Operationalizing the Disablement Process for Research on Older Adults: A Critical Review

ABSTRACTSelf-care disability is difficulty with or dependence on others to perform activities of daily living, such as eating and dressing. Disablement is worsening self-care disability measured over time. The disablement process model (DPM) is often used to conceptualize gerontology research on self-care disability and disablement; however, no summary of variables that align with person-level DPM constructs exists. This review summarizes the results of 88 studies to identify the nature and role of variables associated with disability and disablement in older adults according to the person-level constructs (e.g., demographic characteristics, chronic pathologies) in the DPM. It also examines the evidence for cross-sectional applications of the DPM and identifies common limitations in extant literature to address in future research. Researchers can apply these results to guide theory-driven disability and disablement research using routinely collected health data from older adults.

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The Role of Informal and Formal Leisure Activities in the Disablement Process

The International Journal of Aging and Human Development ◽

10.2190/ag.67.3.c ◽

2008 ◽

Vol 67 (3) ◽

pp. 231-257 ◽

Cited By ~ 28

Author(s):

Megan C. Janke ◽

Laura L. Payne ◽

Marieke Van Puymbroeck

Keyword(s):

Older Adults ◽

Process Model ◽

Functional Limitations ◽

Leisure Activities ◽

Regression Analyses ◽

Moderating Effects ◽

Leisure Involvement ◽

Perceptions Of Disability ◽

Disablement Process

The disablement process model has been used as a framework to investigate factors that accelerate or decelerate disablement among older adults. Although very little is known about the direct and moderating effects of involvement in leisure activities on the disablement process, research has suggested that participation in leisure activities may serve as a factor affecting the disablement pathways. Using longitudinal data from individuals aged 65 and older ( N = 535) in the Americans' Changing Lives study, we examined the influence of leisure involvement on the disablement process model. Through regression analyses, we found that involvement in informal and formal leisure activities was significantly associated with the disablement process in this sample of older adults, and that the effect of informal and formal leisure on disablement changed across time points and at different phases of the pathway. Results suggest that leisure activities may be protective of cognitive health and mitigate the effect of functional limitations, perceptions of disability, and depressive symptoms among older adults.

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Disability in Community-Dwelling Older Adults: Exploring the Role of Stroke and Dementia

Journal of Primary Care & Community Health ◽

10.1177/2150132719852507 ◽

2019 ◽

Vol 10 ◽

pp. 215013271985250 ◽

Cited By ~ 1

Author(s):

Brian J. Stamm ◽

James F. Burke ◽

Chun Chieh Lin ◽

Rory J. Price ◽

Lesli E Skolarus

Keyword(s):

Older Adults ◽

Racial Differences ◽

Daily Living ◽

Cross Sectional Study ◽

Race Differences ◽

Community Dwelling ◽

Cross Sectional ◽

The Impact ◽

Community Dwelling Older Adults

Objectives: We sought to determine the relative contributions of stroke, dementia, and their combination to disability and racial differences in disability among community-dwelling older adults. Methods: We performed a cross-sectional study of 6848 community-dwelling older adults. We evaluated the associations of stroke, dementia, and their combination with activities of daily living (ADL) limitations (range 0-7). We then explored the impact of stroke and dementia on race differences in ADL limitations using Poisson regression after accounting for sociodemographics and comorbidities. Results: After full adjustment, ADL limitations differed among older adults with stroke and dementia. Older adults without stroke or dementia had 0.32 (95% CI 0.29-0.35) ADL limitations compared to 0.64 (95% CI 0.54-0.73) with stroke, 1.36 (95% CI 1.20-1.53) with dementia and 1.84 (95% CI 1.54-2.15) with stroke and dementia. Overall, blacks had 0.27 (95%CI 0.19-0.36) more ADL limitations than whites. Models accounting for stroke led to a 3.7% (95%CI 2.98%-4.43%) reduction in race differences, while those for dementia led to a 29.26% (95%CI 28.53%-29.99%) reduction and the stroke-dementia combination −1.48% (95%CI −2.21% to −0.76) had little impact. Discussion: Older adults with stroke and dementia have greater disability than older adults with either of these conditions alone. However, the amount of disability experienced by older adults with stroke and dementia is less than the sum of the contributions from stroke and dementia. Dementia is likely a key contributor to race differences in disability.

