scholarly journals Association between patient-reported functional measures and incident falls

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wanfen Yip ◽  
Lixia Ge ◽  
Bee Hoon Heng ◽  
Woan Shin Tan
Keyword(s):  
Lower Extremity ◽  
Physical Function ◽  
Assessment Tool ◽  
Multivariable Analysis ◽  
Community Dwelling ◽  
Lower Extremity Function ◽  
Lower Extremity Muscle ◽  
Extremity Function ◽  
Patient Reported ◽  
Function Domain

AbstractLower extremity muscle strength, and functional limitations are important modifiable predictors of falls, but are often examined using performance based measures. We examined the association between self-reported physical function limitations, determined using Late-Life Function and Disability Instrument(LLFDI) and incident falls in community-dwelling elderly individuals. 283 older adults participants were included in this analysis. Physical function limitations were defined as a person’s difficulty in completing items of the lower extremity function domain and composite scores of the LLFDI. Information on falls was obtained through a standardised questionnaire. At one-year follow-up, 15.2% (43) of the participants experienced their first fall. In the multivariable analysis, individuals who reported difficulties in items of lower extremity function domain were more likely to experience a fall (incidence rate ratio[IRR]: ranging between 2.43 and 7.01; all P ≤ 0.046). In addition, decreasing advanced lower extremity function scores (IRR: 1.70, 95% confidence interval[CI]): 1.04, 2.78) and overall function component score (IRR: 2.05, 95% CI: 1.22, 3.44) were associated with higher risk of incident falls. Physical function limitations, determined using LLFDI, were associated with incident falls. Our findings provide further evidence that the LLFDI function component has the potential to be used as a self-assessment tool for fall risk.

scholarly journals Long-term participation in community group exercise improves lower extremity muscle strength and delays age-related declines in walking speed and physical function in older adults

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Chisato Hayashi ◽  
Soshiro Ogata ◽  
Tadashi Okano ◽  
Hiromitsu Toyoda ◽  
Sonoe Mashino
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Physical Exercise ◽  
Lower Extremity ◽  
Physical Function ◽  
Community Dwelling ◽  
Group Exercise ◽  
Community Based ◽  
Lower Extremity Muscle

Abstract Background The effects of group exercise on the physical function of community-dwelling older adults remain unclear. The changes in lower extremity muscle strength, timed up and go (TUG) time, and the motor fitness scale (MFS), over time, among older adults who expressed a willingness to participate in community-based physical exercise groups, were determined using multilevel modelling. Methods We analyzed data of 2407 older adults between April 2010 and December 2019 from the registry of physical tests of community-based physical exercise groups. We conducted a retrospective cohort study to assess the effect of physical exercise on lower extremity muscle strength, TUG time, and MFS scores. The durations of the exercises were evaluated by frequency of physical test’s participate. Results A deterioration in lower extremity muscle strength was found in the short-term participant group only. However, in the mid-term and long-term participation groups, lower extremity muscle strength showed a trend of improvement. The TUG time and the MFS score were negatively correlated with increasing age in both groups divided by the duration of participation. However, there was a slower rate of deterioration in the long-term participation group. Discussion Lower extremity muscle strength, TUG time, and MFS scores decline with increasing age and there were differences in the slope of deterioration that depended on the duration of participation in community-based group exercise. Conclusion Participation in group exercise improved lower extremity muscle strength, TUG time, and MFS scores of older adults living in a community. The positive effects of group exercise were dependent on long-term participation.

scholarly journals Relevance of cognitive and lower extremity function and gender differences in the community-dwelling elderly

2014 ◽  
Vol 4 (2) ◽  
pp. 71-75
Author(s):  
HIRONORI OHSUGI ◽  
SHIN MURATA ◽  
ATSUKO KUBO ◽  
MIZUKI HACHIYA ◽  
AYA HIRAO ◽  
...  
Keyword(s):  
Gender Differences ◽  
Lower Extremity ◽  
Community Dwelling ◽  
Lower Extremity Function ◽  
Extremity Function ◽  
And Gender

Prospective associations between white matter hyperintensities and lower extremity function

Neurology ◽  
2018 ◽  
Vol 90 (15) ◽  
pp. e1291-e1297 ◽  
Author(s):  
So Young Moon ◽  
Philipe de Souto Barreto ◽  
Yves Rolland ◽  
Marie Chupin ◽  
Ali Bouyahia ◽  
...  
Keyword(s):  
Older Adults ◽  
White Matter ◽  
Lower Extremity ◽  
White Matter Hyperintensities ◽  
Brain Mri ◽  
Community Dwelling ◽  
Lower Extremity Function ◽  
Mixed Effect ◽  
Extremity Function ◽  
Slow Progression

