SOCIOECONOMIC INEQUALITIES IN SELF-REPORTED HEALTH AND PHYSICAL FUNCTIONING IN ARGENTINA: FINDINGS FROM THE NATIONAL SURVEY ON QUALITY OF LIFE OF OLDER ADULTS 2012 (ENCaViAM)

2016 ◽  
Vol 49 (5) ◽  
pp. 597-610 ◽  
Author(s):  
Santiago Rodríguez López ◽  
Sonia E. Colantonio ◽  
Dora E. Celton

SummaryThis study aimed to evaluate educational and income inequalities in self-reported health (SRH), and physical functioning (limitations in Activities of Daily Living (ADL)/Instrumental Activities of Daily Living (IADL)), among 60-year-old and older adults in Argentina. Using cross-sectional data from the Argentinian National Survey on Quality of Life of Older Adults 2012 (Encuesta Nacional sobre Calidad de Vida de Adultos Mayores, ENCaViAM), gender-specific socioeconomic inequalities in SRH and ADL and IADL limitations were studied in relation to educational level and householdper capitaincome. The Relative Index of Inequality (RII) – an index of the relative size of socioeconomic inequalities in health – was used. Socioeconomic inequalities in the studied health indicators were found – except for limitations in ADL among women – favouring socially advantaged groups. The results remained largely significant after full adjustment, suggesting that educational and income inequalities, mainly in SRH and IADL, were robust and somehow independent of age, marital status, physical activity, the use of several medications, depression and the occurrence of falls. The findings add to the existing knowledge on the relative size of the socioeconomic inequalities in subjective health indicators among Argentinian older adults, which are to the detriment of lower socioeconomic groups. The results could be used to inform planning interventions aimed at decreasing socioeconomic inequalities in health, to the benefit of socially disadvantaged adults.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 559-559
Author(s):  
Walter Boot

Abstract There has been a great deal of research on technology to support older adults in their performance of Activities and Instrumental Activities of Daily Living. There has been substantially less research, however, on exploring technology solutions that support hobbies and leisure. This is unfortunate, as quality of life and well-being are determined by more than just one’s ability to manage everyday tasks. An overview will be presented of research the Center for Research and Education on Aging and Technology Enhancement (CREATE) has conducted over two decades with the goals of understanding and supporting older adults’ performance of technology-based leisure activities. Many of these studies have involved videogaming, where there exists a substantial age-related digital divide. CREATE has evaluated older adults’ attitudes and game experiences through survey and research studies and has even recorded longitudinal gameplay. How these findings can be applied to support technology-based leisure activities will be expanded upon. Part of a symposium sponsored by Technology and Aging Interest Group.


2020 ◽  
pp. 073346482094432
Author(s):  
Catherine A. Clair ◽  
Maureen Henry ◽  
Lee A. Jennings ◽  
David B. Reuben ◽  
Shana F. Sandberg ◽  
...  

Purpose: The purpose of the study is to capture goals expressed by older adults with functional limitations and their caregivers. Methods: Through focus groups and interviews, 76 older adults with ≥1 activity of daily living limitation and 28 family/friend caregivers were asked about what mattered most to them and their goals for care. Transcripts were coded using an existing taxonomy. Goals that did not fit the taxonomy were assigned new codes. Results: We identified more than 50 goals in eight domains. Domains included (a) Medical Care; (b) Quality of Life: Physical; (c) Quality of Life: Social and Emotional; (d) Access to Services and Supports; (e) Caregiver Needs and Concerns; (f) End of Life; (g) Independence; and (h) Acceptable Housing. Conclusion: While there is overlap between identified goals and the existing taxonomy, new goals emerged. The goal domains identified could serve as a framework to improve and measure the quality of goal-oriented care for older adults with complex needs.


2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S746-S747 ◽  
Author(s):  
Kenneth E Schmader ◽  
Myron J Levin ◽  
Katrijn Grupping ◽  
Sean Matthews ◽  
David Butuk ◽  
...  

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S752-S752
Author(s):  
Debra J Sheets ◽  
Stuart W MacDonald ◽  
Andre Smith ◽  
Mary Kennedy

Abstract Informal caregivers provide 80% of the care needed to support community-dwelling older adults with dementia. Over time caregivers often face adverse effects on their health, quality of life and well-being; particularly those caring for someone with dementia. This study examines the impact of participation in the Voices in Motion (ViM) choir on caregiver burden, mood and quality of life. A measurement burst approach was used to investigate intraindividual variability on key psychosocial and health indicators. Results indicate that choir participation significantly improves caregiver well-being (e.g. mood, burden) and quality of life. Findings suggest that choirs offer significant caregiver support and respite. The discussion focuses the public policy and on the potential economic implications which suggests a shift is needed in the services available to older adults with dementia and their caregivers.


