Excess risk of early death in the elderly attributable to activities of daily living, mental status and traditional risk factors: The Shibata Elderly Cohort Study with a 20-year follow up

2003 ◽  
Vol 3 (1) ◽  
pp. 24-35 ◽  
Author(s):  
Wakako Kushiro ◽  
Tetsuji Yokoyama ◽  
Chigusa Date ◽  
Nobuo Yoshiike ◽  
Heizo Tanaka
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Activities Of Daily Living ◽  
Mental Status ◽  
Daily Living ◽  
Early Death ◽  
The Elderly ◽  
Traditional Risk Factors ◽  
Elderly Cohort

scholarly journals Incidence and risk factors for falls among community-dwelling elderly subjects on a 1-year follow-up: a prospective cohort study from Ernakulam, Kerala, India

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e033691
Author(s):  
Divyamol K Sasidharan ◽  
Priya Vijayakumar ◽  
Manu Raj ◽  
Sumi Soman ◽  
Libin Antony ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Activities Of Daily Living ◽  
Movement Disorders ◽  
Prospective Cohort ◽  
Daily Living ◽  
The Elderly ◽  
Community Dwelling ◽  
Living Alone

ObjectivesThere is limited knowledge regarding epidemiology and risk of falls among the elderly living in low-income and middle-income countries. In this situation, the current study aims to report the incidence of falls and associated risk factors among free living elderly population from Kerala, India.DesignProspective cohort study with stratified random cluster sampling.SettingThe study location was Ernakulam, Kerala, India, and we collected information via house visits using a questionnaire. During the research, the subjects were followed up prospectively for 1 year by phone at intervals of 3 months and missing subjects were contacted by house visits.ParticipantsCommunity-dwelling elderly above 65 years of age.ResultsWe recruited a total of 1000 participants out of which a total of 201 (20.1%) subjects reported a fall during the follow-up. The incidence rate of falls was 31 (95% CI 27.7 to 34.6) per 100 person-years. Female sex (OR 1.48, 95% CI 1.05 to 2.10, p=0.027), movement disorders including Parkinsonism (OR 2.26, 95% CI 1.00 to 5.05, p=0.048), arthritis (OR 1.48, 95% CI 1.05 to 2.09, p=0.026), dependence in basic activities of daily living (OR, 3.49, 95% CI 2.00 to 6.09, p<0.001), not using antihypertensive medications (OR, 1.53, 95% CI 1.10 to 2.13, p=0.012), living alone during daytime (OR 3.27, 95% CI 1.59 to 6.71, p=0.001) and a history of falls in the previous year (OR, 2.25, 95% CI 1.60 to 3.15, p<0.001) predicted a fall in the following year.ConclusionsOne in five community-dwelling senior citizen fall annually and one in four who fall are prone to fall again in the following year. Interventions targeting falls among the elderly need to focus on modifiable risk factors such as living alone during daytime, movement disorders, arthritis and dependence on basic activities of daily living.

scholarly journals Depressive symptoms, emotional support and activities of daily living disability onset: 15-year follow-up of the Bambuí (Brazil) Cohort Study of Aging

2018 ◽  
Vol 34 (7) ◽  
Author(s):  
Juliana Lustosa Torres ◽  
Erico Castro-Costa ◽  
Juliana Vaz de Melo Mambrini ◽  
Sérgio William Viana Peixoto ◽  
Breno Satler de Oliveira Diniz ◽  
...  
Keyword(s):  
Cohort Study ◽  
Social Network ◽  
Depressive Symptoms ◽  
Activities Of Daily Living ◽  
Psychosocial Factors ◽  
Emotional Support ◽  
Daily Living ◽  
Wide Range

Psychosocial factors appear to be associated with increased risk of disability in later life. However, there is a lack of evidence based on long-term longitudinal data from Western low-middle income countries. We investigated whether psychosocial factors at baseline predict new-onset disability in long term in a population-based cohort of older Brazilians adults. We used 15-year follow-up data from 1,014 participants aged 60 years and older of the Bambuí (Brazil) Cohort Study of Aging. Limitations on activities of daily living (ADL) were measured annually, comprising 9,252 measures. Psychosocial factors included depressive symptoms, social support and social network. Potential covariates included sociodemographic characteristics, lifestyle, cognitive function and a physical health score based on 10 self-reported and objectively measured medical conditions. Statistical analysis was based on competitive-risk framework, having death as the competing risk event. Baseline depressive symptoms and emotional support from the closest person were both associated with future ADL disability, independently of potential covariates wide range. The findings showed a clear graded association, in that the risk gradually increased from low emotional support alone (sub-hazard ratio - SHR = 1.11; 95%CI: 1.01; 1.45) to depressive symptoms alone (SHR = 1.52; 95%CI: 1.13; 2.01) and then to both factors combined (SHR = 1.61; 95%CI: 1.18; 2.18). Marital status and social network size were not associated with incident disability. In a population of older Brazilian adults, lower emotional support and depressive symptoms have independent predictive value for subsequent disability in very long term.

