scholarly journals Self-Efficacy Proxy Predicts Physical Frailty Incidence Over 8 Years in Non-Institutionalized Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 392-392
Author(s):  
Melissa Hladek ◽  
Jiafeng Zhu ◽  
Brian Buta ◽  
Sarah Szanton ◽  
Karen Bandeen-Roche ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Sex Education ◽  
Self Efficacy ◽  
Daily Living ◽  
Functional Decline ◽  
Adverse Outcomes ◽  
Physical Frailty ◽  
Frailty Phenotype ◽  
Increased Risk

Abstract Physical frailty is defined as a syndrome of decreased physiologic reserve conferring vulnerability to functional decline, mortality and other adverse outcomes in response to a stressor. One potential modifiable risk factor of frailty is self-efficacy, which is confidence in one’s ability to perform well at a task or domain in life. Self-efficacy is associated with improved health behavior and decreased chronic disease burden but has not been studied extensively in frailty research. Therefore, the purpose of this study was to evaluate a general self-efficacy proxy measure’s ability to predict frailty in a nationally representative sample of older adults using data from the National Health and Aging Trends Study (NHATS) collected from 2011-2018. 4,835 older adults (65+) were dichotomized into low and high self-efficacy groups using the one-item self-efficacy proxy measure in NHATS. The Physical Frailty Phenotype was used to assess frailty. A discrete time hazard model was used to obtain incident hazard ratios of frailty in two models. Model 1 was adjusted for age, race, sex, education and income. Model 2 contained Model 1 covariates and activities of daily living and co-morbidities. We found that low self-efficacy predicted a 41% increased risk of developing frailty over 8 years after adjustment for socio-demographics (P<0.0001) and a 27% risk of incident frailty after further adjustment for activities of daily living and co-morbidities (P=0.004). This study provides preliminary evidence that self-efficacy may be a key modifiable element to incorporate into multi-modal frailty interventions.

scholarly journals Frailty as a predictor of future falls and disability: a four-year follow-up study of Chinese older adults

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Quan Zhang ◽  
Xinyi Zhao ◽  
Huiying Liu ◽  
Hua Ding
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Community Dwelling ◽  
Frailty Phenotype ◽  
Chinese Older Adults ◽  
Frailty Status ◽  
Increased Risk ◽  
Lower Magnitude

Abstract Background Frailty, which is defined as aging-related multisystem impairments, can lead to adverse health outcomes. However, evidence for such a connection in Chinese older adults remains lacking. This study examined the association between frailty and future falls and disability among community-dwelling Chinese older adults. Methods Data were obtained from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. Participants were aged 60 years and above at baseline in 2011 and completed the follow-up survey in 2015. Outcome measures were future falls, incident disability in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), and worsening performance of ADLs and IADLs. A multivariate logistic regression was conducted to examine the association between frailty phenotype and falls, incident disability, and worsening disability during a four-year period. Results We found that frail participants were at increased risk at follow-up for: falls (OR 1.54, 95% CI, 1.14–2.08); developing new ADL difficulties (OR 4.10, 95% CI, 2.79–6.03) and IADL difficulties (OR 3.06, 95% CI, 2.03–4.61); and worsening ADLs performance (OR 2.27, 95% CI, 1.27–4.06), after adjusting for potential confounders. Prefrailty was also significantly associated with future falls, incident disability in ADLs and IADLs, but with a lower magnitude of effect. Conclusions Frailty phenotype is an independent predictor of future falls, incident disability, and worsening performance in ADLs among Chinese older adults. The association suggests the need to pay special attention in caring for frail and prefrail elders and improving individuals’ frailty status.

scholarly journals Association of self-perceived income sufficiency with cognitive impairment among older adults: a population-based study in India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
T. Muhammad ◽  
Shobhit Srivastava ◽  
T. V. Sekher
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Psychological Health ◽  
Daily Living ◽  
Basic Needs ◽  
Well Being ◽  
Asset Ownership ◽  
Increased Risk

