Resilience factors associated with physical function in vulnerable older adults from four countries

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J T Pennington ◽  
T L Sentell ◽  
A Vafaei ◽  
S M Camara ◽  
E Belanger ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Gender Roles ◽  
Physical Function ◽  
Physical Performance ◽  
Self Report ◽  
Bivariate Analysis ◽  
Factors Associated ◽  
Parental Unemployment ◽  
Resilience Factors

Abstract Background Adverse childhood experiences (ACEs) include an array of maltreatment and they have been shown to confer higher risks of early mobility loss and ultimately disablement in older ages. This study aims to identify resilience factors associated with physical function in a diverse sample of older adults (65-74 years) from the 2012 International Mobility in Aging Study (IMIAS) who reported ACEs. Methods 2002 participants were recruited from Kingston, Ontario; St. Hyacinthe, Quebec; Tirana, Albania; Manizales, Colombia; and Natal, Brazil. Economic ACEs were classified by self-report of at least one-poor childhood economic status, childhood hunger, parental unemployment-before the age of 15 years. The Short Physical Performance Battery was used to measure physical function; a score of < 8 was considered poor. Associations between hypothesized resilience factors (education, social support, expressed gender roles) and physical function were identified via bivariate analysis and logistic regression; after adjusting for sex, age, and sample site. Results Nearly half (46%) the participants reported economic ACES. High levels of education (OR 0.39; CI: 0.22-0.66) and social support from family (OR: 0.52; CI: 0.36-0.76), partners (OR: 0.47; CI: 0.29-0.74), and friends (OR: 0.59; CI: 0.38-0.92), as well as masculine (OR:0.49; CI: 0.29-0.83) and androgynous (0.48; CI: 0.30-0.77) gender roles, protected against poor physical function for those reporting childhood economic ACEs. Conclusions Despite encountering economic ACEs, those who achieved high relative levels of education, greater levels of support, as well as those characterized by masculine or androgynous gender roles, were more likely to maintain good physical performance in older ages compared to those with low education, no social support, and those classified as undifferentiated gender roles. Findings highlight critical points of intervention for those who experienced ACES. Key messages These findings imply that the associated negative physical health outcomes of ACEs can be delayed or eliminated via exposure to certain protective factors. Economic ACE exposure may be unavoidable, but there are resilience factors that could be promoted to foster the better health across the life course.

scholarly journals Factors associated with poor physical performance in older adults of 11 Peruvian high Andean communities

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 59
Author(s):  
Diego Urrunaga-Pastor ◽  
Fernando M. Runzer-Colmenares ◽  
Tania M. Arones ◽  
Rosario Meza-Cordero ◽  
Silvana Taipe-Guizado ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Urinary Incontinence ◽  
Cognitive Impairment ◽  
Physical Performance ◽  
Poisson Regression ◽  
Prevalence Ratio ◽  
Female Gender ◽  
Cross Sectional ◽  
Factors Associated

Background: Physical performance in the older adult has been extensively studied. However, only a few studies have evaluated physical performance among older adults of high Andean populations and none have studied the factors associated with it. The objective of this study was to evaluate factors associated with poor physical performance by using the Short Physical Performance Battery (SPPB) in older adults living in 11 Peruvian high Andean communities. Methods: An analytical cross-sectional study was carried out in inhabitants aged 60 or over from 11 high-altitude Andean communities of Peru during 2013-2017. Participants were categorized in two groups according to their SPPB score: poor physical performance (0-6 points) and medium/good physical performance (7-12 points). Additionally, we collected socio-demographic, medical, functional and cognitive assessment information. Poisson regression models were constructed to identify factors associated with poor physical performance. Prevalence ratio (PR) with 95% confidence intervals (95 CI%) are presented. Results: A total of 407 older adults were studied. The average age was 73.0 ± 6.9 years (range: 60-94 years) and 181 (44.5%) participants had poor physical performance (0-6 points). In the adjusted Poisson regression analysis, the factors associated with poor physical performance were: female gender (PR=1.29; 95%CI: 1.03-1.61), lack of social support (PR=2.10; 95%CI: 1.17-3.76), number of drugs used (PR=1.09; 95%CI: 1.01-1.17), urinary incontinence (PR=1.45; 95%CI: 1.16-1.82), exhaustion (PR=1.35; 95%CI: 1.03-1.75) and cognitive impairment (PR=1.89; 95%CI: 1.40-2.55). Conclusions: Almost half of the population evaluated had poor physical performance based on the SPPB. Factors that would increase the possibility of suffering from poor physical performance were: female gender, lack of social support, number of drugs used, urinary incontinence, exhaustion and cognitive impairment. Future studies with a larger sample and longitudinal follow-up are needed to design beneficial interventions for the high Andean population.

