scholarly journals Gait Speed and Instrumental Activities of Daily Living in Older Adults After Hospitalization: A Longitudinal Population-Based Study

2021 ◽  
Author(s):  
Juraj Sprung ◽  
Mariana Laporta ◽  
David S Knopman ◽  
Ronald C Petersen ◽  
Michelle M Mielke ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Gait Speed ◽  
Daily Living ◽  
Functional Limitations ◽  
Parameter Estimate ◽  
Population Based ◽  
Instrumental Activities

Abstract Background Hospitalization can impair physical and functional status of older adults, but it is unclear whether these deficits are transient or chronic. This study determined the association between hospitalization of older adults and changes in long-term longitudinal trajectories of two measures of physical and functional status: gait speed (GS) and Instrumental Activities of Daily Living measured with Functional Activities Questionnaire (FAQ). Methods Linear mixed effects models assessed the association between hospitalization (non-elective vs. elective, and surgical vs. medical) and outcomes of GS and FAQ score in participants (>60 years old) enrolled in the Mayo Clinic Study of Aging who had longitudinal assessments. Results Of 4,902 participants, 1,879 had ≥1 hospital admission. Median GS at enrollment was 1.1 m/s. The slope of the annual decline in GS before hospitalization was -0.015 m/s. The parameter estimate [95%CI] for additional annual change in GS trajectory after hospitalization was -0.009 [-0.011 to -0.006] m/s, P<0.001. The accelerated GS decline was greater for medical vs. surgical hospitalizations (-0.010 vs. -0.003 m/s, P=0.005), and non-elective vs. elective hospitalizations (-0.011 vs -0.006 m/s, P=0.067). The odds of a worsening FAQ-score increased on average by 4% per year. Following hospitalization, odds of FAQ-score worsening further increased (multiplicative annual increase in odds ratio per year [95%C] following hospitalization was 1.05 [1.03, 1.07], P<0.001). Conclusions Hospitalization of older adults is associated with accelerated long-term decline in GS and functional limitations, especially after non-elective admissions and those for medical indications. However, for most well-functioning participants these changes have little clinical significance.

scholarly journals Fatigue as a long-term risk factor for limitations in instrumental activities of daily living and/or mobility performance in older adults after 10 years

2016 ◽  
Vol Volume 11 ◽  
pp. 1579-1587 ◽  
Author(s):  
Sigrid Mueller-Schotte ◽  
Nienke Bleijenberg ◽  
Yvonne T. van der Schouw ◽  
Marieke J. Schuurmans
Keyword(s):  
Older Adults ◽  
Risk Factor ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Mobility Performance ◽  
Instrumental Activities

scholarly journals Frailty and depression predict instrumental activities of daily living in older adults: A population-based longitudinal study using the CARE75+ cohort

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243972
Author(s):  
Peter A. Coventry ◽  
Dean McMillan ◽  
Andrew Clegg ◽  
Lesley Brown ◽  
Christina van der Feltz-Cornelis ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Frailty Index ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Population Based ◽  
Physical And Mental Health ◽  
Living Situation ◽  
Instrumental Activities

Objectives To evaluate if depression contributes, independently and/or in interaction with frailty, to loss of independence in instrumental activities of daily living (ADL) in older adults with frailty. Methods Longitudinal cohort study of people aged ≥75 years living in the community. We used multi-level linear regression model to quantify the relationship between depression (≥5 Geriatric Depression Scale) and frailty (electronic frailty index), and instrumental activities of daily living (Nottingham Extended Activities of Daily Living scale; range: 0–66; higher score implies greater independence). The model was adjusted for known confounders (age; gender; ethnicity; education; living situation; medical comorbidity). Results 553 participants were included at baseline; 53% were female with a mean age of 81 (5.0 SD) years. Depression and frailty (moderate and severe levels) were independently associated with reduced instrumental activities of daily living scores. In the adjusted analysis, the regression coefficient was -6.4 (95% CI: -8.3 to -4.5, p<0.05) for depression, -1.5 (95% CI: -3.8 to 0.9, p = 0.22) for mild frailty, -6.1 (95% CI: -8.6 to -3.6, p<0.05) for moderate frailty, and -10.1 (95% CI: -13.5 to -6.8, p<0.05) for severe frailty. Moreover, depression interacted with frailty to further reduce instrumental activities of daily living score in individuals with mild or moderate frailty. These relationships remained significant after adjusting for confounders. Conclusion Frailty and depression are independently associated with reduced independence in instrumental activities of daily living. Also, depression interacts with frailty to further reduce independence for mild to moderately frail individuals, suggesting that clinical management of frailty should integrate physical and mental health care.

scholarly journals Early Cognitively Based Functional Limitations Predict Loss of Independence in Instrumental Activities of Daily Living in Older Adults

