scholarly journals Associations Between Potentially Modifiable and Nonmodifiable Risk Factors and Gait Speed in Middle- and Older-Aged Adults: Results From the Canadian Longitudinal Study on Aging

2021 ◽  
Author(s):  
Erica Figgins ◽  
Yun-Hee Choi ◽  
Mark Speechley ◽  
Manuel Montero-Odasso
Keyword(s):  
Risk Factors ◽  
Longitudinal Study ◽  
Gait Speed ◽  
Chronic Conditions ◽  
Serum Vitamin ◽  
Lifestyle Factors ◽  
Community Dwelling ◽  
Life Course Perspective ◽  
Factors Associated ◽  
Modifiable Factors

Abstract Background Gait speed is a strong predictor of morbidity and mortality in older adults. Understanding the factors associated with gait speed and the associated adverse outcomes will inform mitigation strategies. We assessed the potentially modifiable and nonmodifiable factors associated with gait speed in a large national cohort of middle and older-aged Canadian adults. Methods We examined cross-sectional baseline data from the Canadian Longitudinal Study on Aging (CLSA) Comprehensive cohort. The study sample included 20 201 community-dwelling adults aged 45–85 years. The associations between sociodemographic and anthropometric factors, chronic conditions, and cognitive, clinical, and lifestyle factors and 4-m usual gait speed (m/s) were estimated using hierarchical multivariable linear regression. Results The coefficient of determination, R  2, of the final regression model was 19.7%, with 12.9% of gait speed variability explained by sociodemographic and anthropometric factors, and nonmodifiable chronic conditions and 6.8% explained by potentially modifiable chronic conditions, cognitive, clinical, and lifestyle factors. Potentially modifiable factors significantly associated with gait speed include cardiovascular conditions (unstandardized regression coefficient, B = −0.018; p < .001), stroke (B = −0.025; p = .003), hypertension (B = −0.007; p = .026), serum Vitamin D (B = 0.004; p < .001), C-reactive protein (B = −0.005; p = .005), depressive symptoms (B = −0.003; p < .001), physical activity (B = 0.0001; p < .001), grip strength (B = 0.003; p < .001), current smoking (B = −0.026; p < .001), severe obesity (B = −0.086; p < .001), and chronic pain (B = −0.008; p = .018). Conclusions The correlates of gait speed in adulthood are multifactorial, with many being potentially modifiable through interventions and education. Our results provide a life-course-perspective framework for future longitudinal assessments risk factors affecting gait speed.

scholarly journals Study of potentially preventable hospitalisations (PPH) for chronic conditions: what proportion are preventable and what factors are associated with preventable PPH?

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038415
Author(s):  
Jennifer Johnston ◽  
Jo Longman ◽  
Dan Ewald ◽  
Jonathan King ◽  
Sumon Das ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Hospital Admissions ◽  
Medication Management ◽  
Community Dwelling ◽  
Living Alone ◽  
Chronic Obstructive ◽  
Discharge Diagnosis ◽  
Obstructive Pulmonary Disease ◽  
Factors Associated ◽  
Study Sites

IntroductionThe proportion of potentially preventable hospitalisations (PPH) which are actually preventable is unknown, and little is understood about the factors associated with individual preventable PPH. The Diagnosing Potentially Preventable Hospitalisations (DaPPHne) Study aimed to determine the proportion of PPH for chronic conditions which are preventable and identify factors associated with chronic PPH classified as preventable.SettingThree hospitals in NSW, Australia.ParticipantsCommunity-dwelling patients with unplanned hospital admissions between November 2014 and June 2017 for congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes complications or angina pectoris. Data were collected from patients, their general practitioners (GPs) and hospital records.Outcome measuresAssessments of the preventability of each admission by an Expert Panel.Results323 admissions were assessed for preventability: 46% (148/323) were assessed as preventable, 30% (98/323) as not preventable and 24% (77/323) as unclassifiable. Statistically significant differences in proportions preventable were found between the three study sites (29%; 47%; 58%; p≤0.001) and by primary discharge diagnosis (p≤0.001).Significant predictors of an admission being classified as preventable were: study site; final principal diagnosis of CHF; fewer diagnoses on discharge; shorter hospital stay; GP diagnosis of COPD; GP consultation in the last 12 months; not having had a doctor help make the decision to go to hospital; not arriving by ambulance; patient living alone; having someone help with medications and requiring help with daily tasks.ConclusionsThat less than half the chronic PPH were assessed as preventable, and the range of factors associated with preventability, including site and discharge diagnosis, are important considerations in the validity of PPH as an indicator. Opportunities for interventions to reduce chronic PPH include targeting patients with CHF and COPD, and the provision of social welfare and support services for patients living alone and those requiring help with daily tasks and medication management.

