scholarly journals Age, Period, and Cohort Effects on Activities of Daily Living, Physical Performance, and Cognitive Functioning Impairment Among the Oldest-Old in China

2019 ◽  
Vol 75 (6) ◽  
pp. 1214-1221 ◽  
Author(s):  
Pei-Dong Zhang ◽  
Yue-Bin Lv ◽  
Zhi-Hao Li ◽  
Zhao-Xue Yin ◽  
Fu-Rong Li ◽  
...  

Abstract Background The aim of this study was to examine the trends in impairment regarding activities of daily living (ADL), physical performance, and cognitive function among the oldest-old (those aged 80 and older) in China between 1998 and 2014. Methods We used data on 34,297 oldest-old individuals from the seven waves of the Chinese Longitudinal Healthy Longevity Study. We estimated age, period, and cohort effects on the prevalence of self-reported ADL impairment, tested physical performance and cognitive function impairment using the age–period–cohort model. Results Regarding age, the prevalence of ADL, physical performance, and cognitive function impairment were highest in the centenarians, but they did not increase with age in this population. Among the literate subgroup, the prevalence of cognitive impairment increased more rapidly with age than that in the illiterate subgroup. Regarding period, the prevalence of self-reported and tested physical impairment slowly increased between 1998 and 2014, but cognitive impairment remained stable. Regarding cohort, ADL impairment continuously decreased. However, physical and cognitive impairment remained stable after a brief decline in the early birth cohorts. Conclusions The results suggest that the age effect is still the most obvious effect regarding several types of functional impairment. The likelihood of a younger person experiencing functional impairment may not change significantly, but ADL is likely to be amenable to improvement resulting from improved medical and social care. Therefore, increased care for the oldest-old may considerably improve their quality of life, particularly regarding their basic ADL.

2019 ◽  
Vol 19 (7) ◽  
pp. 1022-1031 ◽  
Author(s):  
Paula D. Cebrián ◽  
Omar Cauli

Background: Many neurological disorders lead to institutionalization and can be accompanied in their advanced stages by functional impairment, and progressive loss of mobility, and cognitive alterations. Objective: We analyzed the relationship between functional impairment and cognitive performance and its related subdomains in individuals with Parkinson’s disease, Alzheimer’s disease accompanied by motor dysfunction, and with other neurological disorders characterized by both motor and cognitive problems. Methods: All participants lived in nursing homes (Valencia, Spain) and underwent cognitive evaluation with the Mini-Mental State Examination; functional assessment of independence in activities of daily living using the Barthel score and Katz index; and assessment of mobility with the elderly mobility scale. Results: The mean age of the subjects was 82.8 ± 0.6 years, 47% of the sample included individuals with Parkinson’s disease, and 48 % of the sample presented severe cognitive impairment. Direct significant relationships were found between the level of cognitive impairment and functional capacity (p < 0.01) and mobility (p < 0.05). Among the different domains, memory impairment was not associated with altered activities of daily living or mobility. The functional impairment and the risk of severe cognitive impairment were significantly (p<0.05) higher in female compared to male patients. Among comorbidities, overweight/obesity and diabetes were significantly (p < 0.05) associated with poor cognitive performance in those individuals with mild/moderate cognitive impairment. Conclusion: In institutionalized individuals with movement disorders there is an association between functional and cognitive impairment. Reduction of over-weight and proper control of diabetes may represent novel targets for improving cognitive function at such early stages.


2012 ◽  
Vol 43 (4) ◽  
pp. 801-811 ◽  
Author(s):  
A. G. Gildengers ◽  
D. Chisholm ◽  
M. A. Butters ◽  
S. J. Anderson ◽  
A. Begley ◽  
...  

BackgroundWhile bipolar disorder (BD) is a leading cause of disability, and an important contributor to disability in BD is cognitive impairment, there is little systematic research on the longitudinal course of cognitive function and instrumental activities of daily living (IADLs) in late-life. In this report, we characterize the 2-year course of cognitive function and IADLs in older adults with BD.MethodWe recruited non-demented individuals 50 years and older with BD I or BD II (n = 47) from out-patient clinics or treatment studies at the University of Pittsburgh. Comparator subjects (‘controls’) were 22 individuals of comparable age and education with no psychiatric or neurologic history, but similar levels of cardiovascular disease. We assessed cognitive function and IADLs at baseline, 1- and 2-year time-points. The neuropsychological evaluation comprised 21 well-established and validated tests assessing multiple cognitive domains. We assessed IADLs using a criterion-referenced, performance-based instrument. We employed repeated-measures mixed-effects linear models to examine trajectory of cognitive function. We employed non-parametric tests for analysis of IADLs.ResultsThe BD group displayed worse cognitive function in all domains and worse IADL performance than the comparator group at baseline and over follow-up. Global cognitive function and IADLs were correlated at all time-points. The BD group did not exhibit accelerated cognitive decline over 2 years.ConclusionsOver 2 years, cognitive impairment and associated functional disability of older adults with BD appear to be due to long-standing neuroprogressive processes compounded by normal cognitive aging rather than accelerated cognitive loss in old age.