Abstract Background Greater cognitive performance has been shown to be associated with better mental and physical health and lower mortality. The present study contributes to the existing literature on the linkages of self-perceived income sufficiency and cognitive impairment. Study also provides additional insights on other socioeconomic and health-related variables that are associated with cognitive impairment in older ages. Methods Data for this study is derived from the 'Building Knowledge Base on Population Ageing in India'. The final sample size for the analysis after removing missing cases was 9176 older adults. Descriptive along with bivariate analyses were presented to show the plausible associations of cognitive impairment with potential risk factors using the chi-square test. Also, binary logistic regression analysis was performed to provide the relationship between cognitive impairment and risk factors. The software used was STATA 14. Results About 43% of older adults reported that they had no source of income and 7.2% had income but not sufficient to fulfil their basic needs. Older adults with income but partially sufficient to fulfil their basic needs had 39% significantly higher likelihood to suffer from cognitive impairment than older adults who had sufficient income [OR: 1.39; OR: 1.21–1.59]. Likelihood of cognitive impairment was low among older adults with asset ownership than older adults with no asset ownership [OR: 0.83; CI: 0.72–0.95]. Again, older adults who work by compulsion (73.3%) or felt mental or physical stress due to work (57.6%) had highest percentage of cognitive impairment. Moreover, older adults with poor self-rated health, low instrumental activities of daily living, low activities of daily living, low subjective well-being and low psychological health were at increased risk for cognitive impairment. Conclusion The study highlights the pressing need for care and support and especially financial incentives in the old age to preserve cognitive health. Further, while planning geriatric health care for older adults in India, priority must be given to financially backward, with no asset ownership, with poor health status, older-older, widowed, and illiterate older individuals, as they are more vulnerable to cognitive impairment.

scholarly journals Neuropsychological and Functional Impact of COVID-19 on Mild Cognitive Impairment

2020 ◽  
Vol 35 ◽  
pp. 153331752096087
Author(s):  
Kalpana P. Padala ◽  
Christopher M. Parkes ◽  
Prasad R. Padala
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Case Report ◽  
Mild Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Older Adult ◽  
Daily Living ◽  
Functional Decline ◽  
Depression And Anxiety ◽  
Physically Active

We present a case report to showcase that behavioral, cognitive, and functional decline may be associated with COVID-19 stay-home guidance among older adults with pre-existent cognitive impairment. In a functionally independent and physically active older adult with Mild Cognitive Impairment, there was worsening in depression and anxiety symptoms associated with the restrictions of COVID-19. Functional decline was also noted as assessed by Instrumental Activities of Daily Living. We discuss solutions to mitigate the effects of COVID-19 restrictions in this vulnerable population.

Heterogeneous Long-Term Trajectories of Dependency in Older Adults: The PAQUID Cohort, a Population-Based Study over 22 years

2020 ◽  
Vol 75 (12) ◽  
pp. 2396-2403 ◽  
Author(s):  
Arlette Edjolo ◽  
Jean-François Dartigues ◽  
Karine Pérès ◽  
Cécile Proust-Lima
Keyword(s):  
Activities Of Daily Living ◽  
Sex Education ◽  
Successful Aging ◽  
Daily Living ◽  
Functional Decline ◽  
Population Based ◽  
Theory Model ◽  
Factors Associated ◽  
Instrumental Activities ◽  
High Dependency