scholarly journals Factors Associated with the Caregivers’ Desire to Institutionalize Persons with Dementia: A Cross-Sectional Study

2018 ◽  
Vol 46 (5-6) ◽  
pp. 298-309 ◽  
Author(s):  
Sophie Vandepitte ◽  
Koen Putman ◽  
Nele Van Den Noortgate ◽  
Sofie Verhaeghe ◽  
Eric Mormont ◽  
...  
Keyword(s):  
Behavioral Problems ◽  
The Elderly ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Respite Care ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Factors Associated ◽  
Care Services ◽  
Modifiable Factors

Background/Aims: Dementia is one of the main reasons for institutionalization among the elderly. Few studies have explored factors associated with the caregivers’ (CG) desire to institutionalize (DTI) a person with dementia (PWD). The objective of this study is to identify modifiable and non-modifiable psychosocial and sociodemographic factors associated with a caregiver’s DTI. Methods: Cross-sectional data of 355 informal CG of community-dwelling PWD were analyzed. Several characteristics were identified in CG and PWD to be included in a multivariable regression model based on the purposeful selection method. Results: Positively modifiable associated factors were: higher CG burden, being affected by behavioral problems, and respite care use. Positively associated non-modifiable factors were: CG older age, being professionally active, and CG higher educational level. Cohabitation and change of professional situation were negatively associated. Conclusion: Although no causality can be assumed, several practical recommendations can be suggested. First of all, these results reconfirm the importance of multicomponent strategies, especially support aimed at decreasing burden and in learning coping strategies. Also, CG might benefit from information about support options, such as respite care services. Finally, special attention should be given to older and working CG. In the latter, flexible and adaptive working conditions might alleviate burden and therefore reduce the DTI of the PWD.

scholarly journals Modifiable Factors Associated with Reversion from Mild Cognitive Impairment to Cognitively Normal Status: A Prospective Cohort Study

2021 ◽  
Author(s):  
Feng Sha ◽  
Ziyi Zhao ◽  
Chang Wei ◽  
Zhirong Yang ◽  
Bingyu Li
Keyword(s):  
Cohort Study ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Psychological Factors ◽  
Large Scale ◽  
Cox Regression ◽  
Lifestyle Factors ◽  
Cognitively Normal ◽  
Factors Associated ◽  
Modifiable Factors

