Factors Influencing Oral Bolus Hold Type: Tipper or Dipper

2021 ◽  
pp. 1-8
Author(s):  
Kendrea L. (Focht) Garand ◽  
Mary Catherine Reilly ◽  
Dahye Choi ◽  
Rajarshi Dey ◽  
Julie Estis ◽  
...  
Keyword(s):  
Common Type ◽  
Community Dwelling ◽  
Barium Swallow ◽  
Older Individuals ◽  
Exact Test ◽  
Significant Relationships ◽  
Factors Influencing ◽  
Thickened Liquid ◽  
Healthy Community ◽  
The Impact

Purpose: This retrospective study investigated the impact of age, sex, and swallow task on bolus hold location during cued liquid swallows in healthy, community-dwelling adults. Furthermore, we investigated the association between bolus hold location and Modified Barium Swallow Impairment Profile (MBSImP) Components 2 (bolus hold) and 4 (lingual transport) scores. Method: Cued swallows of standardized barium liquids (thin, nectar-thickened, honey-thickened) observed during videofluoroscopy in 195 participants were judged as either tipper or dipper bolus hold type. Logistic regression was used to determine relationships between bolus hold location and age, sex, and swallow task. Fisher's exact test was used to determine associations between MBSImP scores and bolus hold type. Results: The majority of swallow tasks (95%) were of tipper bolus hold type. A significant relationship was observed between age and bolus hold type for swallows of 5-ml thin liquid and 5-ml honey-thickened liquid, with older individuals more likely to demonstrate a tipper bolus hold type. Sex was observed to be a significant factor for two swallow tasks (cup sip of thin liquid and 5 ml of nectar-thickened liquid), with males being more likely to be dippers. No significant relationships were observed between bolus hold type and MBSImP Component 2 or 4 scores. Conclusions: A tipper bolus hold type was the most common type observed in healthy adults, although the dipper bolus hold type was also observed (albeit at a lower frequency). These study findings further contribute to defining typical swallowing behaviors.

scholarly journals Impact of COVID-19 Pandemic Exacerbation of Depressive Symptoms for Social Frailty from the ORANGE Registry

2022 ◽  
Vol 19 (2) ◽  
pp. 986
Author(s):  
Ayuto Kodama ◽  
Yu Kume ◽  
Sangyoon Lee ◽  
Hyuma Makizako ◽  
Hiroyuki Shimada ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Depressive Symptoms ◽  
Multiple Logistic Regression Analysis ◽  
Community Dwelling ◽  
Older Individuals ◽  
State Of Emergency ◽  
Frailty Status ◽  
The Social ◽  
The Impact ◽  
At Home

Background: Recent longitudinal studies have reported proportion of frailty transition in older individuals during the COVID-19 pandemic. Our study aimed at clarifying the impact of social frailty in community-dwelling older adults during the COVID-19 pandemic and at identifying factors that can predict transition to social frailty. Methods: We performed this study from 2019 (before declaration of the state of emergency over the rising number of COVID-19 cases) to 2020 (after declaration of the emergency). We applied Makizako’s social frail index to our study subjects at the baseline and classified into robust, social prefrailty, and social frailty groups. Multiple logistic regression analysis was performed using robust, social prefrailty, or social frailty status as dependent variable. Results: Analysis by the Kruskal–Wallis test revealed significant differences in the score on the GDS-15 among the robust, social prefrailty, and social frailty groups (p < 0.05). Furthermore, multiple regression analysis identified a significant association between the social frailty status and the score on GDS-15 (odds ratio, 1.57; 95% confidence interval (95% CI), 1.15–2.13; p = 0.001). Conclusion: The increase in the rate of transition of elderly individuals to the social frailty group could have been related to the implementation of the stay-at-home order as part of the countermeasures for COVID-19. Furthermore, the increased prevalence of depressive symptoms associated with the stay-at-home order could also have influenced the increase in the prevalence of social frailty during the COVID-19 pandemic.