ObjectiveTo evaluate the relationship of white matter hyperintensities (WMH) with decline in lower extremity function (LEF) over approximately 3 years in dementia-free older adults with memory complaints.MethodsWe obtained brain MRI data from 458 community-dwelling adults, aged 70 years or over, at baseline, and from 358 adults over an average follow-up of 963 days. We evaluated LEF using the Short Physical Performance Battery (SPPB). We related baseline WMH volumes and progression to SPPB scores over time, using mixed-effect linear regressions. For the secondary analyses, we categorized baseline WMH volume into quartiles, and dichotomized the WMH progression to compare fast and slow progression.ResultsBaseline WMH volume (β = −0.017, 95% confidence interval [CI] −0.025 to −0.009), as well as WMH progression (β = −0.002, 95% CI −0.003 to −0.001), significantly associated with a decline in SPPB performance in adjusted analyses. Compared with the lowest quartile of baseline WMH volume, the highest quartile associated with a decline in SPPB performance (β = −0.301, 95% CI −0.558 to −0.044). Fast progression also associated with a decline in SPPB performance. We found clinically meaningful differences in the SPPB, with higher scores in participants with slow progression of WMH, at both 24 and 36 months.ConclusionsBaseline level and WMH progression associated with longitudinal decline in SPPB performance among older adults. We detected clinically meaningful differences in SPPB performance on comparing fast with slow progression of WMH, suggesting that speed of WMH progression is an important determinant of LEF during aging.

scholarly journals Plasma Ceramides and Risk of Impaired Lower-Extremity Function in Older Adults: A Nested Case–Control Study

2020 ◽  
Author(s):  
Francisco Félix Caballero ◽  
Ellen A Struijk ◽  
Antonio Buño ◽  
Fernando Rodríguez-Artalejo ◽  
Esther Lopez-Garcia
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Lower Extremity ◽  
Body Mass ◽  
Case Control Study ◽  
Case Control ◽  
Community Dwelling ◽  
Lower Extremity Function ◽  
Extremity Function ◽  
Control Study

Abstract Background Higher levels of ceramides have been linked to several chronic diseases; also there is emerging cross-sectional evidence that ceramides are associated with lower physical functioning. This research assessed for the first time the prospective relationship between ceramide species and impaired lower-extremity function (ILEF) in older adults. Methods Case–control study with 43 cases of ILEF and 86 age- and sex-matched controls, which was nested in the Seniors-ENRICA cohort of community-dwelling older adults. Incident ILEF from 2015 to 2017 was ascertained with the Short Physical Performance Battery. In 2015, 27 ceramide species were measured in plasma by liquid chromatography-tandem mass spectrometry. Conditional logistic regression models were used to assess the longitudinal relationship between ceramides concentration and incidence of ILEF. Results After adjusting for education level, body mass index, alcohol and total energy intake, physical activity, and presence of chronic conditions, some ceramide species were related to 2-year incidence of ILEF. Specifically, the odds ratios of ILEF per 1-SD increase in ceramide concentration were: 1.66 [95% CI = (1.03, 2.68)] for ceramide C14:0, 1.61 (1.00, 2.59) for ceramide C16:0, and 1.64 (1.03, 2.60) for ceramide C16:1 (n-7). In the case of ceramides C16:0 and C16:1 (n-7), a stronger relationship was found in those with a higher body mass index; systolic blood pressure could also mediate the relationship between ceramide C16:1 (n-7) and ILEF (p for interaction = .03). Conclusions Higher plasma levels of ceramides C14:0, C16:0, and C16:1 (n-7) are associated with higher risk of ILEF, and might serve as risk markers for functional decline in older adults.

scholarly journals An Examination of Lower Extremity Function and Its Correlates in Older African American and White Men

2015 ◽  
Vol 25 (3) ◽  
pp. 271 ◽  
Author(s):  
Olivio J. Clay, PhD ◽  
Roland J. Thorpe, Jr., PhD ◽  
Larrell L. Wilkinson, PhD ◽  
Eric P. Plaisance, PhD ◽  
Michael Crowe, PhD ◽  
...  
Keyword(s):  
African American ◽  
Lower Extremity ◽  
Racial Differences ◽  
African American Men ◽  
White Men ◽  
Community Dwelling ◽  
Potential Range ◽  
Lower Extremity Function ◽  
Targeted Interventions ◽  
Extremity Function

