scholarly journals Intrinsic capacity predicts negative health outcomes in older adults

2021 ◽  
Author(s):  
Erwin Stolz ◽  
Hannes Mayerl ◽  
Wolfgang Freidl ◽  
Regina Roller-Wirnsberger ◽  
Thomas M Gill
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Health Outcomes ◽  
Warning System ◽  
Repeated Measurements ◽  
Intrinsic Capacity ◽  
Adl Disability ◽  
Nursing Home Stay ◽  
Negative Health Outcomes

Abstract BACKGROUND Monitoring trajectories of intrinsic capacity (IC) in older adults has been suggested by the WHO as a means to inform prevention to avoid or delay negative health outcomes. Due to a lack of longitudinal studies, it is currently unclear how IC changes over time and whether repeatedly measured IC predicts negative health outcomes. METHODS Based on 4,751 repeated observations of IC (range=0-100) during 21 years of follow-up among 754 older adults 70+ years, we assessed longitudinal trajectories of IC, and whether time-varying IC predicted the risk of chronic ADL disability, long-term nursing home stay, and mortality using joint models. RESULTS Average IC declined progressively from 77 to 11 points during follow-up, with substantial heterogeneity between older adults. Adjusted for socio-demographics and chronic diseases, a one-point lower IC value was associated with a 7% increase in the risk of ADL disability, a 6% increase in the risk of a nursing home stay, and a 5% increase in mortality. Accuracy for 5- and 10-year predictions based on up to three repeated measurements of IC ranged between moderate and good (AUC = 0.76-0.82). DISCUSSION Our study indicates that IC declines progressively and that it predicts negative health outcomes among older adults. Therefore, regular monitoring of IC could work as an early warning system informing preventive efforts.

scholarly journals Intrinsic capacity predicts negative health outcomes in older adults

2021 ◽  
Author(s):  
Erwin Stolz ◽  
Hannes Mayerl ◽  
Wolfgang Freidl ◽  
Regina Roller-Wirnsberger ◽  
Thomas M Gill
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Health Outcomes ◽  
Warning System ◽  
Repeated Measurements ◽  
Intrinsic Capacity ◽  
Adl Disability ◽  
Nursing Home Stay ◽  
Negative Health Outcomes

BACKGROUND: Monitoring trajectories of intrinsic capacity (IC) in older adults has been suggested by the WHO as a means to inform prevention to avoid or delay negative health outcomes. Due to a lack of longitudinal studies, it is currently unclear how IC changes over time and whether repeatedly measured IC predicts negative health outcomes. METHODS: Based on 4,751 repeated observations of IC (range=0-100) during 21 years of follow-up among 754 older adults 70+ years, we assessed longitudinal trajectories of IC, and whether time-varying IC predicted the risk of chronic ADL disability, long-term nursing home stay, and mortality using joint models for longitudinal and time-to-event data. RESULTS: Average IC declined progressively from 77 to 11 points during follow-up, with substantial heterogeneity between older adults. Adjusted for socio-demographics and chronic diseases, a one-point lower IC value was associated with a 7% increase in the risk of ADL disability, a 6% increase in the risk of a nursing home stay, and a 5% increase in mortality. Accuracy for 5- and 10-year predictions based on up to three repeated measurements of IC ranged between moderate and good (AUC = 0.76-0.82). DISCUSSION: Our study indicates that IC declines progressively and that it predicts negative health outcomes among older adults. Therefore, regular monitoring of IC could work as an early warning system informing preventive efforts.

scholarly journals Intrinsic Capacity vs. Multimorbidity: A Function-Centered Construct Predicts Disability Better Than a Disease-Based Approach in a Community-Dwelling Older Population Cohort

2021 ◽  
Vol 8 ◽  
Author(s):  
Jing Zhao ◽  
Jagadish K. Chhetri ◽  
Yi Chang ◽  
Zheng Zheng ◽  
Lina Ma ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Diseases ◽  
Area Under The Curve ◽  
Community Dwelling ◽  
The Status ◽  
Intrinsic Capacity ◽  
Adl Disability ◽  
Community Dwelling Older Adults ◽  
Better Than

