Executive functioning independently predicts self-rated health and improvement in self-rated health over time among community-dwelling older adults

ObjectivesPoor self-rated health (SRH) is a strong predictor of premature mortality in older adults. Trajectories of poor SRH are associated with multimorbidity and unhealthy behaviours. Whether trajectories of SRH are associated with deviating physiological markers is unclear. This study identified trajectories of SRH and investigated the associations of trajectory membership with chronic diseases, health risk behaviours and physiological markers in community-dwelling older adults.Study design and settingProspective general population cohort.ParticipantsTrajectories of SRH over 5 years were identified using data of 11 600 participants aged 65 years and older of the Lifelines Cohort Study.Outcome measuresTrajectories of SRH were the main outcome. Covariates included demographics (age, gender, education), chronic diseases, health-risk behaviour (physical activity, smoking, drinking) and physiological markers (body mass index, cardiovascular function, lung function, glucose metabolism, haematological condition, endocrine function, renal function, liver function and cognitive function).ResultsFour stable trajectories were identified, including excellent (n=607, 6%), good (n=2111, 19%), moderate (n=7677, 65%) and poor SRH (n=1205, 10%). Being women (OR: 1.4; 95% CI: 1.0 to 1.9), low education (OR: 2.1; 95% CI: 1.5 to 3.0), one (OR: 10.4; 95% CI: 7.4 to 14.7) or multiple chronic diseases (OR: 37.8; 95% CI: 22.4 to 71.8), smoking (OR: 1.8; 95% CI: 1.0 to 3.2), physical inactivity (OR: 3.1; 95% CI: 1.8 to 5.2), alcohol abstinence (OR: 2.2; 95% CI: 1.4 to 3.2) and deviating physiological markers (OR: 1.5; 95% CI: 1.1 to 2.0) increase the odds for a higher probability of poor SRH trajectory membership compared with excellent SRH trajectory membership.ConclusionSRH of community-dwelling older adults is stable over time with the majority (65%) having moderate SRH. Older adults with higher probabilities of poor SRH often have unfavourable health status.

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Executive Function - 3 Self-Reported Complexity of Daily Life Moderates the Association Between Executive Functioning and Daily Medication Management in Community Dwelling Older Adults

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acy060.18 ◽

2018 ◽

Vol 33 (6) ◽

pp. 692-702

Author(s):

Y Suchy ◽

R Ziemnik ◽

M Niermeyer ◽

S Lopez ◽

A Ray ◽

...

Keyword(s):

Older Adults ◽

Executive Function ◽

Executive Functioning ◽

Daily Life ◽

Medication Management ◽

Community Dwelling ◽

Community Dwelling Older Adults

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Longitudinal relationships between subjective fatigue, cognitive function, and everyday functioning in old age

International Psychogeriatrics ◽

10.1017/s1041610212001718 ◽

2012 ◽

Vol 25 (2) ◽

pp. 275-285 ◽

Cited By ~ 22

Author(s):

Feng Lin ◽

Ding-Geng Chen ◽

David E. Vance ◽

Karlene K. Ball ◽

Mark Mapstone

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Latent Class ◽

Growth Mixture Modeling ◽

Community Dwelling ◽

Everyday Functioning ◽

Subjective Fatigue ◽

Community Dwelling Older Adults ◽

Over Time

ABSTRACTBackground: The present study examined the prospective relationships between subjective fatigue, cognitive function, and everyday functioning.Methods: A cohort study with secondary data analysis was conducted using data from 2,781 community-dwelling older adults without dementia who were enrolled to participate in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized intervention trial. Measures included demographic and health information at baseline, and annual assessments of subjective fatigue, cognitive function (i.e. speed of processing, memory, and reasoning), and everyday functioning (i.e. everyday speed and everyday problem-solving) over five years.Results: Four distinct classes of subjective fatigue were identified using growth mixture modeling: one group complaining fatigue “some of the time” at baseline but “most of the time” at five-year follow-up (increased fatigue), one complaining fatigue “a good bit of the time” constantly over time (persistent fatigue), one complaining fatigue “most of the time” at baseline but “some of the time” at five-year follow-up (decreased fatigue), and the fourth complaining fatigue “some of the time” constantly over time (persistent energy). All domains of cognitive function and everyday functioning declined significantly over five years; and the decline rates, but not the baseline levels, differed by the latent class of subjective fatigue. Except for the decreased fatigue class, there were different degrees of significant associations between the decline rates of subjective fatigue and all domains of cognitive function and everyday functioning in other classes of subjective fatigue.Conclusion: Future interventions should address subjective fatigue when managing cognitive and functional abilities in community-dwelling older adults.