Multidisciplinary assessment and reporting of fitness to drive in brain tumor patients: A gray matter.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6130-6130
Author(s):  
Alexander V. Louie ◽  
Esther Chan ◽  
Michelle Hanna ◽  
David Palma ◽  
Glenn Bauman ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Brain Tumour ◽  
Mail Survey ◽  
Family Physicians ◽  
Fitness To Drive ◽  
Exact Test ◽  
Physician Knowledge ◽  
Brain Radiotherapy ◽  
Factors Influencing ◽  
The Impact

6130 Background: In some jurisdictions, there is a legal requirement for physicians to report medically unfit drivers. Objectives of this study are to determine physician knowledge and attitudes on reporting legislation and driving assessment, and review our institution’s experience in evaluating fitness to drive in brain tumour patients. Methods: Physicians caring for brain tumour patients in South-western Ontario were identified by public databases and surveyed by mail. Survey questions elicited demographics, opinions, and factors influencing the decision to report. Patients receiving brain radiotherapy at our institution between January and June 2009 were identified and details of driving assessment were extracted. Fisher’s exact test and a logistic regression model were used to determine differences in responses between specialists and family physicians and factors influencing reporting. Results: Surveys (n=467) were distributed with 198 (43%) responses. Most (76%) felt that reporting guidelines were unclear. Neurologists (43%) and Family Physicians (22%) were felt to be the most responsible to report unfit drivers. Compared to specialists, Family Physicians were less likely: to be comfortable with reporting (p=0.02), to consider reporting (p<0.001), or discuss the implications of driving (p<0.001). Perceived barriers in assessing fitness to drive included: lack of tools to assess (57%) and the impact on the patient-physician relationship (34%). 158 patients were retrospectively reviewed. Forty-eight patients (30%) were reported to the provincial licensing authority and 64 (41%) were advised not to drive. 53 patients experienced seizures, of which 36 (68%) had a documented discussion on driving. Only 30 (56%) of these patients were reported to the licensing authority despite legal requirements. Age, primary disease, previous neurosurgery and seizures were predictive of reporting (p<0.05). On logistic regression modeling, seizures (OR 12.4) and primary CNS disease (OR 15.5) remained predictive of reporting. Conclusions: Despite guidelines and laws, the assessment of fitness to drive in patients with brain tumours is not routinely conducted or documented in a multidisciplinary setting.

scholarly journals The Impact of a Submaximal Level of Exercise on Balance Performance in Older Persons

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Hani Asilah Alias ◽  
Maria Justine
Keyword(s):  
Sensory Integration ◽  
Older Persons ◽  
Community Dwelling ◽  
Rank Test ◽  
Clinical Test ◽  
Older Individuals ◽  
Balance Performance ◽  
Eyes Closed ◽  
Soft Surface ◽  
The Impact

Objective. The purpose of this study was to determine the impact of a submaximal level of exercise on balance performance under a variety of conditions.Material and Method. Thirteen community-dwelling older persons with intact foot sensation (age = 66.69 ± 8.17 years, BMI = 24.65 ± 4.08 kg/m2, female,n=6) volunteered to participate. Subjects’ balance performances were measured using the Modified Clinical Test of Sensory Integration of Balance (mCTSIB) at baseline and after test, under four conditions of stance: (1) eyes-opened firm-surface (EOF), (2) eyes-closed firm-surface (ECF), (3) eyes-opened soft-surface (EOS), and (4) eyes-closed soft-surface (ECS). The 6-minute walk test (6MWT) protocol was used to induce the submaximal level of exercise. Data was analyzed using the Wilcoxon Signed-Rank Test.Results. Balance changes during EOF (z=0.00,P=1.00) and ECF (z=-1.342,P=0.180) were not significant. However, balance changes during EOS (z=-2.314,P=0.021) and ECS (z=-3.089,P=0.02) were significantly dropped after the 6MWT.Conclusion. A submaximal level of exercise may influence sensory integration that in turn affects balance performance, particularly on an unstable surface. Rehabilitation should focus on designing intervention that may improve sensory integration among older individuals with balance deterioration in order to encourage functional activities.

scholarly journals Effect of successful aging on mortality in older individuals: The PALA study

