scholarly journals A systematic review of the evidence for the efficacy of opioids for chronic non-cancer pain in community-dwelling older adults

2020 ◽  
Vol 49 (2) ◽  
pp. 175-183
Author(s):  
Michael David Cory O’Brien ◽  
Anne Pamela Frances Wand
Keyword(s):  
Systematic Review ◽  
Older People ◽  
Cancer Pain ◽  
Activities Of Daily Living ◽  
Social Engagement ◽  
Daily Living ◽  
Nursing Home Residents ◽  
Community Dwelling ◽  
Opioid Use ◽  
Opioid Prescription

Abstract Introduction the ageing global population and concomitant increase in the use of opioid analgesia have highlighted the need to evaluate the effectiveness of opioids for chronic pain in older people. Methods a systematic review of the evidence for the efficacy of opioids for chronic non-cancer pain in community-dwelling people aged 65 years or more was conducted using PRISMA guidelines. The databases MEDLINE, EMBASE, Pubmed and PsychINFO were searched. The quality of studies was assessed. Secondary aims were to assess correlates of opioid use and the decision-making processes of prescribers. Results seven studies were identified of low to high quality. The majority of older people experienced ongoing pain despite continuing opioid therapy. There were mixed results regarding benefits of opioids in terms of activities of daily living and social engagement. In nursing home residents, opioid use at baseline was associated with severe pain, severe impairment in activities of daily living and a diagnosis of depression. Fear of causing harm to older people was common amongst opioid prescribers, limiting prescription. Facilitators of opioid prescription included educational interventions and access to an evidence base for opioid use. Conclusion there is limited evidence supporting the use of long-term opioid use in older people for chronic non-cancer pain and a lack of trials in this age group. Age-specific guidelines are required addressing initial assessment, indications, monitoring and de-prescribing.

scholarly journals Interventions to reduce dependency in personal activities of daily living in community dwelling adults who use homecare services: a systematic review

2015 ◽  
Vol 29 (11) ◽  
pp. 1064-1076 ◽  
Author(s):  
Phillip J Whitehead ◽  
Esme J Worthington ◽  
Ruth H Parry ◽  
Marion F Walker ◽  
Avril ER Drummond
Keyword(s):  
Systematic Review ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Community Dwelling

Instrumental activities of daily living performance in healthy and cognitively intact seniors from a Brazilian sample and its relation to age and other socio-demographic variables

2012 ◽  
Vol 24 (5) ◽  
pp. 784-793 ◽  
Author(s):  
Pedro Fonseca Zuccolo ◽  
Renata Ávila ◽  
Eduardo Y. Nakano ◽  
Júlio Litvoc ◽  
Marcos A. Lopes ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Older People ◽  
Activities Of Daily Living ◽  
Functional Capacity ◽  
Daily Living ◽  
Demographic Variables ◽  
Community Dwelling ◽  
Medical Conditions ◽  
Instrumental Activities ◽  
Cognitively Intact

ABSTRACTBackground: Studies on functional capacity in community-dwelling older people have shown associations between declines in instrumental activities of daily living (IADL) and several factors. Among these, age has been the most consistently related to functional capacity independent of other variables. We aimed at evaluating the performance of a sample of healthy and cognitively intact Brazilian older people on activities of daily living and to analyze its relation to social-demographic variables.Methods: We conducted a secondary analysis of data collected for previous epidemiological studies with community-dwelling subjects aged 60 years or more. We selected subjects who did not have dementia or depression, and with no history of neurological diseases, heart attack, HIV, hepatitis or arthritis (n = 1,111). Functional capacity was assessed using the Brazilian version of the Older American Resources and Services Questionnaire (BOMFAQ). ADL performance was analyzed according to age, gender, education, and marital status (Pearson's χ2, logistic regression).Results: IADL difficulties were present in our sample, especially in subjects aged 80 years or more, with lower levels of education, or widowed. The logistic regression analysis results indicated that “higher age” and “lower education” (p ≤ 0.001) remained significantly associated with IADL difficulty.Conclusions: Functional decline was present in older subjects even in the absence of medical conditions and cognitive impairment. Clinicians and researchers could benefit from knowing what to expect from older people regarding IADL performance in the absence of medical conditions.

scholarly journals Use of personal call alarms among community-dwelling older people

2012 ◽  
Vol 34 (1) ◽  
pp. 67-89 ◽  
Author(s):  
SAMUEL R. NYMAN ◽  
CHRISTINA R. VICTOR
Keyword(s):  
Older People ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Community Dwelling ◽  
Living Alone ◽  
Cross Sectional ◽  
Term Care ◽  
Community Dwelling Older People ◽  
Serious Injury

