Design for independent living: activity demands and capabilities of older people

2010 ◽  
Vol 30 (7) ◽  
pp. 1239-1255 ◽  
Author(s):  
DAVID SEIDEL ◽  
KATHRYN RICHARDSON ◽  
NATHAN CRILLY ◽  
FIONA E. MATTHEWS ◽  
P. JOHN CLARKSON ◽  
...  
Keyword(s):  
Older People ◽  
Independent Living ◽  
Functional Limitations ◽  
Community Dwelling ◽  
The Body ◽  
Body Postures ◽  
Logistic Regression Models ◽  
Hand Functions ◽  
Design Changes

ABSTRACTThe ability to perform the instrumental activities of daily living (IADLs) is an important focus for the promotion of independent living in old age. If strategies to enable older people to remain in their own homes are to be developed, advances must be made in understanding the demands associated with IADLs. This paper reports on a study of how activity demands – the body postures, actions and hand functions involved in cooking, housework, laundering and shopping – relate to the capabilities of a sample of older people in Great Britain. Task data were analysed for 4,886 community-dwelling 55–93-year-olds who were enrolled in a follow-up survey to the 1996/97 Family Resources Survey. Logistic regression models were used to calculate adjusted odds ratios for associations between functional limitations and IADL difficulty. Attributable fraction estimates were also used to assess the population impact of the functional limitations. Comparable effect sizes were observed across activities for limitations in body postures (standing, reaching and bending/stooping), actions (lifting/lowering and holding/carrying) and hand functions. Most of the difficulties were attributable to limitations in body postures, primarily bending/stooping, whereas actions and hand functions accounted for much less difficulty. We present a matrix of the potential impact that design changes to alleviate each limitation would have on the ability to perform the activities studied. This can help to prioritise interventions aimed at supporting continued independent living.

scholarly journals The impact of lockdown during SARS-CoV-2 outbreak on behavioral and psychological symptoms of dementia

2021 ◽  
Vol 42 (3) ◽  
pp. 825-833
Author(s):  
Arianna Manini ◽  
Michela Brambilla ◽  
Laura Maggiore ◽  
Simone Pomati ◽  
Leonardo Pantoni
Keyword(s):  
Logistic Regression ◽  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Community Dwelling ◽  
Caregiver Distress ◽  
Neuropsychiatric Inventory ◽  
Logistic Regression Models ◽  
The Impact ◽  
Behavioral And Psychological Symptoms

Abstract Background During Covid-19 pandemic, the Italian government adopted restrictive limitations and declared a national lockdown on March 9, which lasted until May 4 and produced dramatic consequences on people’s lives. The aim of our study was to assess the impact of prolonged lockdown on behavioral and psychological symptoms of dementia (BPSD). Methods Between April 30 and June 8, 2020, we interviewed with a telephone-based questionnaire the caregivers of the community-dwelling patients with dementia who had their follow-up visit scheduled from March 9 to May 15 and canceled due to lockdown. Among the information collected, patients’ BPSDs were assessed by the Neuropsychiatric Inventory (NPI). Non-parametric tests to compare differences between NPI scores over time and logistic regression models to explore the impact of different factors on BPSD worsening were performed. Results A total of 109 visits were canceled and 94/109 caregivers completed the interview. Apathy, irritability, agitation and aggression, and depression were the most common neuropsychiatric symptoms experienced by patients both at baseline and during Covid-19 pandemic. Changes in total NPI and caregiver distress scores between baseline and during lockdown, although statistically significant, were overall modest. The logistic regression model failed to determine predictors of BPSD worsening during lockdown. Conclusion This is one of the first studies to investigate the presence of BPSD during SARS-CoV-2 outbreak and related nationwide lockdown, showing only slight, likely not clinically relevant, differences in BPSD burden, concerning mostly agitation and aggression, anxiety, apathy and indifference, and irritability.

scholarly journals Body Composition in Community-Dwelling Older Adults Before and After SARS-CoV-2 Infection: A Longitudinal Prospective Study in a Rural Village Struck by the Pandemic

2021 ◽  
Vol 12 ◽  
pp. 215013272110477
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera ◽  
Denisse A. Rumbea ◽  
Pedro Pérez ◽  
Bettsy Y. Recalde ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Body Composition ◽  
Regression Models ◽  
Community Dwelling ◽  
The Body ◽  
Study Results ◽  
The Impact ◽  
Community Dwelling Older Adults