2014 ◽  
Vol 8 (2) ◽  
pp. 182-186 ◽  
Author(s):  
Ana Luiza Camozzato ◽  
Claudia Godinho ◽  
Márcia Lorena Fagundes Chaves
Keyword(s):  
Mortality Rate ◽  
Successful Aging ◽  
Healthy Aging ◽  
Causes Of Death ◽  
Cox Regression ◽  
Normal Aging ◽  
Community Dwelling ◽  
Older Individuals ◽  
Increased Risk ◽  
The Impact

ABSTRACT The definition of successful aging and identification of predictors have been extensively reviewed, less attention however, has been given to the role of this condition on mortality. Objective: To evaluate the effect of aging status (normal or successful) on mortality in a South Brazilian population-based cohort, adjusted for sociodemographic and clinical variables, and to report the mortality rate and causes of death in this population. Methods: The baseline sample comprised 345 community-dwelling, independent and healthy Southern Brazilian older individuals who were followed for 12 years. Clinical, socio-demographic, functional and cognitive variables were assessed at baseline and during the follow-up. At baseline, 214 participants fulfilled criteria for successful aging, and 131 for normal aging. The main outcome was death. Results: The Cox regression model showed an increased risk for mortality in subjects with normal aging (HR=1.9; p=0.003) adjusted by age (HR=1.1; p<0.001) and by sex (HR=1.9; p=0.002). The overall mortality rate was 41% and the rate was significantly lower among successful than normal agers (p=0.001). The main causes of death were cardiovascular disease and cancer. Conclusion: Our main finding was an increased risk of mortality among normal in comparison with successful aging subjects, emphasizing the impact of the heterogeneity of the healthy aging process on mortality.

Abstract 12981: Association of Serum Growth Differentiation Factor-15 With Egfr, Hemoglobin and Sarcopenia in Healthy Community-dwelling Older Females

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Taira Fukuda ◽  
Shigeru Toyoda ◽  
Shichiro Abe ◽  
Teruo Inoue ◽  
Toshiaki Nakajima
Keyword(s):  
Renal Dysfunction ◽  
Grip Strength ◽  
Walking Speed ◽  
Bioelectrical Impedance ◽  
Hand Grip Strength ◽  
Community Dwelling ◽  
Enzyme Linked Immunosorbent Assay ◽  
Older Individuals ◽  
Hand Grip ◽  
Healthy Community

Introduction: Anemia and sarcopenia with renal dysfunction caused by cytokine imbalance can contribute to decreased quality of life for older individuals. Several studies showed that serum GDF-15 level, a member of the TGF-β cytokine superfamily, was negatively correlated with eGFR. In this study, we examined the association of GDF-15 with eGFR, hemoglobin (Hb) and sarcopenia in healthy community-dwelling older females. Methods: A total of 66 healthy older community-dwelling females (age: 75.8 ± 6.2 years) were enrolled for this study. Skeletal muscle mass index (SMI) by bioelectrical impedance analysis, hand-grip strength and walking speed were assessed, and sarcopenia was evaluated. Serum GDF-15 concentration was determined by enzyme-linked immunosorbent assay. Hb, serum iron (Fe), serum albumin (Alb) and high-sensitive C reactive protein (hsCRP) levels were measured and estimated glomerular filtration rate (eGFR) was evaluated. Multiple linear regression analyses with serum GDF-15 concentration, eGFR and Hb as the dependent variable were performed to identify influencing independent factors. Results: Among the study subjects, 4 (6%) had sarcopenia. The serum GDF-15 level was positively correlated with age (r = 0.486, p < 0.001) and negatively correlated with walking speed (r = -0.363, p = 0.003), but there was no correlation between GDF-15 level and hand-grip strength or SMI. Serum GDF-15 level was also negatively correlated with eGFR (r = -0.535, p < 0.001) and serum Fe level, but had no correlation with hsCRP, Hb or Alb levels. In multiple regression analysis, eGFR and Hb were independent variables to predict serum GDF-15 level, even after adjusting for age and body mass index (eGFR: β = -0.423, p <0.001; Hb: β = -0.363, p=0.004). Serum GDF-15 level was an independent variable to predict eGFR and Hb. Conclusions: Serum GDF-15 level was negatively correlated with eGFR, although it had no correlation with muscle strength or mass. Both Hb and eGFR were predictors for serum GDF-15 concentration in healthy older females. In these community-dwelling older females, renal dysfunction via GDF-15 might be accompanied by anemia, but not sarcopenia.

