scholarly journals Change of Health and Change of Preferences on Life-Sustaining Treatment: Evidence From a Longitudinal Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 19-20
Author(s):  
Yifan Lou ◽  
Mercedes Bern-Klug ◽  
Jinyu Liu
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Living Will ◽  
Socioeconomic Background ◽  
Policy And Practice ◽  
Logistic Regression Models ◽  
Perceived Change ◽  
Eol Care

Abstract Background Decision-making for end-of-life (EoL) care is not a one-off choice. Older adults may change their preferences for life-sustaining treatments along their health continuum. Guided by prospect theory, we hypothesize that perceived change in health status is a driver behind preference changes. Method: Health and Retirement Study Wave 2012 to 2018 data. Sample is limited to 5,646 older adults who reported whether they requested to limit treatment in living will during two waves of data. Two possible preference changes were tested: from limited to default care and from default to limited care. Change in health status was indicated by changes (1=same, 2=improve, 3=decline) in physical pain, general health, activities of daily living, instrumental activities of daily living (IADL), and number of diagnoses. Multilevel logistic regression models were used to understand how change of health status was related to changes in EoL preferences. Results 700 older adults changed their preferences some time in 8 years. Those who changed their preferences are more likely to be older and not married, and to have lower socioeconomic background. Older adults who experienced deteriorated pain levels were more likely to change their preferences from default to limited care (OR=3.77, p<.05) and less likely to change from limited to default care (OR=0.63, p<.05). Change in IADL is also a significant predictor of change of preferences. Implication: The findings highlight the importance of periodic reassessment of EoL care preferences with older adults. We discuss policy and practice implications regarding health changes as underlying mechanisms of preference changes.

scholarly journals PREVALENCE AND CORRELATES OF IMPAIRMENTS IN ACTIVITIES OF DAILY LIVING IN OLDER KOREANS: COMPARISON OF YOUNG-OLD AND OLD-OLD

2019 ◽  
Vol 15 (3) ◽  
pp. e1-e10 ◽  
Author(s):  
Seonho Kim ◽  
Dallong Han ◽  
Jongeun Lee
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Health Status ◽  
Cognitive Function ◽  
Activities Of Daily Living ◽  
Age Differences ◽  
Daily Living ◽  
Regular Exercise ◽  
Perceived Health Status ◽  
Young Old

Background and ObjectiveSocietal aging and increasing average life expectancy have led to a significant increase in the population of individuals aged 75 years or above. Hence, it is becoming more meaningful and appropriate for researchers to divide those above the age of 65 years into various subgroups, such as young-old and old-old. Based on this division, we investigated the prevalence and correlates of impairments in activities of daily living (ADLs) among community-dwelling older adults (young-old vs. old-old) in South Korea. Material and MethodsThis was a cross-sectional study. We used the data of 4,368 older adults (≥65 years old) from the 2012 Korean Longitudinal Study of Aging. ADL impairment was assessed using a modified version of the Katz Index of Independence in Activities of Daily Living. ResultsThe prevalence of ADL impairment was greater in old-old participants (12.7%) than in young-old ones (3.0%). ADL impairment was significantly associated with gender, perceived health status, regular exercise, cognitive function, and depressive symptoms in young-old individuals. By contrast, in old-old individuals, the significant predictors were residential area, socioeconomic status, perceived health status, regular exercise, cognitive function, and depressive symptoms. Among both age subgroups, cognitive function was the strongest predictive factor of ADL impairment. Conclusion We found clear age differences in the prevalence and correlates of ADL impairment in older Koreans. Such age differences should be considered when studying and developing interventions for ADL impairment in older adults.

Performance-Based Impairment Measures as Predictors of Early-Stage Activity Limitations in Community-Dwelling Older Adults

2016 ◽  
Vol 29 (5) ◽  
pp. 880-892 ◽  
Author(s):  
Lauren Terhorst ◽  
Margo B. Holm ◽  
Pamela E. Toto ◽  
Joan C. Rogers
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Early Stage ◽  
Secondary Analysis ◽  
Community Dwelling ◽  
Logistic Regression Models ◽  
Performance Quality ◽  
Functional Reach ◽  
Community Dwelling Older Adults

Objective: The objective of the current investigation was to explore performance-based predictors of decline in the performance quality of everyday tasks as a first step for early identification, screening, and referral to minimize disability in community-dwelling older adults. Method: This was a secondary analysis of data from 256 community-based older women. Mobility, activities of daily living (ADLs), and instrumental activities of daily living (IADLs) were measured using the Performance Assessment of Self-Care Skills (PASS). Logistic regression models explored cognitive and motor predictors of performance quality while controlling for demographics and diagnoses. Results: Functional reach ( p = .049) and cognition ( p = .012) were predictive of mobility quality, whereas balance ( p = .007) and the Keitel Function ( p = .005) were predictive of ADL quality. Manipulation and cognitive measures were predictive of cognitive and physical IADL quality. Discussion: Cognitive and physical screens are both important to identify older adults at risk for disability.

scholarly journals Health Status and Health Patterns in Urban-rural Dwelling Elderly in Nakhonratchasima Province, Thailand