2015 ◽  
Vol 21 (9) ◽  
pp. 688-698 ◽  
Author(s):  
Karen M. Lau ◽  
Mili Parikh ◽  
Danielle J. Harvey ◽  
Chun-Jung Huang ◽  
Sarah Tomaszewski Farias
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Disability ◽  
Neuropsychological Functioning ◽  
Functional Limitations ◽  
Instrumental Activities ◽  
Increased Risk ◽  
Iadl Disability

AbstractOlder adults with early forms of neurodegenerative disease are at risk for functional disability, which is often defined by the loss of independence in instrumental activities of daily living (IADLs). The current study investigated the influence of mild changes in everyday functional abilities (referred to as functional limitations) on risk for development of incident functional disability. A total of 407 participants, who were considered cognitively normal or diagnosed with mild cognitive impairment (MCI) at baseline, were followed longitudinally over an average 4.1 years (range=0.8–9.2 years). Informant-based ratings from the Everyday Cognition (ECog; Farias et al., 2008) and the Instrumental Activities of Daily Living (Lawton & Brody, 1969) scales assessed the degree of functional limitations and incident IADL disability, respectively. Cox proportional hazards models revealed that more severe functional limitations (as measured by the Total ECog score) at baseline were associated with approximately a four-fold increased risk of developing IADL disability a few years later. Among the ECog domains, functional limitations in Everyday Planning, Everyday Memory, and Everyday Visuospatial domains were associated with the greatest risk of incident functional disability. These results remained robust even after controlling for participants’ neuropsychological functioning on tests of executive functions and episodic memory. Current findings indicate that early functional limitations have prognostic value in identifying older adults at risk for developing functional disability. Findings highlight the importance of developing interventions to support everyday abilities related to memory, executive function, and visuospatial skills in an effort to delay loss of independence in IADLs. (JINS, 2015,21, 688–698)

scholarly journals Assessing Functional Need of Minority Older Adults Across Two Long-Term Services and Supports Settings

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 180-180
Author(s):  
Jasmine Travers ◽  
Andrew Cohen ◽  
Norma Coe ◽  
Mary Naylor
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Comparison Group ◽  
Functional Limitations ◽  
Minority Group ◽  
Services And Supports ◽  
Retirement Study

Abstract Research has suggested that growth in Black and Hispanic older adults’ nursing home (NH) use may be the result of disparities in options for long-term services and supports (LTSS). To investigate this issue, we aimed to determine whether there were no differences in the functional needs of racial and ethnic groups who received care in NHs versus the community. We identified respondents aged ≥65 years in the 2016 Health and Retirement Study who reported requiring caregiving help. We compared the site of care for Black and Hispanic older adults (minority group) to White older adults (comparison group). We performed unadjusted analyses to assess the association of functional need with community vs. NH care. Functional need was operationalized using a functional-limitations score and six individual activities of daily living (ADL). There were 186 minority older adults (community=78%, NH=22%) and 357 White older adults (community=50%, NH=50%). Across settings, minority older adults did not differ in age, marital status, and income, but a greater percentage of men were in NHs (48% versus 28%; p=0.01). The functional-limitations score was higher in NHs than in the community for both groups. Functional needs for the minority group were similar across the two settings in 2/6 ADLs (dressing p=0.11, toileting p=0.09), while White older adults in NHs were more impaired in all ADLs. Functional need for minority older adults primarily differed by setting while demographics did not. These are important factors to consider when implementing programs to keep older adults out of NHs and in the community.

scholarly journals Impact of Gait Speed and Instrumental Activities of Daily Living on All-Cause Mortality in Adults ≥65 Years With Heart Failure

2015 ◽  
Vol 115 (6) ◽  
pp. 797-801 ◽  
Author(s):  
Alexander X. Lo ◽  
John P. Donnelly ◽  
Gerald McGwin ◽  
Vera Bittner ◽  
Ali Ahmed ◽  
...  
Keyword(s):  
Heart Failure ◽  
Activities Of Daily Living ◽  
Gait Speed ◽  
Daily Living ◽  
Instrumental Activities ◽  
All Cause Mortality

Polyneuropathy relates to impairment in daily activities, worse gait, and fall-related injuries

Neurology ◽  
2017 ◽  
Vol 89 (1) ◽  
pp. 76-83 ◽  
Author(s):  
Rens Hanewinckel ◽  
Judith Drenthen ◽  
Vincentius J.A. Verlinden ◽  
Sirwan K.L. Darweesh ◽  
Jos N. van der Geest ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Linear Regression ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Health Assessment ◽  
Population Based ◽  
Daily Activities ◽  
Instrumental Activities ◽  
Gait Parameters ◽  
History Of