Objective: This study aimed to assess the status of intrinsic capacity (IC)—a novel function-centered construct proposed by the WHO and examine whether impairment in IC predicts subsequent 1-year activities of daily living (ADL) disability better than a disease-based approach, i. e., multimorbidity status.Methods: This study included data of community-dwelling older adults from the Beijing Longitudinal Study on Aging II aged 65 years or older who were followed up at 1 year. Multivariate logistic regressions were performed to estimate the odds of ADL disability at baseline and 1-year follow-up.Results: A total of 7,298 older participants aged 65 years or older were included in the current study. About 4,742 older adults were followed up at 1 year. At baseline, subjects with a higher impairment in IC domains showed higher odds of ADL disability [adj. odds ratio (OR) = 9.51 for impairment in ≥3 domains, area under the curve (AUC) = 0.751] compared to much lower odds of ADL disability in subjects with a higher number (≥3) of chronic diseases (adj. OR 3.92, AUC = 0.712). At 1-year follow-up, the overall incidence of ADL disability increased with the impairment in IC domains higher than the increase in multimorbidity status. A higher impairment in IC domains showed higher odds of incidence ADL disability for impairment in 2 or ≥3 IC domains (adj. OR 2.32 for impairment in ≥3 domains, adj. OR 1.43 for impairment in two domains, AUC = 0.685). Only subjects who had ≥3 chronic diseases had higher odds of 1-year incident ADL disability (adj. OR 1.73, AUC = 0.681) that was statistically significant.Conclusion: Our results imply that a function-centered construct could have higher predictability of disability compared to the multimorbidity status in community older people. Our results need to be confirmed by studies with longer follow-up.

scholarly journals Prevalence and Impact of Comorbid Cancer and Dementia on Health Outcomes in Older Adults: A Longitudinal Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 184-184
Author(s):  
Jyotsana Parajuli ◽  
Diane Berish ◽  
Ying-Ling Jao ◽  
Yo-Jen Liao ◽  
Lee Ann Johnson
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Health Outcomes ◽  
Activities Of Daily Living ◽  
Hospital Stay ◽  
Daily Living ◽  
Medical Expenditure ◽  
Future Research ◽  
Longitudinal Impact ◽  
Nursing Home Stay

Abstract Dementia and cancer are two common chronic conditions in older adults. However, there are few studies examining the prevalence of comorbid cancer and dementia and the longitudinal impact of these comorbid conditions on health outcomes. This study investigated the prevalence and longitudinal impact on health outcomes in older adults with comorbid cancer and dementia. This is a secondary analysis, using data from the 2010 and 2016 waves of the Health and Retirement Study (HRS). The health outcomes of the study included nursing home stay, hospital stay, home care use, activities of daily living (ADL) limitations, instrumental activities of daily living (IADL), self-rated health status, mortality, and the out-of-pocket medical expenditure in older adults with cancer and dementia. Data were analyzed using descriptive statistics, logistic regression, and linear regression analyses. The results revealed that the prevalence of comorbid cancer and dementia ranged from 2.6% to 2.8% over the 6-year period. Older adults with comorbid cancer and dementia demonstrated higher likelihood of nursing home stay, ADL and IADL limitations, and mortality; but a decreased likelihood of homecare use and hospital stay compared to older adults with cancer only or dementia only (some outcomes were not significant for dementia only group). Findings point out the risk of increased functional decline and mortality in older adults with comorbid cancer and dementia. Future research is needed to explore the contributing factors of the risk and identify interventions to promote physical function and reduce mortality for this population.

Appendicular Lean Mass, Grip Strength, and the Development of Hospital-Associated Activities of Daily Living Disability among Older Adults in the Health ABC Study

2021 ◽  
Author(s):  
James S Andrews ◽  
Laura S Gold ◽  
May J Reed ◽  
Jose M Garcia ◽  
Robyn L McClelland ◽  
...  
Keyword(s):  
Older Adults ◽  
Grip Strength ◽  
Lean Mass ◽  
Daily Living ◽  
Adult Survivors ◽  
Regression Analyses ◽  
Appendicular Lean Mass ◽  
Adl Disability ◽  
Separate Regression