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Complementary Medicine and Self-Care Strategies in Women with (Recurrent) Urinary Tract and Vaginal Infections: A Cross-Sectional Study on Use and Perceived Effectiveness in The Netherlands

Antibiotics ◽

10.3390/antibiotics10030250 ◽

2021 ◽

Vol 10 (3) ◽

pp. 250

Author(s):

Louise Witteman ◽

Herman A. van Wietmarschen ◽

Esther T. van der Werf

Keyword(s):

Urinary Tract ◽

The Netherlands ◽

Complementary Medicine ◽

Self Care ◽

Future Research ◽

Perceived Effectiveness ◽

Vaginal Infections ◽

Cross Sectional ◽

Treatment Implementation ◽

Specific Symptoms

Due to the excessive use of antibiotic and antimycotic treatments, the risk of resistant microbes and fungi is rapidly emerging. Previous studies have demonstrated that many women with (recurrent) urinary tract infection (UTI) and/or vaginal infections (VIs) welcome alternative management approaches to reduce the use of antibiotics and antifungals and avoid short- and long-term adverse effects. This study aims to determine which complementary medicine (CM) and self-care strategies are being used by women suffering from (recurrent) UTI and VI in The Netherlands and how they perceive their effectiveness in order to define directions for future research on safety, cost-effectiveness, and implementation of best practices. A cross-sectional online survey was performed among women, ≥18 years old, with a history of UTIs; 162 respondents were included in the data analysis, with most participants aged between 50 and 64 years (36.4%). The women reported having consulted a CM practitioner for UTI-specific symptoms (23.5%) and VI-specific symptoms (13.6%). Consultations of homeopaths, acupuncturists, and herbal physicians are most often reported. Overall, 81.7% of the women suffering from UTI used complementary or self-care strategies besides regular treatment, and 68.7% reported using CM/self-care strategies to treat vaginal symptoms. UTI- related use of cranberries (51.9%), vitamin C (43.8%), and D-mannose (32.7%) were most reported. Perceived effectiveness was mostly reported for homeopathic remedies and D-mannose. The results showed a substantial burden of UTI and VI on daily and sexual activities. Besides the frequency of use, the indication of perceived effectiveness seems to be an important parameter for further and rigorously designed research to encourage nonantibiotic/antifungal treatment implementation into daily clinical practice.

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Social Engagement and Episodic Memory in Non-Hispanic Black and White Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1101 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 343-343

Author(s):

Abbey Hamlin ◽

A Zarina Kraal ◽

Laura Zahodne

Keyword(s):

Social Support ◽

Older Adults ◽

Episodic Memory ◽

Cognitive Aging ◽

Social Engagement ◽

Future Research ◽

Social Activities ◽

Linear Regression Models ◽

Significant Positive Association ◽

Cross Sectional

Abstract Social engagement may confer cognitive benefits in older adulthood, but studies have typically been restricted to largely non-Hispanic White (NHW) samples. Levels of social engagement vary across race such that NHW report larger social networks, more frequent participation in social activities, and greater social support than non-Hispanic Blacks (NHB). Associations between social engagement and cognition may also vary by race, but research is sparse. The current cross-sectional study examined associations between different aspects of social engagement and episodic memory performance, as well as interactions between social engagement and race among NHB and NHW participants in the Michigan Cognitive Aging Project (N = 247; 48.4% NHB; age = 64.19 ± 2.92). Social engagement (network size, activities, support) was self-reported. Episodic memory was a z-score composite of immediate, delayed, and recognition trials of a list-learning task. Separate hierarchical linear regression models quantified interactions between race and each of the three social engagement variables on episodic memory, controlling for sociodemographics, depressive symptoms, and health conditions. Results showed a main effect of more frequent social activity on better episodic memory, as well as an interaction between race and social support indicating a significant positive association in NHB but not NHW. These preliminary findings suggest that participating in social activities may be equally beneficial for episodic memory across NHB and NHW older adults and that social support may be particularly beneficial for NHB. Future research is needed to determine the potential applications of these results in reducing cognitive inequalities through the development of culturally-relevant interventions.

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306 - Loneliness and mortality in older adults and the role of depression

International Psychogeriatrics ◽

10.1017/s1041610220002069 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 64-64

Author(s):

T.J. Holwerda ◽

D. Rhebergen ◽

H.C. Comijs ◽

J.J.M. Dekker ◽

M.L. Stek

Keyword(s):

Cardiovascular Disease ◽

Older Adults ◽

Mortality Risk ◽

Meta Analysis ◽

Clinical Perspective ◽

Cross Sectional ◽

Mediating Role ◽

Underlying Mechanisms ◽

Dexamethasone Suppression

Background:The prevalence of loneliness increases with age. The presence of loneliness in older adults has been found to be associated with health problems such as depression, decreased cognitive functioning, increases in systolic blood pressure and increased mortality. The underlying mechanisms of the higher mortality risk are largely unknown.Methods:Meta-analysis to investigate the present evidence for the associations between loneliness and mortality. Cross-sectional studies investigating the associations between loneliness and cardiovascular disease and between loneliness and cortisol in 378 depressed and 132 non-depressed older adults.Results:Loneliness appears to be associated with increased mortality, although when only studies are included that consider depression as a covariate, the association is not significant. Therefore it seems likely that depression plays a mediating role in the higher mortality risk.We did not find a significant association between loneliness and cardiovascular disease. In contrast, loneliness was significantly associated with lower cortisol output and decreased dexamethasone suppression.Discussion:The results and their implications for prevention and treatment will be discussed from a clinical perspective as well as a general health perspective. Is loneliness as potentially dangerous as depression?