Background: Information on the body composition of inhabitants of remote communities during the SARS-CoV-2 pandemic is limited. Using a longitudinal population-based study design, we assessed the association between SARS-CoV-2 infection and changes in body composition. Methods: Community-dwelling older adults living in a rural Ecuadorian village received body composition determinations before and 1 year after the pandemic as well as serological tests for detection of SARS-CoV-2 antibodies. The independent association between SARS-CoV-2 infection and abnormalities in body composition at follow-up was assessed by fitting linear mixed models for longitudinal data. Results: Of 327 enrolled individuals, 277 (85%) received baseline and follow-up body composition determinations, and 175 (63%) of them became SARS-CoV-2 seropositive. Overall, diet and physical activity deteriorated during the follow-up. Multivariate random-effects generalized least squares regression models that included the impact of time and seropositivity on follow-up body composition, showed that neither variable contributed to a worsening in body composition. Multivariate logistic regression models disclosed that the serological status at follow-up cannot be predicted by differences in body composition and other baseline covariates. Conclusions: Study results suggest no increased susceptibility to SARS-CoV-2 infection among older adults with abnormal body composition and no significant changes as a result of worse physical activity and dietary habits or seropositivity during the length of the study. Together with a previous study in the same population that showed decrease in hand-grip strength after SARS-CoV-2, results confirm that dynapenia (and not sarcopenia) is associated with SARS-CoV-2 infection in older adults.

scholarly journals Does the Meeting Centres Support Programme reduce unmet care needs of community-dwelling older people with dementia? A controlled, 6-month follow-up Polish study

2019 ◽  
Vol Volume 14 ◽  
pp. 113-122 ◽  
Author(s):  
Justyna Mazurek ◽  
Dorota Szcześniak ◽  
Katrzyna Urbańska ◽  
Rose-Marie Dröes ◽  
Maciej Karczewski ◽  
...  
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
Care Needs ◽  
Support Programme ◽  
People With Dementia ◽  
Polish Study ◽  
Community Dwelling Older People

scholarly journals Psychosocial resources related to survival among non-robust community-dwelling older people: an 18-year follow-up study

2020 ◽  
Vol 11 (3) ◽  
pp. 475-481
Author(s):  
Sirkku Lavonius ◽  
Marika Salminen ◽  
Tero Vahlberg ◽  
Raimo Isoaho ◽  
Sirkka-Liisa Kivelä ◽  
...  
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
Psychosocial Resources ◽  
Follow Up Study ◽  
Community Dwelling Older People

scholarly journals Fall-related efficacy is a useful and independent index to detect fall risk in Japanese community-dwelling older people: a 1-year longitudinal study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Naoto Kamide ◽  
Yoshitaka Shiba ◽  
Miki Sakamoto ◽  
Haruhiko Sato ◽  
Akie Kawamura
Keyword(s):  
Risk Factors ◽  
Older People ◽  
Physical Performance ◽  
Fall Risk ◽  
Community Dwelling ◽  
Confounding Factors ◽  
Potential Risk Factors ◽  
Community Dwelling Older People ◽  
Walking Time

Abstract Background Fall-related efficacy has been found to be associated with both falls and fall risk factors such as physical performance. The aim of the present study was to clarify whether fall-related efficacy is, independent of physical performance and other potential risk factors, associated with future falls in community-dwelling older people. Methods The study participants were 237 Japanese older people aged 65 years and over who were living independently in their community. Fall-related efficacy and physical performance were assessed at baseline using the short version of the Falls Efficacy Scale-International (short FES-I) and 5-m walking time, the Timed Up and Go Test, the 5 Times Sit to Stand Test, and grip strength. Physical performance was then again assessed at 1-year follow-up. The number of falls was obtained every 6 months for 1 year after the baseline survey. Instrumental activities of daily living (IADL), depression, fall history, current medications, medical history, and pain were also investigated as potential confounding factors that have possible associations with falls. The associations between the short FES-I, physical performance, and number of falls were analyzed using Poisson regression analysis adjusted for physical performance and potential confounding factors. Results The mean age of the participants (75.9% women) was 71.1 ± 4.6 years, and 92.8% could perform IADL independently. The total numbers of falls and fallers during the 1-year follow-up period were 70 and 42, respectively. On Poisson regression analysis adjusted for walking time and potential confounding factors, independent of physical performance, the short FES-I was found to be significantly associated with number of falls (relative risk = 1.09, p < 0.05). On the other hand, physical performance was not significantly associated with the number of falls. Conclusions The findings of the present study suggest that the short FES-I, independent of physical performance and other potential risk factors, is a useful index to detect fall risk in community-dwelling older people, and that fall-related efficacy is an important factor in terms of fall prevention.

scholarly journals Personality-Related Determinants of Subtle Cognitive Decline in Old Age: A Population-Based Study