scholarly journals Assessing the validity of RMR equations in healthy Danish community-dwelling older adults

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Simon Schacht ◽  
Ida Lysdahl Fahrenholtz ◽  
Anna Melin ◽  
Lars Holm ◽  
Inge Tetens
Keyword(s):  
Older Adults ◽  
Indirect Calorimetry ◽  
Energy Requirement ◽  
Predictive Ability ◽  
Community Dwelling ◽  
Energy Requirements ◽  
Past Century ◽  
Older Individuals ◽  
Healthy Community ◽  
Apparently Healthy

AbstractBackgroundEstimating basal energy requirements is important in terms of assessing energy balance and targeting nutritional support. Assessing Resting Metabolic Rate (RMR) via indirect calorimetry is considered a reliable way of estimating basal energy requirements. Several RMR equations have been developed during the past century through indirect calorimetry, but only few have specifically focused on older adults (> 65 yrs). This may lessen the validity of the equations in relation to older adults, as body composition which is an important determinant for energy requirement changes considerably with age. Additional studies are therefore needed to assess the validity of available RMR equations in specific populations of older adults.AimThe aim of the present study was to investigate the validity of commonly available RMR equations in a group of older apparently healthy community-dwelling Danes (65 + y).MethodsRMR was measured by indirect calorimetry (mRMR) in 42 older individuals (10 females and 32 males; 65–81 years) participating in the CALM intervention study. Oxygen consumption and carbon dioxide production was measured for 25 min using a ventilated open hood system (Oxycon Pro 4; Jeager, Hoechberg, Germany). Predicted RMR (pRMR) was calculated using four different equations; the Harris-Benedict (1919) (HB), the Mifflin et al. (1990), the Lührmann et al. (2002) and the Henry et al. (2005) equations. The ratio between mRMR and pRMR (RMRratio) as well as the predictive ability (percentage of individual pRMR within + /-10% of mRMR) were calculated as a measure of validity.ResultsRMRratio for both sexes combined was 0.95 ± 0.08 for HB, 0.97 ± 0.07 for Mifflin et al., 0.92 ± 0.06 for Lürhmann et al. and 0.94 ± 0.07 for the Henry equations, respectively. The predictive ability was 73.8% (78.1% males and 60.0% of females, p = 0.410) for the HB, 81.0% (81.3% of males, and 80.0% of females, p≈1.00) for the Mifflin et al., 54.8% (56.3% of males and 50.0% of females, p≈1.00) for the Lührmann et al. equation, and 59.5% (59.4% of males and 60.0% of females, p≈1.00) for the Henry equations, respectively.ConclusionIn the present study, we found that the Mifflin equation was the most valid equations for predicting the RMR of older apparently healthy community-dwelling Danes. Generally, RMRratios and predictive ability were slightly lower for the H-B and Henry equations and lowest for the Lürhmann equation.

scholarly journals Prevention of falls in old people – a review

2013 ◽  
Vol 23 (3) ◽  
pp. 206-222 ◽  
Author(s):  
Magnus K. Karlsson ◽  
Caroline Karlsson ◽  
Maria Cöster ◽  
Håkan Magnusson ◽  
Björn E. Rosengen
Keyword(s):  
Vitamin D ◽  
Older People ◽  
Fall Risk ◽  
Risk Groups ◽  
Vitamin D Supplementation ◽  
Community Dwelling ◽  
Older Individuals ◽  
Surgical Interventions ◽  
Healthy Community ◽  
Training Modalities