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Same, same, but different? A longitudinal, mixed-methods study of stability in values and preferences for future end-of-life care among community-dwelling, older adults

BMC Palliative Care ◽

10.1186/s12904-021-00839-7 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Malin Eneslätt ◽

Gert Helgesson ◽

Carol Tishelman

Keyword(s):

Older Adults ◽

Decision Making ◽

Mixed Methods ◽

End Of Life ◽

End Of Life Care ◽

Community Dwelling ◽

Life Care ◽

T1 And T2 ◽

Community Dwelling Older Adults ◽

Over Time

Abstract Background End-of-life preferences may change over time, e.g. due to illness progression or life events. Research on stability of end-of-life preferences has largely focused on life-sustaining treatments in seriously ill patients or medical decision-making based on hypothetical illness scenarios and possible treatment options. Few studies focus on community-dwellers in natural settings. The aim of this study was thus to explore if and how community-dwelling, older adults’ prioritizations and reasoning about values and preferences for future end-of-life care change over time. Methods Using a mixed-methods design, we explored stability of end-of-life preferences in older community-dwelling adults without imminent end-of-life care needs. At two timepoints (T1 and T2), 5.5–12 months apart, 52 individuals discussed what would be important to them at the end-of-life, through open conversations and while using DöBra cards, a Swedish version of GoWish cards. Participants ranked their most important card statements from 1 to 10. Stability in card rankings, i.e. a card recurring in the top-10 ranking at T2 regardless of position, was explored using descriptive statistics and non-parametric analyses. Participants’ reasoning about card choices were explored with longitudinal qualitative analysis. Results Stability between T1 and T2 in the top-10 priorities ranged from 20 to 80%, median 60%. Stability in cards rankings could not be explained by changes in participants’ health status, extent of card use (no/little/frequent use) between interviews, or days between T1 and T2, nor was it related to demographic variables. Qualitative analysis showed that consistent reasoning was not always paired with consistency in card choices and changed card choices were not always related to changes in reasoning. Conclusions Longitudinal exploration combining DöBra card rankings with underlying reasoning about end-of-life preferences over time furthers knowledge on the dynamics between values and preferences in end-of-life decision-making. Individuals’ end-of-life preferences in form of card choices were relatively stable over time albeit with large variation between different individuals. However, the values and underlying reasoning that participants used to motivate their choices appeared more stable than ranking of card choices. We thus conclude that concurrent conversation-based exploration is a more comprehensive indicator of end-of-life values and preferences over time than ranking of cards alone.

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Prevalence and factors associated with poor self-rated health among community dwelling older adults in Lomé (Togo) in 2019

Journal of Public Health in Africa ◽

10.4081/jphia.2020.1302 ◽

2020 ◽

Vol 11 (1) ◽

Author(s):

Fifonsi Adjidossi Gbeasor-Komlanvi ◽

Martin Kouame Tchankoni ◽

Ama Boilassi Adjonko ◽

Wendpouire Ida Carine Zida-Compaore ◽

Nicolas Konan Kouakou ◽

...

Keyword(s):

Older Adults ◽

Cross Sectional Study ◽

Community Dwelling ◽

Sub Saharan Africa ◽

Cross Sectional ◽

Herbal Products ◽

Factors Associated ◽

Self Rated Health ◽

Sub Saharan ◽

Community Dwelling Older Adults

The number of older adults is increasing worldwide, including in sub-Saharan Africa (SSA). However, there is a paucity of data on the overall health status of older adults living in SSA. To assess the prevalence and factors associated with poor Self-Rated Health (SRH) among community-dwelling older adults in Lomé, Togo, we conducted a cross-sectional study from January to June 2019 in Lomé among community-dwelling older adults aged 50 years and older. A 30- minute questionnaire was used to collect socio-demographic characteristics, medical history, patterns of medication use and use of herbal products and dietary supplements during a face-to-face interview. SRH was assessed using a single item: Overall, you would say that your health is… (1) excellent, (2) very good, (3) good, (4) fair and (5) poor with response fair or poor defining poor SRH. A total of 344 respondents with median age 63 years, (IQR: 55-72) were enrolled in the study. Women represented 57.6% of the sample. Overall prevalence of poor SRH was 56.4% (95%CI: 51.0-61.9) and was the highest among females (62.6% vs 47.9%; P=0.007) and participants >60 years (61.5% vs 51.1%; P=0.021). Female sex, aged ≥60 years, osteoarthritis, hospitalization within the 12 months preceding the survey, polypharmacy, and the use of herbal products were factors associated with poor SRH (P<0.05). More than half of community- dwelling older adults had poor SRH in Lomé. Further studies are needed to guide policymakers in their efforts to design and implement meaningful policies to improve older adults health conditions.

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