Factors associated with life expectancy (LE) < 3 months (mo) among older adults receiving palliative chemotherapy (chemo).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9034-9034
Author(s):  
Arti Hurria ◽  
Molly Hardt ◽  
William P. Tew ◽  
Supriya Gupta Mohile ◽  
Cynthia Owusu ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Logistic Regression ◽  
Functional Status ◽  
Physical Function ◽  
Advanced Cancer ◽  
Bivariate Analysis ◽  
Multivariate Logistic Regression ◽  
Unintentional Weight Loss ◽  
Factors Associated

9034 Background: Optimal treatment decision-making for older adults with advanced cancer requires a better understanding of risk factors associated with limited LE. Our objective was to evaluate the factors associated with LE< 3mo among patients (pts) age > 65 who were beginning a new chemo regimen. Methods: We conducted a secondary analysis of a multi-site cohort study of pts ≥65 years receiving chemo (Hurria et al, JCO 2011). This analysis included only pts receiving palliative chemo. Bivariate analysis and multivariate logistic regression were utilized to identify factors associated with LE < 3 mo including: sociodemographics, labs [hemoglobin (Hb), albumin, liver function, creatinine clearance], and geriatric assessment (GA) variables (functional status, social support, comorbidity, psychological, cognitive, and nutritional status). Results: Among 290 pts (median age 72 [range 65-91], 52% female) with advanced cancer (gastrointestinal 28%, lung 31%, breast/gyn 22%, other 19%), 13.4% died within 3 mo of chemo initiation. In bivariate analysis, pts with LE < 3mo were more likely (p<0.05 for each variable) to have lower albumin and Hb, unintentional weight loss, and poorer physical function [defined as need for assistance with instrumental activities of daily living (IADL), lower score on Medical Outcomes Survey (MOS) Physical Health, MD-rated and patient-rated Karnofsky performance status (KPS), and MOS Social Activity score]. Measures of functional status were highly correlated with one another and therefore one functional status measure (in addition to measures significant in bivariate analysis) was included in each multivariate logistic regression. In multivariate analyses, (controlling for age, comorbidity, and line of chemo) poorer physical function (as evaluated by need for assistance with IADLs, MOS Physical <70, or MD-rated KPS <70) and unintentional weight loss were independently associated with LE<3mo (p<0.05). Conclusions: Among older pts with advanced cancer who were prescribed a new chemo regimen for palliative intent, physical function measures (as evaluated by geriatric assessment and MD report) and unintentional weight loss were associated with LE < 3months.

scholarly journals Factors associated with poor physical performance in older adults of 11 Peruvian high Andean communities

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 59 ◽  
Author(s):  
Diego Urrunaga-Pastor ◽  
Fernando M. Runzer-Colmenares ◽  
Tania M. Arones ◽  
Rosario Meza-Cordero ◽  
Silvana Taipe-Guizado ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Urinary Incontinence ◽  
Cognitive Impairment ◽  
Physical Performance ◽  
Poisson Regression ◽  
Prevalence Ratio ◽  
Female Gender ◽  
Cross Sectional ◽  
Factors Associated