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Related Factors and Clinical Outcomes of Osteosarcopenia: A Narrative Review

Nutrients ◽

10.3390/nu13020291 ◽

2021 ◽

Vol 13 (2) ◽

pp. 291

Author(s):

Tatsuro Inoue ◽

Keisuke Maeda ◽

Ayano Nagano ◽

Akio Shimizu ◽

Junko Ueshima ◽

...

Keyword(s):

Older Adults ◽

Longitudinal Studies ◽

Clinical Outcomes ◽

Daily Living ◽

Community Dwelling ◽

Related Factors ◽

Cross Sectional ◽

Meta Analyses ◽

Community Dwelling Older Adults

Osteopenia/osteoporosis and sarcopenia are common geriatric diseases among older adults and harm activities of daily living (ADL) and quality of life (QOL). Osteosarcopenia is a unique syndrome that is a concomitant of both osteopenia/osteoporosis and sarcopenia. This review aimed to summarize the related factors and clinical outcomes of osteosarcopenia to facilitate understanding, evaluation, prevention, treatment, and further research on osteosarcopenia. We searched the literature to include meta-analyses, reviews, and clinical trials. The prevalence of osteosarcopenia among community-dwelling older adults is significantly higher in female (up to 64.3%) compared to male (8–11%). Osteosarcopenia is a risk factor for death, fractures, and falls based on longitudinal studies. However, the associations between osteosarcopenia and many other factors have been derived based on cross-sectional studies, so the causal relationship is not clear. Few studies of osteosarcopenia in hospitals have been conducted. Osteosarcopenia is a new concept and has not yet been fully researched its relationship to clinical outcomes. Longitudinal studies and high-quality interventional studies are warranted in the future.

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Strategies and cognitive reserve to preserve lexical production in aging

GeroScience ◽

10.1007/s11357-021-00367-5 ◽

2021 ◽

Author(s):

Monica Baciu ◽

Sonja Banjac ◽

Elise Roger ◽

Célise Haldin ◽

Marcela Perrone-Bertolotti ◽

...

Keyword(s):

Older Adults ◽

Cognitive Aging ◽

Individual Variability ◽

Future Research ◽

Aging Effects ◽

Main Hypothesis ◽

Compensatory Strategies ◽

Age Related ◽

Complementary Domain

AbstractIn the absence of any neuropsychiatric condition, older adults may show declining performance in several cognitive processes and among them, in retrieving and producing words, reflected in slower responses and even reduced accuracy compared to younger adults. To overcome this difficulty, healthy older adults implement compensatory strategies, which are the focus of this paper. We provide a review of mainstream findings on deficient mechanisms and possible neurocognitive strategies used by older adults to overcome the deleterious effects of age on lexical production. Moreover, we present findings on genetic and lifestyle factors that might either be protective or risk factors of cognitive impairment in advanced age. We propose that “aging-modulating factors” (AMF) can be modified, offering prevention opportunities against aging effects. Based on our review and this proposition, we introduce an integrative neurocognitive model of mechanisms and compensatory strategies for lexical production in older adults (entitled Lexical Access and Retrieval in Aging, LARA). The main hypothesis defended in LARA is that cognitive aging evolves heterogeneously and involves complementary domain-general and domain-specific mechanisms, with substantial inter-individual variability, reflected at behavioral, cognitive, and brain levels. Furthermore, we argue that the ability to compensate for the effect of cognitive aging depends on the amount of reserve specific to each individual which is, in turn, modulated by the AMF. Our conclusion is that a variety of mechanisms and compensatory strategies coexist in the same individual to oppose the effect of age. The role of reserve is pivotal for a successful coping with age-related changes and future research should continue to explore the modulating role of AMF.

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Visualization approaches to support healthy aging: A systematic review

Journal of Innovation in Health Informatics ◽

10.14236/jhi.v23i3.860 ◽

2016 ◽

Vol 23 (3) ◽

pp. 600 ◽

Cited By ~ 4

Author(s):

Uba Backonja ◽

Nai-Ching Chi ◽

Yong Choi ◽

Amanda K Hall ◽

Thai Le ◽

...