2009 ◽  
Vol 15 (2) ◽  
pp. 117 ◽  
Author(s):  
A. Foley ◽  
S. Hillier ◽  
R. Barnard

Pre and post testing were conducted on community-dwelling older adults referred to a geriatric day rehabilitation centre (DRC). Consecutive DRC clients were screened for inclusion over a 16-month period and were eligible if: aged 60+ years; cognitively intact; and reason for referral involved spinal or lower limb musculoskeletal impairment, disability or surgery, and/or reduced functional mobility or falls. Clients were excluded if they had a neurological disorder, or did not complete the program. Outcome measures included: lower limb strength; balance; mobility; self-reported pain; activities of daily living; and quality of life. Data were summarised using descriptive statistics and analysed using paired t-tests. Of the 137 participants recruited, 110 were female and the mean age was 79.5 ± 7.3 years. In total, 106 participants completed the DRC program and were assessed at baseline and re-assessed at discharge. The mean length of stay was 12.4 ± 2.9 weeks, with 21.4 ± 5.4 attendances. From baseline to discharge, statistically significant differences were found for all objective measures of physical functioning, balance, and for all lower limb strength tests (P < 0.0001). Glasgow Pain Questionnaire scores demonstrated statistically significant improvements in all five domains of the scale (P < 0.0001). The Barthel Index and Multi-dimensional Functional Assessment Questionnaire both showed a statistically significant improvement in the level of independence in activities of daily living (ADL) (P < 0.05). The Assessment of Quality of Life Questionnaire showed a statistically significant improvement (P = 0.027). The Exercise Benefits/Barriers Scale also showed a statistically significant improvement over DRC attendance (P = 0.005). The Falls Efficacy Scale showed a positive change, but the improvement was not statistically significant (P = 0.80). The study’s results indicate that community-dwelling older adults with physical disabilities and multiple comorbidities who attended the interdisciplinary geriatric DRC, significantly improved their lower limb strength, balance and physical function, and also showed significant decreases in self-reported pain, and improvements in independence in ADL and quality of life. Given the limitations of the current study, further research, in the form of high quality studies with larger sample sizes that involve direct comparisons with other forms of care or against a control group, is needed to determine whether day rehabilitation centre programs provide the optimum mode of rehabilitation for this population in the most cost effective manner.


2020 ◽  
Vol 32 (7) ◽  
pp. 849-861
Author(s):  
Darina V. Petrovsky ◽  
Karen B. Hirschman ◽  
Miranda Varrasse McPhillips ◽  
Justine S. Sefcik ◽  
Alexandra L. Hanlon ◽  
...  

ABSTRACTObjectives:Daytime sleepiness is associated with multiple negative outcomes in older adults receiving long-term services and supports (LTSS) including reduced cognitive performance, need for greater assistance with activities of daily living and decreased social engagement. The purpose of this study was to identify predictors of change in subjective daytime sleepiness among older adults during their first 2 years of receiving LTSS.Design and Setting:Secondary analysis of data from a prospective longitudinal study of older adults who received LTSS in their homes, assisted living communities or nursing homes interviewed at baseline and every 3 months for 24 months.Participants:470 older adults (60 years and older) newly enrolled in LTSS (mean = 81, SD = 8.7; range 60–98; 71% women).Measurements:Subjective daytime sleepiness was assessed every 3 months through 2 years using the Epworth Sleepiness Scale. Multiple validated measures were used to capture health-related quality of life characteristics of enrollees and their environment, including symptom status (Symptom Bother Scale), cognition (Mini Mental Status Exam), physical function (Basic Activities of Daily Living), physical and mental general health, quality of life (Dementia Quality of Life, D-QoL), depressive symptoms (Geriatric Depression Scale) and social support (Medical Outcomes Survey-Social Support).Results:Longitudinal mixed effects modeling was used to examine the relationship between independent variables and continuous measure of daytime sleepiness. Increased feelings of belonging, subscale of the D-QoL (effect size = −0.006, 95% CI: −0.013 to −0.0001, p = 0.045) and higher number of depressive symptoms (effect size = −0.002, 95% CI: −0.004 to −0.001, p = 0.001) at baseline were associated with slower rates of increase in daytime sleepiness over time.Conclusions:Comprehensive baseline and longitudinal screening for changes in daytime sleepiness along with depression and perceived quality of life should be used to inform interventions aimed at reducing daytime sleepiness among older adults receiving LTSS.