2020 ◽  
Author(s):  
Qian Sun ◽  
Nan Jiang ◽  
Nan Lu ◽  
Vivian W. Q. Lou

Abstract Background The Chinese population is experiencing rapid aging, limitations in activities of daily living and decline in cognitive function among the oldest-old group causes tremendous economic, family and social burden. Examining their relationship is critically relevant for policymakers. The present study aimed to determine the bidirectional relationship between cognitive function and the loss hierarchy of activities of daily living among older adults in China. Methods Data were derived from a sample of 469 older adults who participated in both the 2010 and 2013 waves of a Longitudinal Study on Family Caregivers for Frail Older Adults. Cognitive function was assessed using the Chinese version of the Short Portable Mental Status Questionnaire and activities of daily living were measured by self-reports of having difficulty or needing help with basic daily activities. A cross-lagged analysis was adopted. Results In general, the results showed cognitive function in 2010 was a significant predictor of middle loss activities of daily living (dressing, moving, bathing and toileting) in 2013, and late loss activities of daily living (feeding and hygiene) in 2013. The loss hierarchy of activities of daily living among older adults was not shown to be significant as a risk factor of cognitive function in 2013. Conclusions The findings expanded understanding of the relationship between cognitive function and the loss hierarchy of activities of daily living as well as provided evidence for clinicians and service planners for anticipating the subsequent care and service needs of the elderly and their families.


2016 ◽  
Vol 74 (7) ◽  
pp. 549-554 ◽  
Author(s):  
Giseli de Fátima dos Santos Chaves ◽  
Alexandra Martini Oliveira ◽  
Juliana Aparecida dos Santos Chaves ◽  
Orestes Vicente Forlenza ◽  
Ivan Aprahamian ◽  
...  

ABSTRACT Mild impairment in activities of daily living (ADL) can occur in Mild Cognitive Impairment (MCI), but the nature and extent of these difficulties need to be further explored. The Canadian occupational performance measure (COPM) is one of the few individualized scales designed to identify self-perceived difficulties in ADL. The present study investigated impairments in ADL using the COPM in elderly with MCI. A total of 58 MCI patients were submitted to the COPM for studies of its validity and reliability. The COPM proved a valid and consistent instrument for evaluating ADL in elderly MCI patients. A total of 74.6% of the MCI patients reported difficulties in ADL. Of these problems, 41.2% involved self-care, 31.4% productivity and 27.4% leisure. This data further corroborates recent reports of possible functional impairment in complex ADL in MCI.


2021 ◽  
Vol 8 ◽  
Author(s):  
Yaxin Zhang ◽  
Pan Liu ◽  
Yiming Pan ◽  
Ying Li ◽  
Li Zhang ◽  
...  

Background: Physical function gradually decreases with age in older adults, affecting their independence and quality of life and leaving them prone to adverse outcomes. Despite the importance of assessing function for older adults, most studies have focused on disability and paid less attention to functional impairment. Thus, given the lack of valid and practical methods for evaluating functional impairment for older adults, we developed the function impairment screening tool (FIST) using the Delphi method.Objective: This study aimed to evaluate the reliability and validity of the FIST in Chinese older adults.Methods: A total of 489 participants aged 60 years or older, and who had completed the FIST were included. A subgroup of 50 participants completed the FIST a second time, 1 week after the first round, and the test–retest reliability was evaluated using the intraclass correlation coefficient (ICC). Reliability was tested using Cronbach's alpha. Validity was examined using exploratory factor analysis. Criterion-related validity was assessed using correlations between the FIST and the Barthel Index activities of daily living (ADL), Lawton, and Brody instrumental activities of daily living (LB-IADL).Results: The Cronbach's alpha coefficient for the FIST was 0.930 (P &lt; 0.001). The test–retest reliability was good, with an ICC of 0.928 (95% confidence interval [0.874, 0.960]). Exploratory factor analyses revealed one factor accounting for 60.14% of the scale's variance and the load values of every item were &gt;0.4 (0.489–0.872). The correlation coefficient was 0.572 (P &lt; 0.001) between the FIST score and ADL, and was 0.793 (P &lt; 0.001) between the FIST score and IADL. The FIST score was positively correlated with walking speed (r = 0.475, P &lt; 0.001) and grip strength (r = 0.307, P &lt; 0.001), and negatively correlated with age (r = −0.588, P &lt; 0.001) and Fried frailty phenotype (r = −0.594, P &lt; 0.001).Conclusion: The FIST is a reliable and valid instrument for assessing physical function impairment in older adults.


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