2016 ◽  
Vol 6 (1) ◽  
pp. 120-132 ◽  
Author(s):  
Cristelle Rodriguez ◽  
Emiliano Albanese ◽  
Alan Pegna ◽  
Simona Toma ◽  
Marine Ackermann ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Protective Factor ◽  
Brain Aging ◽  
Population Based ◽  
Community Dwelling ◽  
Personality Factors ◽  
Healthy Controls ◽  
Logistic Regression Models ◽  
Healthy Elderly

Background/Aims: Recent studies of cases with mild cognitive impairment (MCI) suggested that besides Alzheimer disease (AD)-related biomarkers, some personality dimensions are associated with progression to AD. To date, there are no studies addressing the psychological determinants of subtle cognitive decline in healthy elderly controls. Methods: 488 community-dwelling healthy controls were assessed with a detailed neuropsychological battery at baseline and an 18-month follow-up. Personality factors and facets were investigated at baseline using the NEO-Personality Inventory-Revised (NEO-PI-R). Upon follow-up, there were 264 stable controls (sCON) and 224 deteriorating controls (dCON). Their personality data were compared to those of the 102 MCI cases using one-way analysis of variance and logistic regression models. Results: Significantly higher scores of Openness factor (as well as Aesthetics, Ideas and Values facets) were found in sCON than in both dCON and MCI cases. The three groups did not differ in the other NEO-PI-R factor and facet scores. Openess factor (and the same facets) was associated with cognitive preservation in healthy controls (OR: 0.72, 95% CI: 0.59, 0.87). Lower scores in the same factor and facets conferred higher risk to have MCI (OR: 0.61, 95% CI: 0.46, 0.79). Conclusion: Higher openness to new experiences and thoughts may be a protective factor against early cognitive decline in brain aging.

scholarly journals Out-of-Pocket Expenses Related to Aging in Place for Older People Experiencing Frailty: A Scoping Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 875-875
Author(s):  
Elaine Moody ◽  
Rebecca Ganann ◽  
Marilyn Macdonald ◽  
Lori Weeks ◽  
Liz Orr ◽  
...  
Keyword(s):  
Health Care ◽  
Older People ◽  
Scoping Review ◽  
Health Care Systems ◽  
Aging In Place ◽  
Community Dwelling ◽  
The Body ◽  
Cross Sectional ◽  
Functional Changes ◽  
Out Of Pocket Expenses

Abstract Supporting older people to live in the community as they experience health and functional changes has become a priority for policy makers, health system leaders and community members, including many older people themselves. Aging-in-place has been promoted as a way to support the sustainability of health care systems and limit health care and societal costs. However, the expenses borne by individuals and caregivers to support older people to age-in-place when experiencing changes in health and functional ability are often not considered in health care literature and policy. We conducted a scoping review using Joanna Briggs Institute methodology to explore the out-of-pocket expenses for people with frailty living in the community. We included research and policy papers on community-dwelling people over 60 and experiencing frailty. Findings about financial out-of-pocket expenses were extracted. A total of 9669 sources were screened by two reviewers and 42 sources were included. The sources were from 17 countries, most from the US, and had various designs, including 14 qualitative designs, 15 cross sectional, 11 other quantitative and 2 policy discussions. The sources most often reported expenses related to home care (16), medication (12), housekeeping (10), transportation (8), and medical equipment (6). Gaps in the body of literature include lack of a consistent measure of out-of-pocket expenses and cost considerations of co-housing programs. The context—including policy, community and personal—was particularly important to the experience of out-of-pocket expenses for people with frailty, and further research is needed to expand on this knowledge.

scholarly journals 306Association between polypharmacy and mortality in the community-dwelling older population: a data linkage study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Johan Van der Heyden ◽  
Finaba Berete ◽  
Brecht Devleesschauwer ◽  
Karin De Ridder ◽  
Olivier Bruyère ◽  
...  
Keyword(s):  
Older People ◽  
Functional Limitations ◽  
Critical Evaluation ◽  
Community Dwelling ◽  
Health Care Use ◽  
Mortality Data ◽  
Health Interview Survey ◽  
Health Interview ◽  
Interview Survey ◽  
The Impact

Abstract Background Literature findings on the association between polypharmacy and mortality in older people are not consistent. Appropriate tools, making use of linkages, are helpful to investigate this further. Methods Data of participants of the Belgian Health Interview Survey 2013 aged ≥ 65 years (n = 1950) were linked with billing data and 5 year’s mortality follow-up information. Polypharmacy was defined as concomitant use of ≥ 5 medicines in the past 24 hours or ≥ 5 recent prescriptions of reimbursed medicines. The impact of polypharmacy on mortality was assessed through mortality rate ratios (MRR) from a Poisson regression model adjusting for gender, age, multimorbidity, functional limitations and health care use, and including interactions. Results The prevalence of polypharmacy was 38,3%. Age and disability status were effect modifiers in the association between polypharmacy and mortality. Whereas polypharmacy was significantly associated with mortality among people aged 65-79 years (MRR 2.52; 95% CI 1.67-3.80), this was not so for the 80 + (MRR 1.46; 95% CI 0.93-2.29). Polypharmacy was a mortality predictor among people with no/moderate functional limitations (MRR 2,29; 95% CI 1.61-3.25), but not for those with severe functional limitations (MRR 1,22; 95% CI 0.67-2.34). Conclusions By linking health interview survey, billing and mortality data further insights can be gained on the association between polypharmacy and mortality. Key messages A critical evaluation of polypharmacy in older people below 80 years and in people without severe functional limitations may reduce mortality in these population groups.

