. These findings suggest further studies on ADL assessment and intervention during transition care for older patients with HF after discharge to prevent readmission.

A Longitudinal Study of Cognitive and Instrumental Activities of Daily Living Disablement Among the Oldest Mexican Americans

2021 ◽  
pp. 089826432110375
Author(s):  
Jiwon Kim ◽  
Jacqueline L. Angel ◽  
Sunshine M. Rote
Keyword(s):  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Mexican Americans ◽  
Daily Living ◽  
Oldest Old ◽  
Epidemiologic Study ◽  
Mobility Limitations ◽  
Limited Mobility ◽  
Community Activities ◽  
Instrumental Activities

Objectives Mexican Americans live longer on average than other ethnic groups, but often with protracted cognitive and physical disability. Little is known, however, about the role of cognitive decline for transitions in instrumental activities of daily living (IADL) disability and tertiary outcomes of the IADL disablement for the oldest old (after 80 years old). Methods We employ the Hispanic Established Populations for the Epidemiologic Study of the Elderly (2010–2011, 2012–2013, and 2016, N = 1,078) to investigate the longitudinal patterns of IADL decline using latent transition analysis. Results Three IADL groups were identified: independent (developing mobility limitations), emerging dependence (limited mobility and community activities), and dependent (limited mobility and household and community activities). Declines in cognitive function were a consistent predictor of greater IADL disablement, and loneliness was a particularly salient distal outcome for emerging dependence. Discussion These results highlight the social consequences of cognitive decline and dependency as well as underscore important areas of intervention at each stage of the disablement process.

scholarly journals Improved outcome in hip fracture patients in the aging population following co-managed care compared to conventional surgical treatment: a retrospective, dual-center cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Carl Neuerburg ◽  
Stefan Förch ◽  
Johannes Gleich ◽  
Wolfgang Böcker ◽  
Markus Gosch ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Trauma Care ◽  
Daily Living ◽  
Aging Population ◽  
Readmission Rates ◽  
Term Outcome ◽  
Long Term Outcome

Abstract Background Hip fracture patients in the aging population frequently present with various comorbidities, whilst preservation of independency and activities of daily living can be challenging. Thus, an interdisciplinary orthogeriatric treatment of these patients has recognized a growing acceptance in the last years. As there is still limited data on the impact of this approach, the present study aimed to evaluate the long-term outcome in elderly hip fracture patients, by comparing the treatment of a hospital with integrated orthogeriatric care (OGC) with a conventional trauma care (CTC). Methods We conducted a retrospective, two-center, cohort study. In two maximum care hospitals all patients presenting with a hip fracture at the age of ≥ 70 years were consecutively assigned within a 1 year period and underwent follow-up examination 12 months after surgery. Patients treated in hospital site A were treated with an interdisciplinary orthogeriatric approach (co-managed care), patients treated in hospital B underwent conventional trauma care. Main outcome parameters were 1 year mortality, readmission rate, requirement of care (RC) and personal activities of daily living (ADL). Results A total of 436 patients were included (219 with OGC / 217 with CTC). The mean age was 83.55 (66–99) years for OGC and 83.50 (70–103) years for CTC (76.7 and 75.6% of the patients respectively were female). One year mortality rates were 22.8% (OGC) and 28.1% (CTC; p = 0.029), readmission rates were 25.7% for OGC compared to 39.7% for CTC (p = 0.014). Inconsistent data were found for activities of daily living. After 1 year, 7.8% (OGC) and 13.8% (CTC) of the patients were lost to follow-up. Conclusions Interdisciplinary orthogeriatric management revealed encouraging impact on the long-term outcome of hip fracture patients in the aging population. The observed reduction of mortality, requirements of care and readmission rates to hospital clearly support the health-economic impact of an interdisciplinary orthogeriatric care on specialized wards. Trial registration The study was approved and registered by the bavarian medical council (BLAEK: 7/11192) and the local ethics committee of munich university (Reg. No. 234–16) and was conducted as a two-center, cohort study at a hospital with integrated orthogeriatric care and a hospital with conventional trauma care.

Predictors of difficulty in carrying out basic activities of daily living among the old-old: A 2-year community-based cohort study

2015 ◽  
Vol 16 (2) ◽  
pp. 214-222 ◽  
Author(s):  
Ryota Sakamoto ◽  
Kiyohito Okumiya ◽  
Masayuki Ishine ◽  
Taizo Wada ◽  
Michiko Fujisawa ◽  
...  
Keyword(s):  
Cohort Study ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Community Based

scholarly journals Depressive symptoms, emotional support and activities of daily living disability onset: 15-year follow-up of the Bambuí (Brazil) Cohort Study of Aging

2018 ◽  
Vol 34 (7) ◽  
Author(s):  
Juliana Lustosa Torres ◽  
Erico Castro-Costa ◽  
Juliana Vaz de Melo Mambrini ◽  
Sérgio William Viana Peixoto ◽  
Breno Satler de Oliveira Diniz ◽  
...  
Keyword(s):  
Cohort Study ◽  
Social Network ◽  
Depressive Symptoms ◽  
Activities Of Daily Living ◽  
Psychosocial Factors ◽  
Emotional Support ◽  
Daily Living ◽  
Wide Range