Background: Physical performance in the older adult has been extensively studied. However, only a few studies have evaluated physical performance among older adults of high Andean populations and none have studied the factors associated with it. The objective of this study was to evaluate factors associated with poor physical performance by using the Short Physical Performance Battery (SPPB) in older adults living in 11 Peruvian high Andean communities. Methods: An analytical cross-sectional study was carried out in inhabitants aged 60 or over from 11 high-altitude Andean communities of Peru during 2013-2017. Participants were categorized in two groups according to their SPPB score: poor physical performance (0-6 points) and medium/good physical performance (7-12 points). Additionally, we collected socio-demographic, medical, functional and cognitive assessment information. Poisson regression models were constructed to identify factors associated with poor physical performance. Prevalence ratio (PR) with 95% confidence intervals (95 CI%) are presented. Results: A total of 407 older adults were studied. The average age was 73.0 ± 6.9 years (range: 60-94 years) and 181 (44.5%) participants had poor physical performance (0-6 points). In the adjusted Poisson regression analysis, the factors associated with poor physical performance were: female gender (PR=1.29; 95%CI: 1.03-1.61), lack of social support (PR=2.10; 95%CI: 1.17-3.76), number of drugs used (PR=1.09; 95%CI: 1.01-1.17), urinary incontinence (PR=1.45; 95%CI: 1.16-1.82), exhaustion (PR=1.35; 95%CI: 1.03-1.75) and cognitive impairment (PR=1.89; 95%CI: 1.40-2.55). Conclusions: Almost half of the population evaluated had poor physical performance based on the SPPB. Factors that would increase the possibility of suffering from poor physical performance were: female gender, lack of social support, number of drugs used, urinary incontinence, exhaustion and cognitive impairment. Future studies with a larger sample and longitudinal follow-up are needed to design beneficial interventions for the high Andean population.

scholarly journals Inappropriate medications and physical function: a systematic review

2021 ◽  
Vol 12 ◽  
pp. 204209862110303
Author(s):  
Elizabeth Manias ◽  
Md Zunayed Kabir ◽  
Andrea B. Maier
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Physical Performance ◽  
Inappropriate Medication ◽  
Functional Independence ◽  
Potentially Inappropriate Medications ◽  
Timed Up And Go ◽  
Risk Of Falls ◽  
Prescribing Omissions ◽  
Inappropriate Medications

Background and aims: Inappropriate medication prescription is highly prevalent in older adults and is associated with adverse health outcomes. The aim of this study was to examine the associations between potentially inappropriate medications (PIMS) and potential prescribing omissions with physical function in older adults situated in diverse environments. Methods: A systematic search was completed using the following databases: MEDLINE, CINAHL, PsycINFO, EMBASE and COCHRANE. Results were extracted from the included studies. Results: In total, 55 studies reported on 2,767,594 participants with a mean age of 77.1 years (63.5% women). Study designs comprised 26 retrospective cohort studies, 21 prospective cohort studies and 8 cross-sectional studies. Inappropriate medications in community and hospital settings were significantly associated with higher risk of falls (21 out of 30 studies), higher risk of fractures (7 out of 9 studies), impaired activities of daily living (ADL; 8 out of 10 studies) and impaired instrumental ADL (IADL) score (4 out of 6 studies). Five out of seven studies also showed that PIMs were associated with poorer physical performance comprising the Timed Up and Go test, walking speed, grip strength, time to functional recovery, functional independence and scale of functioning. Many medication classes were implicated as PIMs in falls, fractures and impairment in physical performance including antipsychotic, sedative, anti-anxiety, anticholinergic, antidiabetic, opioid and antihypertensive medications. For patients not receiving musculoskeletal medications, such as calcium, vitamin D and bisphosphonates, older adults were found to be at risk of a hospital admission for a fall or fracture. Conclusion: Inappropriate medication prescriptions are associated with impaired physical function across longitudinal and cross-sectional studies in older adults situated in diverse settings. It is important to support older people to reduce their use of inappropriate medications and prevent prescribing omissions. Plain language summary Inappropriate medications and physical function Background and aims: The use of inappropriate medications is very common in older adults and is associated with harmful health problems. The aim was to examine associations between potentially inappropriate medications and potential prescribing omissions with physical function in older adults situated in diverse environments. Methods: Library databases were examined for possible studies to include and a systematic search was completed. Relevant information was obtained from the included studies. Results: In total, 55 studies reported on 2,767,594 participants who were an average age of 77.1 years and about 6 out of 10 were women. A variety of different study designs were used. Inappropriate medication prescriptions in community and hospital settings were significantly associated with higher risk of falls (21 out of 30 studies), higher risk of fractures (7 out of 9 studies), problems with activities of daily living (ADL), such as eating, bathing, dressing, grooming, walking and toileting (8 out of 10 studies) and problems with instrumental ADL such as managing medications, house cleaning and shopping (4 out of 6 studies). Five out of seven studies also showed that inappropriate medications were associated with poorer physical performance involving the Timed Up and Go test, walking speed, grip strength, time to functional recovery, functional independence and scale of functioning. Many types of medication classes were shown to be associated with a risk of falls, fractures and problems with physical performance. Omitted medications were also associated with falls and fractures. Conclusion: Inappropriate medication prescriptions are associated with problems relating to physical function. It is important to support older people to reduce their use of inappropriate medications and prevent prescribing omissions.