Activities of Daily Living after Hip Fracture: Pre- and Post Discharge

1992 ◽  
Vol 12 (6) ◽  
pp. 342-356 ◽  
Author(s):  
Mary Egan ◽  
S.A. Warren ◽  
Patrick A. Hessel ◽  
Gail Gilewich
Keyword(s):  
Social Support ◽  
Health Status ◽  
Activities Of Daily Living ◽  
Mental Status ◽  
Daily Living ◽  
Post Discharge ◽  
Telephone Interviews ◽  
Adl Performance ◽  
At Home

Sixty-one individuals hospitalized for hip fractures received activities of daily living (ADL) assessments during the 3 days prior to discharge. Information was also collected regarding anticipated role loss, depression, mental status, health status, and social support. Independence in ADL at home was measured 3 weeks following discharge by telephone interviews. The concordance between predischarge and post discharge ADL scores was low but statistically significant (Kw = .223; p < .05). Approximately 50.8% of the subjects demonstrated greater dependence post discharge. More dependent ADL performance at home was not related to role loss, depression, mental status, health status, or social support. Predischarge ADL assessments are often taken into consideration when formulating discharge plans. However, these evaluations do not always accurately predict post discharge ADL independence. It is recommended, therefore, that community follow-up be carried out with patients who have fractured hips.

scholarly journals Postoperative Delirium Is Associated with Long-term Decline in Activities of Daily Living

2019 ◽  
Vol 131 (3) ◽  
pp. 492-500 ◽  
Author(s):  
Zhongyong Shi ◽  
Xinchun Mei ◽  
Cheng Li ◽  
Yupeng Chen ◽  
Hailin Zheng ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Postoperative Delirium ◽  
Postoperative Mortality ◽  
The Elderly ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Lost To Follow Up

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Postoperative delirium is one of the most common complications in the elderly surgical population. However, its long-term outcomes remain largely to be determined. Therefore a prospective cohort study was conducted to determine the association between postoperative delirium and long-term decline in activities of daily living and postoperative mortality. The hypothesis in the present study was that postoperative delirium was associated with a greater decline in activities of daily living and higher mortality within 24 to 36 months after anesthesia and surgery. Methods The participants (at least 65 yr old) having the surgeries of (1) proximal femoral nail, (2) hip replacement, or (3) open reduction and internal fixation under general anesthesia were enrolled. The Confusion Assessment Method algorithm was administered to diagnose delirium before and on the first, second, and fourth days after the surgery. Activities of daily living were evaluated by using the Chinese version of the activities of daily living scale (range, 14 to 56 points), and preoperative cognitive function was assessed by using the Chinese Mini-Mental State Examination (range, 0 to 30 points). The follow-up assessments, including activities of daily living and mortality, were conducted between 24 and 36 months after anesthesia and surgery. Results Of 130 participants (80 ± 6 yr, 24% male), 34 (26%) developed postoperative delirium during the hospitalization. There were 32% of the participants who were lost to follow-up, resulting in 88 participants who were finally included in the data analysis. The participants with postoperative delirium had a greater decline in activities of daily living (16 ± 15 vs. 9 ± 15, P = 0.037) and higher 36-month mortality (8 of 28, 29% vs. 7 of 75, 9%; P = 0.009) as compared with the participants without postoperative delirium. Conclusions Postoperative delirium was associated with long-term detrimental outcomes, including greater decline in activities of daily living and a higher rate of postoperative mortality.

Prevalence and risk factors for attempted suicide in the elderly: a cross-sectional study in Shanghai, China

2016 ◽  
Vol 29 (5) ◽  
pp. 709-715 ◽  
Author(s):  
Wei Zhang ◽  
Hansheng Ding ◽  
Peng Su ◽  
Qin Xu ◽  
Lixia Du ◽  
...  
Keyword(s):  
Risk Factors ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Attempted Suicide ◽  
The Elderly ◽  
Bivariate Analysis ◽  
Cluster Sampling ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Increased Risk

ABSTRACTBackground:Previous studies have thoroughly investigated the prevalence and risk factors for completed suicide. In marked contrast is the lack of a better understanding of attempted suicide in the elderly. The aim of this study was to estimate the prevalence of attempted suicide in the elderly and examine the associated factors.Methods:Using a multi-stage cluster sampling approach, a cross-sectional survey of 8,399 elderly house-dwelling residents was conducted in Shanghai, China.Results:The two-week prevalence of attempted suicide in the elderly was 0.75%. In the bivariate analysis, having no caregivers, depressive, anxiety, sad, fear, obsessive-compulsive and anger symptom, and lower scores on the Barthel Index of Activities of Daily Living and the Lawton Instrumental Activities of Daily Living Scale were significantly associated with an increased risk of attempted suicide in the elderly. In the multivariate analysis, sad and fear symptoms were significantly and independently associated with a higher risk of attempted suicide in the elderly.Conclusion:The two-week prevalence of attempted suicide in the elderly is relatively high when compared with the annualized or lifetime prevalence reported in China and foreign settings. Elderly individuals with certain mental symptoms should be targeted for suicide prevention and provided with timely mental health support.

