Predisposing and Facilitating Factors of Severe Psychological Distress among Frail Elderly Adults

ABSTRACTA sample of frail older adults (65 years and over) living at home or institutionalized (n = 664) with a significant functional limitation was used to document predisposing and facilitating factors of severe psychological distress among frail elderly adults. Our results indicated that 48.2 per cent of the older adults living at home presented severe psychological distress symptoms, compared to 34.3 per cent of elderly adults living in institutions. The probability of reporting a severe level of psychological distress was associated with the respondents' social support, cognitive and functional status. When the respondents' cognitive and functional status were controlled, no evidence of a significant association was found between the respondents' age, gender, marital status, education or income and the level of their psychological distress symptoms. Our results showed that 77.9 per cent of the respondents with severe psychological distress symptoms were still severely distressed 12 months after their first interview. Findings suggest that severe psychological distress represents an important challenge for practitioners in gerontology and geriatrics. It is suggested that other studies focusing on the consequences of psychological distress on older adults' quality of life, functional decline, institutionalization and mortality may help document the gravity of this symptomatology in the elderly population.

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THE INFLUENCE OF SOCIAL ISOLATION AND NEIGHBORHOOD DANGER ON OLDER ADULTS’ FUNCTIONAL STATUS

Innovation in Aging ◽

10.1093/geroni/igz038.1947 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S529-S530

Author(s):

Ilana J Engel ◽

Tamara A Baker

Keyword(s):

Older Adults ◽

Health Outcomes ◽

Functional Status ◽

Social Isolation ◽

Social Life ◽

Functional Decline ◽

Total Sample ◽

As Stress ◽

Perceived Social Isolation ◽

The Relationship

Abstract Social isolation is often associated with smaller social networks, bereavement, and chronic health problems. In addition, underserved neighborhoods, without the resources and social support of other areas, may further promote social isolation among older adults. This study utilized data from the 2nd wave of the nationally representative National Social Life, Health, and Aging Project (NSHAP) to examine if perceived neighborhood danger mediates the relationship between social isolation and functional impairment. We hypothesized that those who are less socially connected and feel less safe in their communities may experience worse health outcomes. Data for the total sample (N=1,804; 62-91 years of age) showed that partial mediation was supported, (F 2, 1801 = 22.91, p<0.01). Similar statistics were found by gender (men, F 2, 985 = 8.20, p<0.01; women, F 2, 813 = 14.79, p<0.01). This relationship, however, showed a stronger association among women (β = -.39, p<.01) than men (β = -.26, p<.05). Findings indicate that the relationship between perceived social isolation and impaired functional status may be partially explained by perceived neighborhood danger. These findings suggest that older adults who perceive their neighborhoods as dangerous, may be more socially isolated, and at risk for functional decline. These results support the Reserve Capacity Model, which posits that social resources are of increased importance for socioeconomically disadvantaged individuals. Additional research is needed to examine how such factors as stress, environment, and access to care contribute to our understanding of health outcomes among this population of adults.

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Home-based physical therapy may reduce functional decline among moderately frail elderly adults

Evidence-based Healthcare ◽

10.1016/s1462-9410(02)00132-8 ◽

2003 ◽

Vol 7 (1) ◽

pp. 12-13

Keyword(s):

Physical Therapy ◽

Frail Elderly ◽

Functional Decline ◽

Elderly Adults ◽

Home Based

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Characteristics Associated With Functional Changes During Systemic Cancer Treatments: A Systematic Review Focused on Older Adults

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2020.7684 ◽

2021 ◽

Vol 19 (9) ◽

pp. 1055-1062

Author(s):

Kah Poh Loh ◽

Vivian Lam ◽

Katey Webber ◽

Simran Padam ◽

Mina S. Sedrak ◽

...

Keyword(s):

Older Adults ◽

Functional Status ◽

Older Adult ◽

Functional Decline ◽

Functional Change ◽

Cancer Treatments ◽

Functional Changes ◽

Systemic Treatments ◽

Wide Range ◽

Patient Reported

Background: Maintaining functional status is important to older adults with cancer, but data are limited on how systemic treatments affect functional status. We systematically reviewed changes in functional status during systemic cancer treatments and identified characteristics associated with functional decline and improvement. Methods: We searched PubMed, Embase, Web of Science, and Cochrane Register of Controlled Trials for articles examining characteristics associated with functional changes in older adults during systemic cancer treatment published in English between database inception and January 11, 2019 (PROSPERO CRD42019123125). Findings were summarized with descriptive statistics. Study characteristics between older adult–specific and non–older adult–specific studies were compared using the Fisher exact test. Results: We screened 15,244 titles/abstracts and 519 full texts. The final analysis included 44 studies, which enrolled >8,400 patients; 39% of studies focused on older adults (1 study enrolled adults aged ≥60 years, 10 enrolled adults aged ≥65 years, and 6 enrolled adults aged ≥70 years). Almost all studies (98%) used patient-reported outcomes to measure functional status; only 20% used physical performance tests. Reporting of functional change was heterogeneous, with 48% reporting change scores. Older adult–specific studies were more likely to analyze functional change dichotomously (29% vs 4%; P=.008). Functional decline ranged widely, from 6% to 90%. The most common patient characteristics associated with functional decline were older age (n=7 studies), worse performance status (n=4), progressive disease status (n=4), pain (n=4), anemia (n=4), and worse nutritional status (n=4). Twelve studies examined functional improvement and identified 11 unique associated characteristics. Conclusions: Functional decline is increasingly recognized as an important outcome in older adults with cancer, but definitions and analyses are heterogeneous, leading to a wide range of prevalence. To identify patients at highest risk of functional decline during systemic cancer treatments, trials need to routinely analyze functional outcomes and measure characteristics associated with decline (eg, nutrition).