scholarly journals Reduced strength, poor balance and concern about falls mediate the relationship between knee pain and fall risk in older people

2019 ◽  
Author(s):  
Cameron J Hicks ◽  
Pazit Levinger ◽  
Jasmine C Menant ◽  
Stephen R Lord ◽  
Perminder S Sachdev ◽  
...  
Keyword(s):  
Older People ◽  
Knee Pain ◽  
Fall Risk ◽  
Postural Sway ◽  
Knee Extension ◽  
Community Dwelling ◽  
Pain Group ◽  
Eyes Closed ◽  
The Relationship

Abstract Aims Pain is an independent risk factor for falling. One in two older community-dwelling people with musculoskeletal pain fall each year. This study examined physical, psychological and medical factors as potential mediators to explain the relationship between knee pain and falls.Methods Three hundred and thirty-three community-dwelling people aged 70+ years (52% women) participated in this cohort study with a 1-year follow-up for falls. Participants completed questionnaires (medical history, general health and concern about falls) and underwent physical performance tests. Participants were classified into ‘pain’ and ‘no pain’ groups based on self-reported knee pain. Poisson Regression models were computed to determine the Relative Risk (RR) of having multiple falls and potential mediators for increased fall risk.Results One hundred and eighteen (35.5%) participants were categorised as having knee pain. This group took more medications and had more medical conditions (P <0.01) compared to the no pain group. The pain group had poorer balance, physical function and strength and reported increased concern about falls. Sixty one participants (19.5%) reported ≥ 2 falls, with the pain group twice as likely to experience multiple falls over the 12 month follow up (RR = 2.0, 95% confidence interval (CI) = 1.27 – 3.13). Concern about falls, knee extension torque and postural sway with eyes closed were identified as significant and independent mediators of fall risk, and when combined explained 23% of the relationship between knee pain and falls.Conclusion This study has identified several medical, medication, psychological, sensorimotor, balance and mobility factors to be associated with knee pain, and found the presence of knee pain doubles the risk of multiple falls in older community living people. Alleviating knee pain, as well as addressing associated risk factors may assist in preventing falls in older people with knee pain.

scholarly journals 400Overactive bladder with/without urinary incontinence and falls in the community-dwelling elderly

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Kenji Omae ◽  
Noriaki Kurita ◽  
Taro Takeshima ◽  
Toru Naganuma ◽  
Sei Takahashi ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Fall Risk ◽  
Community Dwelling ◽  
Important Predictor ◽  
Multivariable Logistic Regression Analysis ◽  
Logistic Regression Models ◽  
Falls In Older Adults ◽  
Tree Approach

Abstract Background Little is known about the fall risk of older adults with overactive bladder (OAB), especially in the absence of urgency incontinence (UI). Methods This prospective cohort study included 630 community-dwelling, independent older adults 75 years old or older who attended a health check-up in 2017 with a 1-year follow-up. The associations of OAB with and without UI (OAB-wet and OAB-dry) with a fall history, and future fall risk compared to no OAB were assessed using logistic regression models. The contribution of OAB as a predictor of falls was examined using a random forest and decision tree approach. Results Of the 577 analyzed participants (median age 79 years), 273 were men. The prevalence of OAB-dry and OAB-wet at baseline was 15% and 14%, respectively. Multivariable logistic regression analysis revealed that both OAB-dry and OAB-wet were associated with a higher likelihood of prior falls (adjusted ORs vs no OAB 2.03 and 2.21, respectively; 95% CI 1.23–3.37 and 1.29–3.78, respectively). Among the 363 participants without a fall history, the adjusted ORs (95% CIs) of OAB-dry and OAB-wet for the occurrence of falls during the 1-year follow-up were 2.74 (1.19–6.29) and 1.35 (0.47–3.87), respectively. The tree-based approach used for all participants showed that OAB was an important predictor of falls in adults without a fall history. Conclusions OAB, even in the absence of UI, is an important predictor of falls in older adults with a low absolute fall risk. Key messages Our findings suggest that OAB is a risk factor for falls in the community-dwelling elderly irrespective of the presence of UI.

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