Keyword(s):

Older Adults ◽

Health Behaviors ◽

Healthy Aging ◽

A Priori ◽

Aging In Place ◽

Future Research ◽

Health Technologies ◽

Data Visualizations ◽

Informatics Tools

Background: Health technologies have the potential to support the growing number of older adults who are aging in place. Many tools include visualizations (data visualizations, visualizations of physical representations). However, the role of visualizations in supporting aging in place remains largely unexplored.Objective: To synthesize and identify gaps in the literature evaluating visualizations (data visualizations and visualizations of physical representations), for informatics tools to support healthy aging.Methods: We conducted a search in CINAHL, Embase, Engineering Village, PsycINFO, PubMed, and Web of Science using a priori defined terms for publications in English describing community-based studies evaluating visualizations used by adults aged ≥65 years.Results: Six out of the identified 251 publications were eligible. Most studies were user studies and varied methodological quality. Three visualizations of virtual representations supported performing at-home exercises. Participants found visual representations either (a) helpful, motivational, and supported their understanding of their health behaviors or (b) not an improvement over alternatives. Three data visualizations supported understanding of one’s health. Participants were able to interpret data visualizations that used precise data and encodings that were more concrete better than those that did not provide precision or were abstract. Participants found data visualizations helpful in understanding their overall health and granular data.Conclusions: Studies we identified used visualizations to promote engagement in exercises or understandings of one’s health. Future research could overcome methodological limitations of studies we identified to develop visualizations that older adults could use with ease and accuracy to support their health behaviors and decision-making.

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Vision and Hearing Impairments Affecting Activities of Daily Living among Malaysian Older Adults by Gender

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126271 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6271

Author(s):

Yee Mang Chan ◽

Norhafizah Sahril ◽

Ying Ying Chan ◽

Nor’ Ain Ab Wahab ◽

Norliza Shamsuddin ◽

...

Keyword(s):

Older Adults ◽

Gender Differences ◽

Activities Of Daily Living ◽

Hearing Impairment ◽

Daily Living ◽

Hearing Impairments ◽

Cross Sectional ◽

Middle Income ◽

Middle Income Countries ◽

Adl Disability

Vision and hearing impairments are common among older adults and can cause undesirable health effects. There are limited studies from low- and middle-income countries exploring gender differences between vision and hearing impairment with Activities of Daily Living (ADL) disability. Therefore, this study aimed to investigate gender differences between vision and hearing impairments with ADL disability among older adults in Malaysia. Cross-sectional data from 3977 respondents aged 60 and above from the Malaysian National Health and Morbidity Survey 2018 were used. We used logistic regression analysis to measure associations between vision and hearing impairments with ADL disability, adjusted for covariates. The prevalence of ADL disability was higher among females than males (p < 0.001). The adjusted associations between vision impairment and ADL disability were significant among males (aOR 3.79; 95%CI 2.26, 6.38) and females (aOR 2.66; 95%CI 1.36, 5.21). Similarly, significant adjusted associations were found between hearing impairment and ADL disability among males (aOR 5.76; 95%CI 3.52, 9.40) and females (aOR 3.30; 95%CI 1.17, 9.33). Vision and hearing impairments were significantly associated with ADL disability, with no gender differences identified. Early detection and effective management of vision and hearing impairments are important to prevent ADL disability and improve older adults’ level of independence.

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Dual Effects of Hearing Loss and Dementia on Functional Limitations in Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.690 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 214-214

Author(s):

Michael McKee ◽

Yunshu Zhou ◽

Joshua Ehrlich ◽

Elham Mahmoudi ◽

Jennifer Deal ◽

...

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Self Care ◽

Household Activity ◽

Cross Sectional ◽

Age Related ◽

Increased Risk ◽

Lower Mobility ◽

Independent Effects ◽

The Impact

Abstract Age-related hearing loss (HL) is both common and associated with elevated risk for cognitive decline and poorer health. To care for an aging population, it is critical to understand the effect of coexisting HL and dementia on functional activities. The effect of co-existing dementia and self-reported HL on daily functioning were assessed. A cross-sectional analysis was performed using nationally-representative data from the 2015 National Health and Aging Trends Study consisting of U.S. adults 65+. The sample included 1,829 adults with HL (22.8%) and 5,338 adults without HL. Multivariable Poisson regression was used to model the independent effects and interaction of self-reported HL and dementia status on three validated functional activity scales (self-care, mobility, and household). All analyses adjusted for sociodemographic and medical factors. HL participants were more likely to be white, older, male, less educated (p <0.01). 8.4% had possible dementia and 6.5% had probable dementia. Respondents with HL or possible or probable dementia had significantly lower mobility, self-care, and household activity scores (p<.001 for all comparisons) compared to their peers. A small yet significant interaction was present in all models, suggesting that HL respondents with co-occurring dementia had lower mobility, self-care, and household activity scores than predicted by the independent effects of dementia and self-reported HL (p<.001 for all comparisons). Older adults with co-occurring dementia and HL are at increased risk for poor functioning and should be screened by healthcare providers. Future work should consider the impact of intervention in this vulnerable/at-risk population.

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