The importance of weak physical performance in older adults for the development of musculoskeletal pain that interferes with normal life. A prospective cohort study

2019 ◽  
Vol 19 (4) ◽  
pp. 789-796
Author(s):  
Stina Lilje ◽  
Johan Sanmartin Berglund ◽  
Peter Anderberg ◽  
Lina Palmlöf ◽  
Eva Skillgate
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Grip Strength ◽  
Physical Performance ◽  
Musculoskeletal Pain ◽  
National Study ◽  
Risk Of Falling ◽  
Normal Life ◽  
Sit To Stand ◽  
Proprioceptive Function

Abstract Background and aims There are associations between pain, comorbidity and risk of falling, and falling increases the risk of mortality in older persons, but few studies have investigated the development of pain as a result of impaired physical function. The aim of this study was to examine possible associations between weak physical performance and the development of musculoskeletal pain that interferes with normal life in a sample of older adults. The sample derived from a national, longitudinal multicenter study; the Swedish National Study on Ageing and Care; SNAC-B. Methods The participants (n = 490) were between 60 and 78 years at the baseline examinations. Three variables were chosen for the exposure physical function, from the baseline examinations; One Leg Stand, Grip strength and Sit-to-Stand. The outcome musculoskeletal pain that interferes with normal life was measured using EQ5D and SF-12 6 years later, and logistic regression was used to investigate possible associations between the exposures and the outcome. Results Maximum grip strength (Grippit) was inversely associated with musculoskeletal pain that interferes with normal life (OR 2.31; 95% CI 1.15–4.61), and One-Leg Stand and Sit-to-Stand were not associated with the development of pain (OR 1.30; 95% CI 0.64–2.64) and (OR 0.91; 95% CI 0.45–1.86), respectively. Conclusions Weak grip strength was inversely associated with the development of musculoskeletal pain that interferes with normal life in older adults. Implications Impaired proprioceptive function, strength and mobility in elderly with pain have been found in earlier research. Since pain increases the risk of falling, it is important to investigate if it may develop as a function of an impaired physical function. The results of the present study could be of importance for future prevention programs aiming to protect elderly from falling.

scholarly journals FINANCIAL EXPLOITATION OF OLDER ADULTS: PRELIMINARY RESULTS FROM A PROSPECTIVE LONGITUDINAL STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S192-S192
Author(s):  
Scott R Beach ◽  
Sara J Czaja ◽  
Richard Schulz ◽  
David Loewenstein ◽  
Peter Lichtenberg
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Psychosocial Factors ◽  
Cognitive Abilities ◽  
Self Report ◽  
Prospective Longitudinal Study ◽  
Preliminary Results ◽  
Financial Exploitation ◽  
Advance Theory ◽  
Prospective Longitudinal