<p><strong>Objective: </strong>Maintaining functional status and reducing/eliminating health disparities in late life are key priorities. Older African Americans have been found to have worse lower extremity functioning than Whites, but little is known about potential differences in correlates between African American and White men. The goal of this investigation was to examine measures that could explain this racial difference and to identify race-specific correlates of lower extremity function.</p><p><strong>Methods: </strong>Data were analyzed for a sample of community-dwelling men. Linear regres­sion models examined demographics, medical conditions, health behaviors, and perceived discrimination and mental health as correlates of an objective measure of lower extremity function, the Short Physi­cal Performance Battery (SPPB). Scores on the SPPB have a potential range of 0 to 12 with higher scores corresponding to better functioning.</p><p><strong>Results: </strong>The mean age of all men was 74.9 years (SD=6.5), and the sample was 50% African American and 53% rural. African American men had scores on the SPPB that were significantly lower than White men after adjusting for age, rural residence, marital status, education, and income dif­ficulty (<em>P</em>&lt;.01). Racial differences in cognitive functioning accounted for approximately 41% of the race effect on physical function. Additional models stratified by race revealed a pattern of similar correlates of the SPPB among African American and White men.</p><p><strong>Conclusions: </strong>The results of this investigation can be helpful for researchers and clinicians to aid in identifying older men who are at-risk for poor lower extremity function and in planning targeted interventions to help reduce disparities. <em>Ethn Dis.</em>2015;25(3):271- 278.</p>

scholarly journals The Relationship Between Cognitive Decline and Sedentary Time

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 191-191
Author(s):  
Lorraine Phillips ◽  
Mary Bowen
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cognitive Function ◽  
Lower Extremity ◽  
Sedentary Time ◽  
Community Dwelling ◽  
Physical Activity Intensity ◽  
Lower Extremity Function ◽  
Activity Intensity ◽  
Extremity Function

Abstract Early identification of functional decline in older adults with mild cognitive impairment (MCI) provides the opportunity to initiate behavioral interventions to slow decline. More frequent breaks in sedentary time has been associated with greater lower extremity function. This longitudinal study examined the effect of 6-month change in cognitive function on monthly sedentary time, controlling for lower extremity function, among community-dwelling older adults with MCI. Twenty adults with Montreal Cognitive Assessment Score (MoCA) between 19-25, who were age ≥ 60 years old, and ambulatory, wore an actigraph for 6 months and participated in monthly in-person assessments. Measures included MoCA change (baseline to month 6), Short Physical Performance Battery (SPPB; baseline, months 3 and 6); sedentary time and physical activity intensity; and falls (monthly). The sample was 70% female, 60% non-Hispanic white, with a mean age of 77 years. Sixteen participants provided complete data for mixed-model analysis. Over 6 months, 11 falls occurred among 7 participants. The mean MoCA score declined from 22.7 to 21.9 while SPPB remained stable. Overall time spent in sedentary behavior was high (71%) and physical activity intensity was low (light and moderate combined= 26.1%). Results of multi-level analysis with sedentary time as a continuous Level-1 variable and MoCA change scores, SPPB scores, and age in Level-2 showed that negative change in MoCA (β=-0.11; p≤0.05) was associated with increased sedentary time. Given sedentary time increases as cognitive function declines, older adults with MCI could benefit from interventions designed to interrupt sedentary time as well as increase physical activity.

Abstract WP161: Early Short Physical Performance Battery (SPPB) Score Can Predict Functional Independence and Death for Acute Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Ken-ichi Kumagae ◽  
Kohta Yamauchi ◽  
Risa Hagiwara ◽  
Yasuhiro Koyanagi ◽  
Shuji Arakawa ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Acute Stroke ◽  
Roc Curve ◽  
Assessment Tool ◽  
Functional Independence ◽  
Curve Analysis ◽  
Lower Extremity Function ◽  
Stroke Patients ◽  
Roc Curve Analysis ◽  
Extremity Function