Abstract Background Half of all physical disability, including activity of daily living (ADL) disability, among older adults occurs in the setting of hospitalization. This study examines whether appendicular lean mass (ALM) and grip strength, which are commonly included in various definitions of sarcopenia, are associated with development of hospital-associated ADL disability in older adults in the Health ABC Study. Methods Individuals hospitalized during the first 5 years of follow-up (n=1,724) were analyzed. ALM to body mass index (BMI) ratio (ALMBMI), by dual energy x-ray absorptiometry (DXA), and grip strength, by hand-held dynamometery, were assessed annually. Development of new ADL disability was assessed at the time of the next annual assessment after hospitalization. Separate regression analyses modeled the association of pre-hospitalization ALMBMI or grip strength with death before the next scheduled annual assessment. Next, among those who survived to the next annual assessment, separate regression analyses modeled the association of ALMBMI or grip strength with development of ADL disability. Results Each standard deviation decrement in pre-hospitalization grip strength was associated with an adjusted 1.80 odds of new ADL disability at follow-up (95% CI: 1.18, 2.74). Low, compared to not low, grip strength (per FNIH definition) was associated with an adjusted 2.36 odds of ADL disability at follow-up (95% CI: 1.12, 4.97). ALM measures were not associated with development of hospital-associated ADL disability. ALM and grip strength measures were not associated with death. Conclusions Pre-hospitalization lower grip strength may be an important risk factor for ADL disability among older adult survivors of hospitalization.

scholarly journals Association between cognitive declines and disability in activities of daily living in older adults with COPD: evidence from the China health and retirement longitudinal study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e040098
Author(s):  
Bingyan Gong ◽  
Shaomei Shang ◽  
Chao Wu
Keyword(s):  
Older Adults ◽  
Regression Analysis ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Visuospatial Ability ◽  
Cross Sectional ◽  
Adl Disability

ObjectivesThis study aimed to investigate the relationship between disability and domain-specific cognitive function in older adults with chronic obstructive pulmonary disease (COPD).DesignCross-sectional analyses combined with retrospective longitudinal analyses.SettingWe included 450 communities in China.ParticipantsIn this study, 1022 (mean age: 68.6±6.3; 612 males) and 152 (mean age: 67.0±5.2; 83 males) older adults with COPD from the China Health and Retirement Longitudinal Study were included in a cross-sectional multivariate linear regression analysis and a longitudinal logistic regression analysis, respectively.Outcome measuresDisability was determined by the difficulty or inability to complete 1 of the 12 activity items in basic activities of daily living (ADL) and instrumental ADL. The cognitive dimensions of episodic memory, attention/numerical ability, orientation to time, and visuospatial ability were assessed via the immediate/delayed recall task, serial sevens task, naming the current date and pentagon-figure-drawing tasks, respectively.ResultsOf 1022 older respondents with COPD at wave-4, 48.5% had ADL disability. Declines in the global cognitive function (β (95% CI)=−0.627 (−1.214 to –0.040)), orientation to time (β (95% CI)=−0.207 (−0.364 to –0.050)) and visuospatial ability (β (95% CI)=−0.068 (−0.127 to –0.009)) were significantly associated with the presence of ADL disability, when demographic and health-related variables were adjusted. Of 152 older participants with COPD and without ADL disability in wave-2, 61 (40.1 %) developed disability over a 2-year follow-up. Relative to the participants without a decline in orientation to tine, those with the condition had greater odds of incidence of ADL disability increased by a factor of about 1.46 over a 2-year follow-up.ConclusionsIn older adults with COPD, orientation to time and visuospatial inability are vulnerable to the presence of a disability. Prevention of a decline in orientation to time might help prevent disability in older people with COPD.

Career Preferences of Nursing Students

2012 ◽  
Vol 31 (4) ◽  
pp. 471-482 ◽  
Author(s):  
Odette N. Gould ◽  
Anna MacLennan ◽  
Suzanne Dupuis-Blanchard
Keyword(s):  
Older Adults ◽  
Nursing Students ◽  
Health Outcomes ◽  
Older Patients ◽  
Student Nurses ◽  
Career Interests ◽  
Quadratic Effect ◽  
Advanced Students ◽  
Negative Health Outcomes ◽  
Career Preferences

ABSTRACTThis study investigates novice and experienced student nurses’ attitudes about caring for patients across the lifespan. Students were also asked why they would enjoy or not enjoy caring for children and older adults. Both novice (n = 114) and advanced (n = 56) nursing students were relatively positive about caring for patients across the lifespan. However, novices were significantly more negative about working with older patients, particularly after experiencing a first clinical placement. In contrast, a significant quadratic effect was found for advanced students, indicating more negativity about working with both children and older adults. When giving reasons for why they would enjoy caring for older patients, novices were more likely than were advanced students to focus on stereotypical characteristics and on negative health outcomes of older adults as a group. Overall, results suggest that the attitudes driving career interests in nursing students change as training advances.