Abstract Background A critical step toward successful aging is to identify opportunities for prevention of functional decline. Our aim was to describe the heterogeneity in trajectories of dependency preceding death in elders and to identify factors associated with this heterogeneity. Methods The study relied on 3,238 participants of the prospective population-based PAQUID cohort aged 65+ at baseline in 1988. Dependency was defined from an 11-item scale of basic and instrumental activities of daily living (ADL: bathing, dressing, toileting, continence, eating, and transferring; instrumental activities of daily living (IADL): telephoning, shopping, using transport, handling medication, and managing finances) collected over 22 years. Heterogeneous trajectories were estimated using a longitudinal item response theory model including latent classes. Results Five distinct profiles of functional dependency were identified over the two last decades of life: persistently high (12%), moderate (26%), persistently low (40%), and accelerated high dependency (15%), and no dependency (8%). Main factors associated with heterogeneity included age at death, sex, education, initial cognition (Mini-Mental State Examination [MMSE] score and dementia), initial disability, and poly-medication. Conclusions In the two last decades of life, more than 9 elders in 10 were characterized as functional decliners. On average, around half of the elders died with no or mild dependency, while 27% live several years with a high level of limitations and would need assistance in activities of daily living, at least for 2–4 years preceding death. The identified factors associated with these trajectories are important to understand functional heterogeneity in elders and to propose interventions to postpone or prevent “chronic” disability.

Exergaming as a tool to enhance strength, balance, gait, mobility, participation, self-efficacy for exercise and adherence in older adults

2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
A C Martins ◽  
J Quatorze ◽  
D Guia
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Functional Ability ◽  
Self Efficacy ◽  
Daily Living ◽  
Exercise Program ◽  
Community Dwelling ◽  
Step Test ◽  
Mobility Limitations ◽  
The Impact

Abstract Introduction It is projected that the number of adults aged 60 or above will be 1.4 billion in 2030 and 2.1 billion in 2050. With aging, mobility limitations can cause severe difficulties on being independent during activities of daily living. Exercise has been shown as effective to counteract the impact of aging, although it is hard to create adherence. Exergames, as they increase the appeal of exercise, show promising results in terms of participation and promotion of healthy behaviours. Objectives This study aimed at assessing the effectiveness of the Otago Exercise Program incorporated in FallSensing Exergames. Methodology Community-dwelling older adults aged 60 or over, were recruited from facilities in Coimbra, Portugal and randomized in two groups, 27 allocated to the intervention (IG) and 34 to the control (CG). Regular activities of daily living (CG) were compared to an Exergame program (IG). Assessments were made at baseline and re-assessments at 8 weeks/16 sessions, regarding strength, balance, walking speed, participation and self-efficacy for exercise. Results 61 older adults (77% female), mean ages were 82.22 (IG) and 87.26 (CG) years. After 8 weeks, CG demonstrated a decrease in functional ability. IG got improvement in Step test (p = 0.001), 4 Stage Balance Modified test (p = 0.001), Self-Efficacy for Exercise (p = 0.009) and Activities and Participation Profile Related to Mobility (p < 0.001) questionnaires. Conclusion Exergaming was safe and effective in improving functional ability, participation and self-efficacy. Nevertheless, some considerations are necessary when prescribing an Exergames, mainly concerning frequency and intensity of the exercise program and participants’ age.

scholarly journals Association of late-life depression with cognitive impairment: evidence from a cross-sectional study among older adults in India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
T. Muhammad ◽  
Trupti Meher
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Urban Areas ◽  
Daily Living ◽  
Short Form ◽  
Late Life ◽  
Older Individuals ◽  
Late Life Depression ◽  
Increased Risk