Abstract This paper presents study design and preliminary results from a new study funded by the National Institute on Aging that is examining financial exploitation (FE) among 720 White, African-American and Hispanic adults age 60+ (240 per group; 120 age 60-79; 120 age 80+). A conceptual model linking socio-demographics, physical health, social support / integration, cognitive function, financial skills / supports, and psychosocial factors to FE is being evaluated. Three assessments (baseline, 12; 24 mos.) include: a detailed cognitive battery, web-based banking simulation tasks, scam scenarios, and a standardized battery of self-report measures assessing socio-demographic and psychosocial variables. Preliminary baseline results from ~200 participants show support for the proposed model. Exposure to sales, remote purchasing behavior, and telemarketer receptivity (scam exposure); and scam vulnerability as measured by credibility ratings of “legitimate” and “fake” scam scenarios are positively associated with reports of both stranger-initiated and trusted other FE. Older adults with smaller social networks and less social support were more likely to report both exposure and vulnerability to scams. Higher general cognitive abilities, financial skills, and numeracy; and better performance on online banking tasks correlate with less scam exposure and vulnerability. Preliminary analyses of psychosocial factors also show that more depressed, impulsive, and trusting older adults report more exposure and scam vulnerability. The paper will present updated analyses of ~500 baseline participants. Understanding multiple pathways to FE is important to advance theory and for the development of interventions to minimize risk.

scholarly journals Anthropometric indices predict physical function and mobility in older Australians: the Australian Longitudinal Study of Ageing

2002 ◽  
Vol 5 (5) ◽  
pp. 655-662 ◽  
Author(s):  
Elaine Bannerman ◽  
Michelle D Miller ◽  
Lynne A Daniels ◽  
Lynne Cobiac ◽  
Lynne C Giles ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Weight ◽  
Longitudinal Study ◽  
Waist Circumference ◽  
Physical Function ◽  
South Australia ◽  
Self Report ◽  
Mobility Limitations ◽  
Australian Longitudinal Study ◽  
Increased Risk

AbstractObjective:To evaluate, in terms of function and mobility, the predictive value of commonly adopted anthropometric ‘definitions’ used in the nutritional assessment of older adults, in a cohort of older Australians.Design:Prospective cohort study – Australian Longitudinal Study of Ageing (ALSA).Setting:Adelaide, South Australia (1992–1994).Subjects:Data were analysed from 1272 non-institutionalised (685 males, 587 females) older adults ≥70 years old in South Australia. Seven ‘definitions’ commonly used in the anthropometric assessment of both under- and overnutrition (including four using body mass index (BMI), waist-to-hip ratio, waist circumference and percentage weight change) were evaluated at baseline, for their ability to predict functional and mobility limitation assessed (by self-report questionnaire) at two years follow-up. All questionnaires were administered and anthropometry performed by trained investigators. The associations between the definitions and decline in mobility and physical function were evaluated over two years using multiple logistic regression.Results:A BMI >85th percentile or >30 kgm−2 or a waist circumference of >102 cm in males and >88 cm in females increased risk of functional and mobility limitations. Over two years, a loss of 10% body weight significantly increased the risk of functional and mobility limitations.Conclusion:Maintaining weight within older adults, irrespective of initial body weight, may be important in preventing functional and mobility limitations. Excessive weight is associated with an increased risk of limitation in function and mobility, both key components of health-related quality of life.

scholarly journals Disseminating the Otago Exercise Program in the United States: Perceived and Actual Physical Performance Improvements From Participants

2016 ◽  
Vol 37 (1) ◽  
pp. 79-98 ◽  
Author(s):  
Tiffany E. Shubert ◽  
Matthew Lee Smith ◽  
Luohua Jiang ◽  
Marcia G. Ory
Keyword(s):  
United States ◽  
Older Adults ◽  
Physical Performance ◽  
Functional Performance ◽  
Exercise Program ◽  
The United States ◽  
Functional Mobility ◽  
Self Report ◽  
Timed Up And Go ◽  
Logistic Regression Models

The Otago Exercise Program (OEP) is an evidence-based fall prevention program disseminated internationally. Little is known about the implementation or effectiveness of the OEP in the United States. The purposes were to (a) identify characteristics of older adults enrolled in OEP, and (b) examine perceived and actual functional performance changes after participation in 8 weeks of the program. Baseline and 8-week functional and self-report data were collected on 210 older adults from 2013 to 2015. Linear mixed models and general estimating equations logistic regression models adjusted for socio-demographic factors were performed to assess changes. At 8 weeks, scores dramatically improved on self-report and physical performance tests: Timed Up-and-Go ( p < .001), 30-Second Chair Rise ( p < .001), and Four-Stage Balance ( p < .001). Findings support that participation in the U.S. OEP as part of a plan of care can result in significant improvements in objective functional mobility, balance measures, and self-reported ability.

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