Psychosocial factors appear to be associated with increased risk of disability in later life. However, there is a lack of evidence based on long-term longitudinal data from Western low-middle income countries. We investigated whether psychosocial factors at baseline predict new-onset disability in long term in a population-based cohort of older Brazilians adults. We used 15-year follow-up data from 1,014 participants aged 60 years and older of the Bambuí (Brazil) Cohort Study of Aging. Limitations on activities of daily living (ADL) were measured annually, comprising 9,252 measures. Psychosocial factors included depressive symptoms, social support and social network. Potential covariates included sociodemographic characteristics, lifestyle, cognitive function and a physical health score based on 10 self-reported and objectively measured medical conditions. Statistical analysis was based on competitive-risk framework, having death as the competing risk event. Baseline depressive symptoms and emotional support from the closest person were both associated with future ADL disability, independently of potential covariates wide range. The findings showed a clear graded association, in that the risk gradually increased from low emotional support alone (sub-hazard ratio - SHR = 1.11; 95%CI: 1.01; 1.45) to depressive symptoms alone (SHR = 1.52; 95%CI: 1.13; 2.01) and then to both factors combined (SHR = 1.61; 95%CI: 1.18; 2.18). Marital status and social network size were not associated with incident disability. In a population of older Brazilian adults, lower emotional support and depressive symptoms have independent predictive value for subsequent disability in very long term.

scholarly journals Age, Period, and Cohort Effects on Activities of Daily Living, Physical Performance, and Cognitive Functioning Impairment Among the Oldest-Old in China

2019 ◽  
Vol 75 (6) ◽  
pp. 1214-1221 ◽  
Author(s):  
Pei-Dong Zhang ◽  
Yue-Bin Lv ◽  
Zhi-Hao Li ◽  
Zhao-Xue Yin ◽  
Fu-Rong Li ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Activities Of Daily Living ◽  
Physical Performance ◽  
Functional Impairment ◽  
Daily Living ◽  
Oldest Old ◽  
Cohort Effects ◽  
Birth Cohorts ◽  
Function Impairment

Abstract Background The aim of this study was to examine the trends in impairment regarding activities of daily living (ADL), physical performance, and cognitive function among the oldest-old (those aged 80 and older) in China between 1998 and 2014. Methods We used data on 34,297 oldest-old individuals from the seven waves of the Chinese Longitudinal Healthy Longevity Study. We estimated age, period, and cohort effects on the prevalence of self-reported ADL impairment, tested physical performance and cognitive function impairment using the age–period–cohort model. Results Regarding age, the prevalence of ADL, physical performance, and cognitive function impairment were highest in the centenarians, but they did not increase with age in this population. Among the literate subgroup, the prevalence of cognitive impairment increased more rapidly with age than that in the illiterate subgroup. Regarding period, the prevalence of self-reported and tested physical impairment slowly increased between 1998 and 2014, but cognitive impairment remained stable. Regarding cohort, ADL impairment continuously decreased. However, physical and cognitive impairment remained stable after a brief decline in the early birth cohorts. Conclusions The results suggest that the age effect is still the most obvious effect regarding several types of functional impairment. The likelihood of a younger person experiencing functional impairment may not change significantly, but ADL is likely to be amenable to improvement resulting from improved medical and social care. Therefore, increased care for the oldest-old may considerably improve their quality of life, particularly regarding their basic ADL.

An 18-month prospective cohort study of functional outcome of delirium in elderly patients: activities of daily living

2006 ◽  
Vol 18 (4) ◽  
pp. 681-700 ◽  
Author(s):  
Stephen Vida ◽  
Guillaume Galbaud du Fort ◽  
Ritsuko Kakuma ◽  
Louise Arsenault ◽  
Robert W. Platt ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cohort Study ◽  
Elderly Patients ◽  
Activities Of Daily Living ◽  
Functional Outcome ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Daily Living ◽  
Medical Problems

Objectives: To examine delirium, chronic medical problems and sociodemographic factors as predictors of activities of daily living (ADL), basic ADL (BADL) and instrumental ADL (IADL).Methods: A prospective cohort study of four groups of elderly patients examined in the emergency department (ED): those with delirium, dementia, neither, and both. All were aged 66 years or older and living at home. Delirium was assessed with the Confusion Assessment Method and dementia with the Informant Questionnaire on Cognitive Decline in the Elderly. Demographic variables and chronic medical problems were ascertained with questionnaires. Outcome was ADL at 6, 12 and 18 months, measured with the ADL subscale of the Older Americans Resources and Services instrument.Results: Univariate analyses suggested significantly poorer ADL, particularly IADL, at 18 months in the delirium versus the non-delirium group, in the absence of dementia only. Statistically significant independent predictors of poorer ADL at 18 months in the non-dementia groups were poorer initial ADL, stroke, Parkinson's disease, hypertension and female sex. Independent predictors of poorer BADL at 18 months in the non-dementia groups were poorer initial BADL, Parkinson's disease, stroke, cancer, colds/sinusitis/laryngitis, female sex and hypertension. Independent predictors of poorer IADL at 18 months in the non-dementia groups were poorer initial IADL, stroke, never-married status, colds/sinusitis/laryngitis, arthritis and hypertension, with Parkinson's disease showing a non-significant but numerically large regression coefficient.Conclusion: Rather than finding delirium to be a predictor of poorer functional outcome among survivors, we found an interaction between delirium and dementia and several plausible confounders, primarily chronic medical problems, although we cannot rule out the effect of misclassification or survivor bias.

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