Abstract Background Late-life depression (LLD) is considered as a prodrome to dementia and plays a major role in the development of long-term cognitive disabilities. We aimed to estimate the prevalence and correlates of LLD and cognitive impairment and to explore their associations among older adults in India. Methods Data for this study was derived from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-18). The total sample included 31,464 (15,098 male and 16,366 female) older individuals aged 60 years and above. Cognitive impairment measured from various domains derived from the cognitive module of the Health and Retirement Study (HRS), and major depression measured by the CIDI-SF (Composite International Diagnostic Interview- Short Form) were the outcome variables. Descriptive, bivariate, and multivariable analyses were performed to fulfill the objectives of the study. Results The overall prevalence of LLD and cognitive impairment for the current sample was 8.7% and 13.7 % respectively. Among older individuals who have rated their health status as poor were 2.59 times more likely to suffer from LLD [OR: 2.59, CI: 2.24–2.99] as compared to their counterparts. The older adults who had difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL) were 74% and 69 % more likely to suffer from LLD. Similarly, older adults who were depressed had higher odds of cognitive impairment [OR: 1.22, CI: 1.01–1.48] compared to their counterparts. Also, older adults who were depressed and belonged to rural areas were 2.58 times [AOR: 2.58, CI: 1.95–3.41] more likely to be cognitively impaired than those who were not depressed and resided in urban areas. Conclusions Depression is linked to an increased risk of cognitive decline and dementia; therefore, failing to diagnose and treat LLD in later life may have significant health implications. Moreover, treatment under the care of a cognitive neurologist or geriatric psychiatrist is recommended for people with LLD and cognitive disability due to both the disorders' complex existence.

scholarly journals P052: Utility of data captured by transition referral forms for program evaluation and research

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S75-S75
Author(s):  
L.A. Gaudet ◽  
L.D. Krebs ◽  
S. Couperthwaite ◽  
M. Kruhlak ◽  
N. Loewen ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Decline ◽  
Community Services ◽  
Goals Of Care ◽  
University Of Alberta ◽  
Transition Coordinators ◽  
Discharged Patients ◽  
The University

Introduction: Increase in functional decline of older adults after discharge from the emergency department (ED) has been reported; however, evaluations of interventions to mitigate this problem are infrequent. Data collected in the ED on older adults may document functional status, yet their utility for research is unknown. This study aimed to assess the usability of data collected by ED Transition Coordinators (EDTC) during routine assessments for functional decline research. Methods: EDTCs assess all patients 75 years old presenting to the ED and complete a standardized Transitional Assessment Referral (TAR) form that documents patients independence and daily functioning. To measure the utility of these forms for research purposes, trained research staff evaluated the TARs completed in April 2017 by TCs in the University of Alberta Hospital ED by extracting data from the TARs into a purpose-built REDCap database. Researchers selected and assessed for completeness and clarity the following variables unique to the TARs: facility vs. non-facility living, goals of care and personal directive, fall history, falls in the past 90 days, independence in 14 activities of daily living (ADLs)/instrumental activities of daily living (IADLS), community services in place, and homecare referrals for discharged patients. The proportion of TARs with data for each variable and the proportion of forms with unambiguous responses in each section are reported. Results: Overall, 500 forms were analysed; patients were 41% male with a mean age of 82 (SD=11.2). Homecare referrals, facility vs. non-facility living, and independence with 14 ADLs/IADLs were the most frequently documented variables (81%, 78%, and 79%, respectively); however for ADLs/IADLs, 59% of the 79% had one or more missing components. While fall history was reported in 301 forms (60%), only 107/301 (36%) reported the number of falls in the last 90 days. The referral to homecare variable was complete in 217/268 (81%) forms; however, 99% of files were missing data about goals of care, personal directives, and receipt of community services. Conclusion: Although some information on elderly patients is consistently reported, many of the social service/human factors associated with functional decline are not recorded. While data on the TARs may be useful for studying functional decline in the ED, exploring the barriers to form completion may improve adherence thereby increasing their research utility.

scholarly journals Functional Profile of Older Adults Hospitalized in Convalescence Units of the National Network of Integrated Continuous Care of Portugal: A Longitudinal Study

2021 ◽  
Vol 11 (12) ◽  
pp. 1350
Author(s):  
Ana Ramos ◽  
César Fonseca ◽  
Lara Pinho ◽  
Manuel Lopes ◽  
Henrique Oliveira ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Sex Education ◽  
Daily Living ◽  
Emotional State ◽  
Education Level ◽  
Cognitive State ◽  
Functional Profile ◽  
National Network ◽  
Continuous Care