Abstract Background Previous studies found that about 24% of the mild cognitive impairment (MCI) patients reverse to cognitively normal (CN) status. However, it is unclear which modifiable factors are associated with this reversion. Method We conducted a prospective community-based cohort study based on 2002-2018 Chinese Longitudinal Health Longevity Survey (CLHLS). Of 35,474 older adults from 22 provinces in China in the 5 waves of CLHLS, 7,422 eligible participants with MCI were included. Multivariable Cox regression with least absolute shrinkage and selection operator (LASSO) penalty for variable selection was adopted to investigate the associations between reversion to CN and potential modifiable dietary/lifestyle, cardiometabolic, and psychological factors. Results Our analysis included 7,422 MCI participants [average age: 90.0 (SD 9.5) years]. Among these participants, 1,604 (21.6%) reversed from MCI to CN with a mean (SD) follow-up of 2.9 (1.8) years. Several dietary/lifestyle factors, including daily consumption of fresh fruits (Hazard Ratio [HR]: 1.28, 95% CI: 1.15 to 1.42; P༜.001), engagement in reading (HR: 1.24, 95% CI: 1.00 to 1.54; P =.047), housework (HR: 1.21, 95% CI: 1.08 to 1.35; P =.001), and mah-jong or other card games (HR: 1.23, 95% CI: 1.08 to 1.39; P =.001), were positively associated with possibility of reversion. Cigarette smoking (HR: 0.92, 95% CI: 0.84 to 1.00; P= .041) and duration of alcohol drinking (HR: 0.97, 95% CI: 0.94 to 0.99; P = .012) were negatively associated with possibility of reversion. None of the modifiable cardiometabolic and psychological factors was found to be significantly associated with reversion to CN. Difference was identified among different age and gender group. Conclusion This study identified several dietary/lifestyle factors associated with MCI reversion that may transfer into large-scale dementia prevention practices.

Risk factors for future falls among community-dwelling older adults without a fall in the previous year: A prospective one-year longitudinal study

2020 ◽  
Vol 91 ◽  
pp. 104161 ◽  
Author(s):  
Jaqueline Mello Porto ◽  
Natália Camargo Rodrigues Iosimuta ◽  
Renato Campos Freire Júnior ◽  
Roberta de Matos Brunelli Braghin ◽  
Érika Leitner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Longitudinal Study ◽  
Community Dwelling ◽  
One Year ◽  
Community Dwelling Older Adults

scholarly journals Prevalence and Risk of Polypharmacy among Community-Dwelling, Elderly Kuwaiti Patients

2019 ◽  
Vol 29 (2) ◽  
pp. 166-173 ◽  
Author(s):  
Nabil Ahmed Badawy ◽  
Shokria Adely Labeeb ◽  
Mawaheb Falah Alsamdan ◽  
Badria Faleh Alazemi
Keyword(s):  
Risk Factors ◽  
Hospital Admissions ◽  
Antihypertensive Drugs ◽  
Female Gender ◽  
Community Dwelling ◽  
Older Individuals ◽  
Cross Sectional ◽  
Factors Associated ◽  
High Prevalence ◽  
Study Population

Objectives: To estimate the prevalence of polypharmacy in community-dwelling, older Kuwaiti patients, describe the number and types of drugs used, and identify risk factors associated with polypharmacy. Subjects and Methods: This was a descriptive cross-sectional questionnaire-based survey in which we interviewed 500 community-dwelling Kuwaiti adults over 65 years of age. The data collection occurred during a 4-month period from March to July 2017. Results: Fifty-two percent (n = 260) of the patients were males, with a mean age of 71.73 ± 5.32 years. The prevalence of polypharmacy (5–8 drugs) and excessive polypharmacy (>8 drugs) was 58.4% (n = 292) and 10.2% (n = 51), respectively. The risk factors associated with an increased number of medicines used were: female gender (p = 0.019), a lower level of education (p = 0.003), a high number of hospital admissions (p = 0.000), clinics visited by the patient (p =0.000), and number of comorbidities (p = 0.000). The most commonly used medications (82.6% of the study population) were blood glucose-lowering agents, excluding insulin. Other commonly used medications were antihypertensive drugs and lipid-modifying agents. Conclusion: A significant sector of the older Kuwaiti patient population has a high prevalence of polypharmacy and is thus exposed to its potential hazards. The current study highlights the need to revise the drug-dispensing policy among community-dwelling, older Kuwaiti people, as well as to initiate educational programs among healthcare practitioners concerning prescribing issues in older individuals.