A practical clinical score to predict early death after a comprehensive geriatric assessment (CGA) in elderly cancer patients: A prospective cohort study with 608 patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21537-e21537
Author(s):  
Jurema Telles O Lima ◽  
Anke Bergmann ◽  
Maria Julia Gonçalves Mello ◽  
Zilda Cavalcanti ◽  
Mirella Rebello Bezerra ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Cancer Patients ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Prospective Cohort ◽  
Early Death ◽  
Clinical Score ◽  
Elderly Cancer Patients

e21537 Background: Components of the comprehensive geriatric assessment (CGA) correlate with risk of early mortality in elderly cancer patients (ECP). However, its complexity and the time required for its administration. The aim of this study was to determine the impact of each CGA domain on overall survival(OS) and to first step for the development of a prognostic scoring system to stratify ECP. Methods: a prospective cohort study. Participants with a recent diagnosis of cancer were from eight hospitals and one cancer center in Brazil and were recruited during their first medical appointment at the outpatient oncologic clinic. A basal CGA was done before the care decision (ADL, Charlson Comorbidity Index- CCI, Karnofsky Performance status – KPS, GDS15, IPAQ, MMSE, MNA, MNA-SF, PS, PPS, Polipharmacy, QLQc30, TUG). During the follow up of six months, information about the treatments performed and early death was collected. OS was estimated using the Kaplan–Meier method, and survival curves were compared using the Log rank test for categorical variables. A multivariate Cox proportional hazards model was used to select early death risk factors. A clinical score considering the number of risk variables was created. Results: From 2015-2016, 608 ECP, mean age 71.9 (SD ±7.4; range 60-96), 50.7% male, were enrolled. 100 (16.4%) ECP died in less than six months of follow-up. In our multivariate model, controlled by age, site of cancer and cancer stage, the remaining significant risk factors were malnutrition/nonutrition determined by MNA (HR 3.3, 95%CI 1.81-5.99, p < 0.001), KPS < 50% (HR 2.44, CI 1.56-3.81, p < 0.001) and CCI > 2 (HR 1.6, CI 1.09-2.52, p = 0.018). The risk for early death according to the number of risk variables: three (HR 12.99, CI 5.69-29.60, p < 0.001), two (HR 5.65, CI 2.61-12.24, p < 0.001) or one (HR 2.7, CI 1.28-5.87, p = 0.009). Conclusions: a practical clinical score using three instruments of the CGA (MNA, KPS and CCI) can predict independent the risk for an early death in ECP. The development of a practical system for risk scoring, incorporating few clinical prognostic factors, helps to stratify patients into risk groups and to plan a personalized care.

scholarly journals A retrospective multicenter analysis of elderly Hodgkin lymphoma: outcomes and prognostic factors in the modern era

Blood ◽  
2012 ◽  
Vol 119 (3) ◽  
pp. 692-695 ◽  
Author(s):  
Andrew M. Evens ◽  
Irene Helenowski ◽  
Erika Ramsdale ◽  
Chadi Nabhan ◽  
Reem Karmali ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Activities Of Daily Living ◽  
Hodgkin Lymphoma ◽  
Daily Living ◽  
Prognostic Score ◽  
Geriatric Syndrome ◽  
Multicenter Analysis ◽  
Modern Era

AbstractWe investigated a recent (January 1999 to December 2009) cohort of 95 elderly Hodgkin lymphoma subjects. At diagnosis, median age was 67 years (range, 60-89 years), whereas 61% had significant comorbidity, 26% were unfit, 17% had a geriatric syndrome, and 13% had loss of activities of daily living. Overall response rate to therapy was 85%, whereas incidence of bleomycin lung toxicity was 32% (with associated mortality rate, 25%). With 66-month median follow-up, 2-year and 5-year overall survival were 73% and 58%, respectively (advanced-stage, 63% and 46%, respectively). Most International Prognostic Score factors were not prognostic on univariate analyses, whereas Cox multivariate regression identified 2 risk factors associated with inferior overall survival: (1) age more than 70 years (2.24; 95% CI, 1.16-4.33, P = .02) and (2) loss of activities of daily living (2.71; 95% CI, 1.07-6.84, P = .04). Furthermore, a novel survival model based on number of these risk factors (0, 1, or 2) showed differential 2-year OS of 83%, 70%, and 13%, respectively (P < .0001) and 5-year OS of 73%, 51%, and 0%, respectively (P < .0001).

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