SummaryPhysical training, if including specific different training modalities, reduces the fall risk in healthy community-dwelling older people, as does a home hazards modification programme. Vitamin D supplementation in older individuals with low levels of vitamin D, adjustment of psychotropic medication, and structured modification of multi-pharmacy are all drug-focused programmes that reduce the number of falls. Anti-slip shoe devices during icy conditions for older people who walk outdoors and multifaceted podiatry in patients with specific foot disability reduce the fall risk. First eye cataract surgery and pacemakers in patients with cardio-inhibitory carotid sinus hypersensitivity are surgical interventions that reduce the fall risk. Multi-factorial preventive programmes that include training, both individually designed and generally prescribed, also reduce the fall frequency. With this in mind, we ought to initiate fall preventive programmes in older people, especially in high- risk groups, to reduce the number of falls and fallers in society.

scholarly journals 40 The Association between Apathy, Decline in Physcal Performance, and Falls

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv9-iv12
Author(s):  
Marieke Henstra ◽  
Didi Rhebergen ◽  
Lisette De Groot ◽  
Natasja Van Schoor ◽  
Nathalie Van der Velde
Keyword(s):  
Physical Performance ◽  
Fall Risk ◽  
Older Persons ◽  
Osteoporotic Fractures ◽  
Community Dwelling ◽  
Older Individuals ◽  
Negative Effects ◽  
Age And Gender ◽  
And Gender ◽  
The Impact

Abstract Background Symptoms of apathy are common in older persons. Negative effects on physical performance and fall risk are plausible, considering the pathophysiology of apathy. However, literature is scarce. Aim To longitudinally assess the association between apathy and 1) decline of physical performance and 2) the number of falls in older community-dwelling persons. Methods The ‘B-vitamins for the PRevention Of Osteoporotic Fractures’ study (B-PROOF) provided data on 2919 older persons over a period of two years. Apathy was assessed using the Geriatric Depression Scale3. A physical performance score (PPS) was calculated using three performance tests. Falls were registered prospectively. We calculated adjusted odds ratios (ORs), Incidence Rate Ratios (IRRs) their 95% confidence intervals (CI). Effect-modification by age and gender was investigated. We also investigated mediation by baseline PPS for the association between apathy and the number of falls. Results Apathy and decline of PPS were independently associated. After stratification, the effect only remained in men. Age was an effect modifier; higher ORs for decreasing age. Apathy was also independently associated with the number of falls. After stratification, women had higher IRRs than men. Age modified the association in the opposite direction: higher IRRs for increasing age. Baseline PPS was a mediator in the association. Conclusion The impact of apathy on physical performance and fall-incidents varied with age and gender. Potentially, in older individuals with apathy, fall risk is preceded by a decline in physical performance. In clinical practice, identifying apathy in older persons might be useful to target mobility preserving interventions.

scholarly journals Physical Activity and Cumulative Long-Term Care Cost among Older Japanese Adults: A Prospective Study in JAGES

2021 ◽  
Vol 18 (9) ◽  
pp. 5004
Author(s):  
Hiroshi Hirai ◽  
Masashige Saito ◽  
Naoki Kondo ◽  
Katsunori Kondo ◽  
Toshiyuki Ojima
Keyword(s):  
Physical Activity ◽  
Long Term Care ◽  
Evaluation Study ◽  
Community Dwelling ◽  
Older Individuals ◽  
Term Care ◽  
Cumulative Cost ◽  
Classical Linear Regression ◽  
The Impact

This study aimed to determine the impact of physical activity on the cumulative cost of long-term care insurance (LTCI) services in a cohort of community-dwelling people (65 years and older) in Japan. Using cohort data from the Japan Gerontological Evaluation Study (JAGES) on those who were functionally independent as of 2010/11, we examined differences in the cumulative cost of LTCI services by physical activity. We followed 38,875 participants with LTCI service costs for 59 months. Physical activity was assessed by the frequency of going out and time spent walking. We adopted a generalized linear model with gamma distribution and log-link function, and a classical linear regression with multiple imputation. The cumulative LTCI costs significantly decreased with the frequency of going out and the time spent walking after adjustment for baseline covariates. LTCI’s cumulative cost for those who went out once a week or less was USD 600 higher than those who went out almost daily. Furthermore, costs for those who walked for less than 30 min were USD 900 higher than those who walked for more than 60 min. Physical activity among older individuals can reduce LTCI costs, which could provide a rationale for expenditure intervention programs that promote physical activity.

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