ABSTRACTHaving a fall and then lying on the floor for an hour or more is known as a ‘long lie’, which is associated with serious injury and an elevated risk of admission to hospital, long-term care and death. Personal call alarms are designed to prevent long lies, although little is known about their use. Using cross-sectional data from the English Longitudinal Study on Ageing, this study investigated the proportion of self-reported users of personal call alarms among 3,091 community-dwelling adults aged 65+ who reported difficulties of mobility or activities of daily living. The characteristics of users were then explored through logistic regressions comparing those living alone with those living with others. One hundred and eighty people self-reported using a personal call alarm (6%). Multivariate regression found the following to significantly predict personal call alarm use among both those living alone and with others: greater difficulty with activities/instrumental activities of daily living, older age, and for those living with others only: lower score on the quality of life subscale for control. Personal call alarm use may be markedly lower than the 30 per cent annual incidence of falls among community-dwelling older people. Better understanding is needed of the reasons for low usage, even amongst those at highest falls risk for whom such alarms are most likely to be beneficial.

scholarly journals Koettu terveys, elintavat ja fyysinen toimintakyky – vuosina 1920 ja 1940 syntyneiden kohorttien vertailu

Gerontologia ◽  
2017 ◽  
Vol 31 (4) ◽  
pp. 253-264
Author(s):  
Riitta Henriksson ◽  
Marika Salminen ◽  
Seija Arve ◽  
Matti Viitanen ◽  
Sini Eloranta
Keyword(s):  
Body Mass Index ◽  
Alcohol Consumption ◽  
Older People ◽  
Activities Of Daily Living ◽  
Body Mass ◽  
Health Behaviour ◽  
Physical Functioning ◽  
Daily Living ◽  
Perceived Health ◽  
Community Dwelling

Tutkimuksen tarkoituksena oli vertailla vuosina 1920 (n = 1032) ja 1940 (n = 956) syntyneiden 70-vuotiaiden kotona asuvien turkulaisten koettua terveyttä, elintapoja ja fyysistä toimintakykyä. Tiedot koetusta terveydestä, elintavoista (tupakointi, alkoholinkäyttö ja painoindeksi) ja fyysisestä toimintakyvystä (päivittäiset toiminnot, välineelliset toiminnot ja päivittäisiä toimintoja haittaavat oireet) kerättiin kyselylomakkeiden ja haastatteluiden avulla. Tulosten mukaan vuonna 1940 syntyneet kokivat terveytensä ja fyysisen toimintakykynsä paremmiksi kuin vuonna 1920 syntyneet. Lisäksi 1940 syntyneillä oli vähemmän päivittäistä toimintaa haittaavia oireita kuin vuonna 1920 syntyneillä. Alkoholin käyttö ja ylipaino sen sijaan olivat yleisempiä 1940 syntyneiden kuin 1920 syntyneiden keskuudessa. Tulokset ovat tärkeitä suunniteltaessa ennaltaehkäiseviä palveluita ikääntyville. Self-perceived health, health behaviour and physical functioning – a comparison of two cohorts born in 1920 and 1940 The aim of the study was to compare differences in self-perceived health, health behaviour and physical functioning between community-dwelling 70-year-old citizens of Turku born in 1920 (n=1032) and 1940 (n=956). Data of self-perceived health, health behaviour (smoking, alcohol consumption, body mass index) and physical functioning (activities of daily living, instrumental activities of daily living, symptoms causing difficulties in daily living) were collected using questionnaires and interviews. According to the results, self-perceived health and physical functioning were better among those born in 1940 than among those born in 1920. In addition, symptoms causing difficulties in daily living were less frequent in 1940 cohort than in 1920 cohort. However, alcohol consumption and overweight were more common in 1940 cohort compared to 1920 cohort. These results are applicable in planning of preventive services for older people.

scholarly journals Independence and Caregiver Preferences Among Community-Dwelling Older People in Slovenia: A Cross-Sectional Study

2019 ◽  
Vol 56 ◽  
pp. 004695801986915
Author(s):  
Katarina Galof ◽  
Anja Žnidaršič ◽  
Zvone Balantič
Keyword(s):  
Older People ◽  
Activities Of Daily Living ◽  
Home Environment ◽  
Daily Living ◽  
Community Dwelling ◽  
Daily Activities ◽  
Rank Test ◽  
Cross Sectional ◽  
Term Care ◽  
At Home

Although Slovenia is becoming an aging society, very little is known about the abilities and needs of home-dwelling older people or their preferences regarding assistance. The aim of the study was to explore the need for assistance in daily activities among older Slovenian people living at home. Older adults aged between 65 and 97 years (N = 358) participated in the cross-sectional survey study. A questionnaire that assessed independence in daily activities and assistance in the home environment was developed. Data were analyzed using descriptive statistics, a nonparametric test (Wilcoxon signed rank test), and the chi-square test. The results showed that older Slovenians were more independent in activities of daily living (ADLs) than instrumental activities of daily living (IADLs). Independence was the highest for using the toilet, feeding, and mobility transfers, and the lowest for bathing. With IADLs, assistance was most often required with shopping and housework; this assistance was usually provided by family members. The provider of assistance was generally compatible with older people’s preferences concerning assistance at home. We found no differences in care preferences between urban and rural settings. Assistance in the home environment was predominantly provided by unpaid helpers, which reflects recent developments in health and social services that put an emphasis on a person’s social network. Due to demographic changes and the decrease in the number of adult children, reliance on close relatives might soon become a challenge. These findings can help policy makers understand older people’s choices and preferences better when planning long-term care.

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