Aim: To evaluate the evolution of the functional profile of older adults admitted to a health unit in Portugal; to relate the functional profile of these individuals with age, sex, education level and emotional state; and to evaluate the probability of the degree of dependence as a function of age and sex. Methods: longitudinal, retrospective study with a sample of 59,013 older adults admitted to convalescence units of the National Network of Integrated Continuous Care of Portugal. Results: In the first 75 days of hospitalization, activities of daily living, mobility and cognitive state improved, but there was a decline after 75 days of hospitalization. The ability to perform instrumental activities of daily living improved in the first 15 days of hospitalization, stabilized until 45 days and then began to worsen. Women had a higher probability of having a severe/complete dependence three years earlier than men (88 years to 91 years). A higher education level and stable emotional state were protective factors against functional decline. Conclusions: The functional profile of older adults improved during the length of stay recommended for hospitalization in convalescence units (30 days). It is critical for health systems to adopt strategies to prevent declines in the emotional state of frail individuals.

scholarly journals Dependency Change with Aging and Associated Factors in Uruguay: A Cohort Study

2021 ◽  
pp. 089826432110177
Author(s):  
Alejandra Marroig ◽  
Maximiliano Machado ◽  
Graciela Muniz-Terrera
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Activities Of Daily Living ◽  
Chronic Conditions ◽  
Daily Living ◽  
Associated Factors ◽  
Social Care ◽  
Representative Study ◽  
Increased Risk ◽  
Using Data

Objectives: To assess the heterogeneity of transitions toward dependency in older adults and to explore the robustness of results to different operationalizations of dependency. Method: Using data from people aged 60 years and older from a national representative study in Uruguay ( Encuesta Longitudinal de Protección Social, N = 5071), we fitted multinomial regressions adjusted by sociodemographic and health characteristics to model transitions into dependency and death. We used a harder operationalization with basic activities of daily living (Katz-dependency) and Comprehensive-dependency with basic, instrumental, and advanced activities. Results: Increasing age (RRR = 1.08, CI = [1.05; 1.12], p < .001) and having comorbidities (RRR = 2.16, CI = [1.31; 3.57], p = .003) increased the risk of transition from nondependent to dependent using Katz-dependency. Women with at least two chronic conditions have increased risk of Comprehensive-dependency (RRR = 1.79, CI = [1.15; 2.80], p = .010). Discussion: Inconsistencies in findings emerged when evaluating transitions into dependency with the different measures, which may have social care implications.

scholarly journals Aging in Place: Challenges of Older Adults with Self-Reported Cognitive Decline

2021 ◽  
Vol 24 (2) ◽  
pp. 138-143
Author(s):  
Chantel D. Mayo ◽  
Rebecca Kenny ◽  
Vanessa Scarapicchia ◽  
Lisa Ohlhauser ◽  
Robin Syme ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Daily Living ◽  
Aging In Place ◽  
Cognitive Change ◽  
Structured Interviews ◽  
Emotional Challenges ◽  
Targeted Interventions ◽  
Increased Risk

Background An emergent concern related to the aging and the increased risk of cognitive decline is the institutionalization of older adults. Evidence has shown that aging in place leads to many benefits, including higher quality of life. In order to support older adults, it is imperative that we understand the challenges people with changes in cognition face while aging in place. Methods A total of sixteen older adults with self-reported cognitive decline and six informal caregivers of individuals reporting cognitive decline, all of whom are living in independent residences, participated. Focus group sessions with semi-structured interviews were conducted, followed by thematic qualitative data analyses. Results Thematic analyses led to the identification of six challenges to aging in place, including: 1) memory decline, 2) emotional challenges/low mood, 3) social isolation/loneliness, 4) difficulty with mobility and physical tasks, 5) difficulties with activities of daily living/instrumental activities of daily living, and 6) lack of educational resources on cognitive change. Conclusion The themes identified in the current study represent common challenges in aging in place for older adults with self-reported cognitive decline. Identification of these themes allows for important next steps, which can focus on supports through targeted interventions.

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