Factors Associated With Multimorbidity Patterns in Older Adults in England: Findings From the English Longitudinal Study of Aging (ELSA)

2019 ◽  
Vol 32 (9) ◽  
pp. 1120-1132 ◽  
Author(s):  
Hai Nguyen ◽  
Kia-Chong Chua ◽  
Alexandru Dregan ◽  
Silia Vitoratou ◽  
Ivet Bayes-Marin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Longitudinal Study ◽  
Latent Class ◽  
Future Research ◽  
Factors Associated ◽  
Lifestyle Risk Factors ◽  
Class B ◽  
Lifestyle Risk ◽  
English Longitudinal Study

Objective: We aimed to identify the patterns of multimorbidity in older adults and explored their association with sociodemographic and lifestyle risk factors. Method: The sample included 9,171 people aged 50+ from Wave 2 of the English Longitudinal Study of Aging (ELSA). Latent Class Analysis (LCA) was performed on 26 chronic diseases to determine clusters of common diseases within individuals and their association with sociodemographic and lifestyle risk factors. Result: Three latent classes were identified: (a) a cardiorespiratory/arthritis/cataracts class, (b) a metabolic class, and (c) a relatively healthy class. People aged 70 to 79 were 9.91 times (95% Confidence Interval [CI] = [5.13, 19.13]) more likely to be assigned to the cardiorespiratory/arthritis/cataracts class, while regular drinkers and physically inactive people were 0.33 times (95% CI = [0.24, 0.47]) less likely to be assigned to this class. Conclusion: Future research should investigate these patterns further to gain more insights into the needs of people with multimorbidity.

scholarly journals Risk Factors Associated with Alcohol Use in Early Adolescence among American Inner-City Youth: A Longitudinal Study

2019 ◽  
Vol 55 (3) ◽  
pp. 358-366 ◽  
Author(s):  
Johan Isaksson ◽  
Sebastian Sjöblom ◽  
Mary Schwab-Stone ◽  
Andrew Stickley ◽  
Vladislav Ruchkin
Keyword(s):  
Risk Factors ◽  
Longitudinal Study ◽  
Alcohol Use ◽  
Inner City ◽  
Early Adolescence ◽  
Factors Associated ◽  
Inner City Youth

scholarly journals Factors Associated With Insidious and Noninsidious Disability

2020 ◽  
Vol 75 (11) ◽  
pp. 2125-2129 ◽  
Author(s):  
Thomas M Gill ◽  
Terrence E Murphy ◽  
Evelyne A Gahbauer ◽  
Linda Leo-Summers ◽  
Ling Han
Keyword(s):  
Risk Factors ◽  
Chronic Conditions ◽  
Emergency Department Visits ◽  
Recurrent Event ◽  
Factors Associated ◽  
Shared Set ◽  
Lower Extremity Muscle ◽  
Multivariable Analyses ◽  
Restricted Activity ◽  
Hispanic White

Abstract Background Although disability is often precipitated by an illness/injury, it may arise insidiously. Our objectives were to identify the factors associated with the development of insidious and noninsidious disability and to determine whether these risk factors differ between the two types of disability. Methods We prospectively evaluated 754 community-living persons, 70+ years, from 1998 to 2016. The unit of analysis was an 18-month person-interval, with risk factors assessed at the start of each interval. Disability in four activities of daily living and exposure to intervening events, defined as illnesses/injuries leading to hospitalization, emergency department visits, or restricted activity, were assessed each month. Insidious and noninsidious disability were defined based on the absence and presence of an intervening event. Results The rate of noninsidious disability (21.7%) was twice that of insidious disability (10.8%). In multivariable recurrent-event Cox analyses, six factors were associated with both disability outcomes: non-Hispanic white race, lower extremity muscle weakness, poor manual dexterity, and (most strongly) frailty, cognitive impairment, and low functional self-efficacy. Three factors were associated with only noninsidious disability (older age, number of chronic conditions, and depressive symptoms), whereas four were associated with only insidious disability (female sex, lives with others, low SPPB score, and upper extremity weakness). The modest differences in risk factors identified for the two outcomes in multivariable analyses were less apparent in the bivariate analyses. Conclusions Although arising from different mechanisms, insidious and noninsidious disability share a similar set of risk factors. Interventions to prevent disability should prioritize this shared set of risk factors.

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