1996 ◽  
Vol 4 (2) ◽  
pp. 105-118 ◽  
Author(s):  
Linda C. Campanelli

Functional mobility is generally considered a major contributor to maintaining quality of life at any age. There are several overviews of physiological aging relative to physical functioning and/or mobility in the recent literature. This paper reiterates the need for continued exercise (at all levels) throughout one’s lifetime, specifically to enhance quality of life and functional independence. Implications for professionals and program development are included. Tailored exercises for both ambulatory and nonambulatory older adults to maintain flexibility, gait, and bed mobility are described.


2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 118-118
Author(s):  
Darryl Alan Outlaw ◽  
Chen Dai ◽  
Mustafa Al-Obaidi ◽  
Smith Giri ◽  
Smita Bhatia ◽  
...  

118 Background: The majority of new cancer diagnoses occur in adults greater than 65 years of age. Polypharmacy is a common and potentially devastating problem amongst older adults; however, its prevalence and impact in older adults with gastrointestinal (GI) malignancy is poorly understood. Our objective was to examine the prevalence of polypharmacy and its association with functional status impairments, frailty, and health-related quality of life (HRQoL) in older adults with GI malignancy. Methods: The Cancer and Aging Resilience Evaluation (CARE) registry at the University of Alabama at Birmingham (UAB) is an ongoing prospective cohort study that uses a brief geriatric assessment (CARE survey) in older adults with cancer. We evaluated older adults diagnosed with GI malignancy prior to starting cancer therapy. Our primary outcomes of interest were functional status impairments, including dependence in activities of daily living (ADL) and instrumental activities of daily living (IADL), frailty (as defined by a frailty index derived using the principles of deficit accumulation), and HRQoL (assessed via PROMIS 10 global that includes physical and mental scores). Patients were dichotomized into those taking ≥9 vs. < 9 medications. Multivariable analyses examined associations between polypharmacy and the above-listed outcomes, adjusted for age, sex, race, cancer type, cancer stage, and comorbidities. Results: Overall, 357 patients met eligibility criteria; mean age: 70.1 years; primary diagnoses: colorectal (33.6%), pancreatic (24.6%), hepatobiliary (16.2%), gastroesophageal (10.9%), other (14.6%). Patients reported taking a mean of 6.2 medications: 27.7% with 0-3 medications, 48.2% with 4-8 medications, and 24.1% with ≥ 9 medications. Patients taking ≥ 9 medications were more likely to report limitations in ADL (adjusted odds ratio [aOR] 3.29, 95% CI 1.72-6.29) and IADL (aOR 2.86, 95% CI 1.59-5.14). Polypharmacy was also associated with frailty (aOR 3.06, 95% CI 1.73-5.41) and lower physical (aOR 2.82, 95% CI 1.70-4.69) and mental (aOR 1.73, 95% CI 1.03-2.91) HRQoL. Conclusions: Independent of comorbid conditions, polypharmacy was associated with functional status limitations, frailty, and reduced HRQoL in older adults with GI malignancy. Further study of specific medications and interactions is warranted in order to reduce the negative consequences of polypharmacy in this growing and vulnerable population.


2020 ◽  
Author(s):  
Melissa Lunsman O’Connor

Mobility can be defined as the ability to move effectively and purposefully though the environment in order to accomplish goals. Mobility can be conceptualized and measured in four broad ways. First, the speed, success, and quality of specific movements can be measured, such as gait and balance. Second, one can assess a person’s ability to complete activities of daily living (ADLs) and instrumental activities of daily living (IADLs) that involve movement. Third, the occurrence of adverse events, such as falls and motor vehicle crashes, can be measured. Finally, the range of a person’s movement inside and outside the home can be assessed. Regardless of how it is conceptualized, mobility is one of the most important determinants of quality of life and independence in adulthood. Unfortunately, the prevalence of mobility limitations increases with age. This book chapter will provide a comprehensive overview of mobility among older adults.


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