Background and Purpose: Lower extremity function is a strong predictor for functional outcome and death in a variety of pathological status. National Institute of Health Stroke Scale (NIHSS) is a world-wide standard scoring system for stroke patients; however, it is not sufficient to evaluate lower extremity function. Short Physical Performance Battery (SPPB) is a simple assessment tool for lower extremity function, consists of standing balance, walking speed, and repetitive standing (range: 0-12, 12: high function). SPPB can predict adverse events, such as disability and mortality in elderly population, but its disease specific utility for stroke patients is still unknown. The purpose of this study was to determine whether SPPB score predicts functional independence and death for acute stroke. Methods: Between April 2013 and November 2014, 410 consecutive stroke patients admitted within 7 days after the onset. Patients with premorbid modified Rankin Scale (mRS) of 0-2, and evaluated SPPB at 7 th days after the admission were enrolled in this study. Clinical data were analyzed using univariate and multivariate model to assess functional independence (defined as mRS of 0-2) at 3 months and 1 year mortality adjusting covariates to investigate the association between SPPB and functional independence or death. Receiver operating characteristics (ROC) curve analysis was performed for detecting optimal cut-off value. Results: A total of 243 patients (mean age 73.8 years, male 58.4%) were included in this study. Of them, 132 (54.3%) patients were independent at 3 months follow up, and 14 (5.8%) patients have died. Median SPPB score at 7 th days after the admission was 6 (IQR: 1-11). After adjusting age, sex, BMI, NIHSS score on admission, SPPB score at 7 th days after the admission was significantly associated with 3-month functional independence (odds ratio, 1.48; 95%CI, 1.29-1.69; p<0.001) and 1-year death (hazard ratio, 0.36; 95% CI, 0.17-0.74; p=0.005). ROC curve analysis revealed the cut-off point of SPPB for functional independence was 6 (AUC:0.88, 95%CI, 0.83-0.93, p<0.001, sensitivity: 0.83, specificity:0.84). Conclusions: Early SPPB score is a useful assessment tool in predicting functional independence and death for acute stroke patients.

scholarly journals Preferential activation of spinal sensorimotor networks via lateralized transcutaneous spinal stimulation in neurologically intact humans

2019 ◽  
Vol 122 (5) ◽  
pp. 2111-2118 ◽  
Author(s):  
Jonathan S. Calvert ◽  
Gerome A. Manson ◽  
Peter J. Grahn ◽  
Dimitry G. Sayenko
Keyword(s):  
Spinal Cord ◽  
Lower Extremity ◽  
Muscle Activity ◽  
Network Activity ◽  
Lumbosacral Spine ◽  
Lower Extremity Function ◽  
Initial Stimulus ◽  
Lower Extremity Muscle ◽  
Extremity Function ◽  
Muscle Responses

Transcutaneous spinal stimulation (TSS), a noninvasive technique to modulate sensorimotor circuitry within the spinal cord, has been shown to enable a wide range of functions that were thought to be permanently impaired in humans with spinal cord injury. However, the extent to which TSS can be used to target specific mediolateral spinal cord circuitry remains undefined. We tested the hypothesis that TSS applied unilaterally to the skin ~2 cm lateral to the midline of the lumbosacral spine selectively activates ipsilateral spinal sensorimotor circuitry, resulting in ipsilateral activation of downstream lower extremity neuromusculature. TSS cathodes and anodes were positioned lateral from the midline of the spine in 15 healthy subjects while supine, and the timing of TSS pulses was synchronized to recordings of lower extremity muscle activity and force. At motor threshold, left and right TSS-evoked muscle activity was significantly higher in the ipsilateral leg compared with contralateral recordings from the same muscles. Similarly, we observed a significant increase in force production in the ipsilateral leg compared with the contralateral leg. Delivery of paired TSS pulses, during which an initial stimulus was applied to one side of the spinal cord and 50 ms later a second stimulus was applied to the contralateral side, revealed that ipsilateral leg muscle responses decreased following the initial stimulus, whereas contralateral muscle responses did not decrease, indicating side-specific activation of lateral spinal sensorimotor circuitry. Our results indicate TSS can selectively engage ipsilateral neuromusculature via lumbosacral sensorimotor networks responsible for lower extremity function in healthy humans. NEW & NOTEWORTHY We demonstrate the selectivity of transcutaneous spinal stimulation (TSS), which has been shown to enable function in humans with chronic paralysis. Specifically, we demonstrate that TSS applied to locations lateral to the spinal cord can selectively activate ipsilateral spinal sensorimotor networks. We quantified lumbosacral spinal network activity by recording lower extremity muscle electromyography and force. Our results suggest lumbosacral TSS engages side-specific spinal sensorimotor networks associated with ipsilateral lower extremity function in humans.

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