Prediction of Adverse Outcomes in Nursing Home Residents According to Intrinsic Capacity Proposed by the World Health Organization

2019 ◽  
Vol 75 (8) ◽  
pp. 1594-1599 ◽  
Author(s):  
Alexia Charles ◽  
Fanny Buckinx ◽  
Médéa Locquet ◽  
Jean-Yves Reginster ◽  
Jean Petermans ◽  
...  
Keyword(s):  
Nursing Home ◽  
Health Outcomes ◽  
World Health Organization ◽  
Nursing Home Residents ◽  
World Health ◽  
Balance Performance ◽  
The World ◽  
Unit Increase ◽  
Intrinsic Capacity ◽  
Health Organization

Abstract Background This study aimed to evaluate the predictive value of the domains of intrinsic capacity (ie, cognition, locomotion, sensory, vitality, and psychosocial) proposed by the World Health Organization (WHO) on the 3-year adverse health outcomes of nursing home residents. Methods A 3-year incidence of mortality, falls, repeated falls, and autonomy decline (ie, a one-unit increase in the Katz score) was assessed in a cohort of Belgian nursing home residents. Cognition was assessed using the Mini-Mental State Examination (MMSE). For locomotion, balance, gait speed and chair stand performance were evaluated by the Short Physical Performance Battery test. The sensory domain was measured using the Strawbridge questionnaire for audition and vision. For vitality, abdominal circumference, body mass index, nutritional status (by Mini Nutritional Assessment [MNA]) and handgrip strength were assessed. Psychosocial status was evaluated by the EQ-5D and the Center for Epidemiological Studies Depression scale. Missing data were handled by multiple imputations. Cox proportional hazard models, logistic regressions, and analysis of variance were used for the analyses. Results In the multivariable model, a one-unit increase in balance performance and in the nutrition score decreased the probability of death by 12% (Hazard ratio [HR] = 0.88; 95% confidence interval [CI] 0.78–0.99) and 4% (HR = 0.96; 95% CI 0.93–0.99), respectively. The risk of falling decreased when there was a one-unit increase in balance performance (HR = 0.87, 95% CI 0.79–0.96) and in the nutrition score (HR = 0.96, 95% CI 0.93–0.98). No association was found for intrinsic capacity and repeated falls. Low scores in nutrition (odds ratio = 0.86, 95% CI 0.77–0.96) were associated with a higher probability of autonomy decline. Conclusion Some domains of intrinsic capacity predicted health outcomes among nursing home residents. Nutrition and balance should be regularly checked among this population.

scholarly journals Aging With Vision Loss: A Framework for Assessing the Impact of Visual Impairment on Older Adults

2019 ◽  
Vol 60 (6) ◽  
pp. 989-995 ◽  
Author(s):  
Bonnielin K Swenor ◽  
Moon J Lee ◽  
Varshini Varadaraj ◽  
Heather E Whitson ◽  
Pradeep Y Ramulu
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Visual Impairment ◽  
Successful Aging ◽  
Vision Loss ◽  
Common Causes ◽  
The Impact ◽  
The Relationship ◽  
Negative Health Outcomes ◽  
Multiple Intervention

Abstract There is limited research examining the impact of visual impairment (VI) on older adults while considering the complexities of aging, leaving gaps in our understanding of how health consequences of VI might be averted. We created a framework integrating concepts from disability, geriatrics, and ophthalmology that conceptualizes how VI challenges successful aging. Here, VI influences multiple functional domains, and increases the risk of negative health outcomes. This model acknowledges that common causes, such as risk factors that affect eyes and other systems simultaneously, may also drive the relationship between VI and health outcomes. Finally, the model highlights how the impact of VI on aging outcomes can be addressed at multiple intervention points.

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