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Faculty Opinions recommendation of Obesity and diabetes as accelerators of functional decline: can lifestyle interventions maintain functional status in high risk older adults?

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718070527.793481952 ◽

2013 ◽

Author(s):

Thomas Lang

Keyword(s):

Older Adults ◽

High Risk ◽

Functional Status ◽

Functional Decline ◽

Lifestyle Interventions ◽

Obesity And Diabetes

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Perceptions About Technologies That Help Community-Dwelling Older Adults Remain at Home: Qualitative Study

Journal of Medical Internet Research ◽

10.2196/17930 ◽

2020 ◽

Vol 22 (6) ◽

pp. e17930 ◽

Cited By ~ 2

Author(s):

Henk Verloo ◽

Thomas Kampel ◽

Nicole Vidal ◽

Filipa Pereira

Keyword(s):

Older Adults ◽

Qualitative Study ◽

Home Health Care ◽

High Performance ◽

Functional Decline ◽

Community Dwelling ◽

Surveillance Systems ◽

Convenience Sample ◽

Community Dwelling Older Adults ◽

At Home

Background The population of Europe is aging rapidly. Most community-dwelling older adults (CDOAs) want to remain in their homes, particularly those experiencing functional decline. Politicians and academics repeatedly praise technological instruments for being the preferred solution for helping older adults with deteriorating health to remain at home. Objective This study aimed to understand the perceptions of CDOAs and their informal caregivers (ICs) and professional caregivers (PCs) about technologies that can help keep older adults at home. Methods This qualitative study used personal interviews, focus groups, and photo-elicitation interviews to better understand the perceptions of a convenience sample of 68 CDOAs, 21 ICs, and 32 PCs. Results A fraction of CDOAs did not perceive technological instruments to be a very useful means of helping them remain at home. However, the ICs and PCs were more positive. The CDOAs preferred and were more willing to adopt technologies related to their mobility and safety and those that would help slow down their cognitive decline. The ICs preferred technological aids that assist in the activities of daily living as well as safety-related technologies for detecting falls and helping to locate disoriented older adults. The PCs preferred integrated communication and information systems to improve collaboration between all stakeholders, housing equipped with technologies to manage complex care, high-performance ancillary equipment to transfer people with reduced mobility, and surveillance systems to ensure safety at home. Conclusions Although our study reports that CDOAs have limited interest in innovative technologies to help them remain at home, their technological skills will undoubtedly improve in the future, as will those of ICs and PCs. Technological tools will play an increasingly important role in home health care.

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Obesity and diabetes as accelerators of functional decline: Can lifestyle interventions maintain functional status in high risk older adults?

Experimental Gerontology ◽

10.1016/j.exger.2013.06.007 ◽

2013 ◽

Vol 48 (9) ◽

pp. 888-897 ◽

Cited By ~ 56

Author(s):

Stephen D. Anton ◽

Christy Karabetian ◽

Kelly Naugle ◽

Thomas W. Buford

Keyword(s):

Older Adults ◽

High Risk ◽

Functional Status ◽

Functional Decline ◽

Lifestyle Interventions ◽

Obesity And Diabetes

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EFFECT OF FREQUENCY OF PARTICIPATING IN THE REGION ACTIVITY ON FUNCTIONAL DECLINE

Innovation in Aging ◽

10.1093/geroni/igz038.454 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S124-S124

Author(s):

Masashi Yasunaga ◽

Hisashi Kawai ◽

Hirohiko Hirano ◽

Hiroyuki Suzuki ◽

Yoshinori Fujiwara ◽

...

Keyword(s):

Older Adults ◽

Functional Status ◽

Functional Decline ◽

Mail Survey ◽

Community Dwelling ◽

Independent Effect ◽

Logistic Regression Models ◽

Japanese Older Adults ◽

Independent Effects

Abstract This 3-year prospective study was conducted to explore whether frequency of participating in the region activity exert independent effect on preventing functional decline among urban Japanese older adults after controlling for potential confounders. We examined a prospective cohort of 2,524 community-dwelling persons, aged 65 years or older, who responded to the baseline mail survey in Toshima ward, Tokyo, Japan in 2014. They were followed for the subsequent 3 years in terms of functional status. Multiple logistic regression models were used to analyze independent effects of frequency of participating in the region activity, such as 1) no participation, 2) no participation in the past year, 3) less than one day per month, 4) few days per month, 5) over one day per week, on functional status, controlling for potential confounders such as age, gender, self-rated health, chronic conditions and social capital at baseline. At baseline, the mean age of 1,261 participants who completely responded to follow-up survey in 2018 was72.1 years (SD=5.0), and 56.9% were women. As results of analyzing, only “over one day per week” was significant predictors of preventing subsequent functional decline even after adjustment for confounders (odds ratios .361; 95% CI .180–.725). Frequency of participating in the region activity over one day per week have effect on preventing functional decline among urban Japanese older adults after controlling for potential confounders.

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