Objective:To extensively investigate the association of chronic polyneuropathy with basic and instrumental activities of daily living (BADL and IADL), falls, and gait.Methods:A total of 1,445 participants of the population-based Rotterdam Study (mean age 71 years, 54% women) underwent a polyneuropathy screening involving a symptom questionnaire, neurologic examination, and nerve conduction studies. Screening yielded 4 groups: no, possible, probable, and definite polyneuropathy. Participants were interviewed about BADL (Stanford Health Assessment questionnaire), IADL (Instrumental Activities of Daily Living scale), and frequency of falling in the previous year. In a random subset of 977 participants, gait was assessed with an electronic walkway. Associations of polyneuropathy with BADL and IADL were analyzed continuously with linear regression and dichotomously with logistic regression. History of falling was evaluated with logistic regression, and gait changes were evaluated with linear regression.Results:Participants with definite polyneuropathy had more difficulty in performing BADL and IADL than participants without polyneuropathy. Polyneuropathy related to worse scores of all BADL components (especially walking) and 3 IADL components (housekeeping, traveling, and shopping). Participants with definite polyneuropathy were more likely to fall, and these falls more often resulted in injury. Participants with polyneuropathy had worse gait parameters on the walkway, including lower walking speed and cadence, and more errors in tandem walking.Conclusions:Chronic polyneuropathy strongly associates with impairment in the ability to perform daily activities and relates to worse gait and an increased history of falling.

scholarly journals Trajectories of Limitations in Instrumental Activities of Daily Living in Frail Older Adults With Vision, Hearing, or Dual Sensory Loss

2018 ◽  
Vol 74 (6) ◽  
pp. 936-942 ◽  
Author(s):  
Sigrid Mueller-Schotte ◽  
Nicolaas P A Zuithoff ◽  
Yvonne T van der Schouw ◽  
Marieke J Schuurmans ◽  
Nienke Bleijenberg
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Sensory Loss ◽  
Frail Older Adults ◽  
Instrumental Activities ◽  
Dual Sensory Loss

ASSESSMENT OF INSTRUMENTAL ACTIVITIES OF DAILY LIVING IN OLDER ADULTS WITH SUBJECTIVE COGNITIVE DECLINE USING THE VIRTUAL REALITY FUNCTIONAL CAPACITY ASSESSMENT TOOL (VRFCAT)

2018 ◽  
pp. 1-9
Author(s):  
A.S. Atkins1 ◽  
A. Khan ◽  
D. Ulshen ◽  
A. Vaughan ◽  
D. Balentin ◽  
...  
Keyword(s):  
Older Adults ◽  
Virtual Reality ◽  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Functional Capacity ◽  
Daily Living ◽  
Assessment Tool ◽  
Subjective Cognitive Decline ◽  
Capacity Assessment ◽  
Instrumental Activities

Background: Continuing advances in the understanding of Alzheimer’s disease progression have inspired development of disease-modifying therapeutics intended for use in preclinical populations. However, identification of clinically meaningful cognitive and functional outcomes for individuals who are, by definition, asymptomatic remains a significant challenge. Clinical trials for prevention and early intervention require measures with increased sensitivity to subtle deficits in instrumental activities of daily living (IADL) that comprise the first functional declines in prodromal disease. Validation of potential endpoints is required to ensure measure sensitivity and reliability in the populations of interest. Objectives: The present research validates use of the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) for performance-based assessment of IADL functioning in older adults (age 55+) with subjective cognitive decline. Design: Cross-sectional validation study. Setting: All participants were evaluated on-site at NeuroCog Trials, Durham, NC, USA. Participants: Participants included 245 healthy younger adults ages 20-54 (131 female), 247 healthy older adults ages 55-91 (151 female) and 61 older adults with subjective cognitive decline (SCD) ages 56-97 (45 female). Measures: Virtual Reality Functional Capacity Assessment Tool; Brief Assessment of Cognition App; Alzheimer’s Disease Cooperative Study Prevention Instrument Project – Mail-In Cognitive Function Screening Instrument; Alzheimer’s Disease Cooperative Study Instrumental Activities of Daily Living – Prevention Instrument, University of California, San Diego Performance-Based Skills Assessment – Validation of Intermediate Measures; Montreal Cognitive Assessment; Trail Making Test- Part B. Results: Participants with SCD performed significantly worse than age-matched normative controls on all VRFCAT endpoints, including total completion time, errors and forced progressions (p≤0001 for all, after Bonferonni correction). Consistent with prior findings, both groups performed significantly worse than healthy younger adults (age 20-54). Participants with SCD also performed significantly worse than controls on objective cognitive measures. VRFCAT performance was strongly correlated with cognitive performance. In the SCD group, VRFCAT performance was strongly correlated with cognitive performance across nearly all tests with significant correlation coefficients ranging from 0.3 to 0.7; VRFCAT summary measures all had correlations greater than r=0.5 with MoCA performance and BAC App Verbal Memory (p<0.01 for all). Conclusions: Findings suggest the VRFCAT provides a sensitive tool for evaluation of IADL functioning in individuals with subjective cognitive decline. Strong correlations with cognition across groups suggest the VRFCAT may be uniquely suited for clinical trials in preclinical AD, as well as longitudinal investigations of the relationship between cognition and function.

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