2019 ◽  
Author(s):  
Nutthita Petchprapai
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Activities Of Daily Living ◽  
Rural Areas ◽  
Daily Living ◽  
Tap Water ◽  
The Elderly ◽  
Health Problems ◽  
Religious Activities ◽  
Urban Rural

Introduction: As rapid urbanizing spreads throughout Thailand, the combination of urban-rural lifestyle has been gradually found. These changes may effect on health pattern of the older adults. This study was aimed to explore the incidence of health problems and life styles of the elderly in urban-rural areas. Methods: A random interview survey with qualitative approach was used. Data were randomly collected from 14 areas in central sub-districts of Nakhonratchasima province, Thailand. Twenty-five older adults in each area were interviewed. The recording forms consisted of demographic data, perceived health status and health problems, medication use, activities of daily living, instrumental activities of daily living, mental health, social and religious activities, and accommodation and environment. Non-invasive physical examinations of the elderly were performed by weighing, measuring height and testing muscle strength with one leg standing. Results: Most of the elderly reported having at least one chronic disease and/or degenerative problems that had impact on their daily lives. Forty percent rated their health status as moderate to poor, 18% encountered falls while 18% were hospitalized in the past six months. Only one-third underwent an annual health check–up while 30% of the female had cancer cervix screening. Most of the elderly could perform daily tasks on their own with assistive instruments and were healthy in mind. However, many of them drank tap water without boiling or filtering. Conclusion: The older adults in the urban-rural areas had access to health care services and had a good health status. However, their health promotion and prevention behaviors are questionable

scholarly journals Technology Used to Recognize Activities of Daily Living in Community-Dwelling Older Adults

2020 ◽  
Vol 18 (1) ◽  
pp. 163
Author(s):  
Nicola Camp ◽  
Martin Lewis ◽  
Kirsty Hunter ◽  
Julie Johnston ◽  
Massimiliano Zecca ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Wearable Technology ◽  
Community Dwelling ◽  
Use Of Technology ◽  
Key Stakeholders ◽  
Environmental Technologies ◽  
Current Monitoring ◽  
Future Work

The use of technology has been suggested as a means of allowing continued autonomous living for older adults, while reducing the burden on caregivers and aiding decision-making relating to healthcare. However, more clarity is needed relating to the Activities of Daily Living (ADL) recognised, and the types of technology included within current monitoring approaches. This review aims to identify these differences and highlight the current gaps in these systems. A scoping review was conducted in accordance with PRISMA-ScR, drawing on PubMed, Scopus, and Google Scholar. Articles and commercially available systems were selected if they focused on ADL recognition of older adults within their home environment. Thirty-nine ADL recognition systems were identified, nine of which were commercially available. One system incorporated environmental and wearable technology, two used only wearable technology, and 34 used only environmental technologies. Overall, 14 ADL were identified but there was variation in the specific ADL recognised by each system. Although the use of technology to monitor ADL of older adults is becoming more prevalent, there is a large variation in the ADL recognised, how ADL are defined, and the types of technology used within monitoring systems. Key stakeholders, such as older adults and healthcare workers, should be consulted in future work to ensure that future developments are functional and useable.

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 I'd Rather Be . . . : Activities Older Adults Reported Leading to Decreased Engagement With Cognitive Training

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 325-325
Author(s):  
Erin Harrell ◽  
Nelson Roque
Keyword(s):  
Older Adults ◽  
Risk Factor ◽  
Form Factor ◽  
Activities Of Daily Living ◽  
Cognitive Ability ◽  
Cognitive Training ◽  
Daily Living ◽  
Training Programs ◽  
Qualitative Approach ◽  
Tablet Device

Abstract One modifiable risk factor of dementia is cognitive inactivity. Given cognitive ability is closely tied to continual performance of instrumental activities of daily living, cognitive training programs continue to be explored as a way to boost cognition and allow older adults to remain independent longer. While the efficacy of cognitive training is controversial, identifying activities older adults are willing to limit in exchange for cognitive training provides valuable information in relation to designing cognitive training programs that appeal to older adults. Using a qualitative approach, this study highlights activities older adults (ages 64+) noted as contributing to decreased gameplay of a cognitive training program on a tablet device. We found that respondents (61%) noted playing less as a result of entertainment activities (i.e., reading and playing games), social activities (31%) and travel (27%). Findings have implications for device form factor in administering cognitive training and other programs.

scholarly journals Effects of Dance Therapy on Balance and Risk of Falls in Older Persons

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 234-235
Author(s):  
Esha Chakravarty ◽  
Indrani Chakravarty ◽  
Ipsito Chakravarty ◽  
Prasenjit Bhattacharjee
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Day Care ◽  
Dance Therapy ◽  
Daily Living ◽  
Older Persons ◽  
Healthy Ageing ◽  
Risk Of Falls ◽  
Day Care Centres ◽  
Therapy Sessions

Abstract Loss of balance and risk of falls is a major problem in older persons. Literature shows increasing use of yoga practices and dance therapy across Indian oldage homes and day care centres to improve balance and reduce risk of falls in older persons. Aim of this study is to evaluate the effects of dance therapy with focus on therapeutic movements derived from Indian classical dances on balance and risk of falls in older adults of Day Care Centres in Calcutta Metropolitan Institute of Gerontology, under Ministry of Social Justice and Empowerment, Govt. of India. Total of 24 older adults across 2 day care centres participated in the study attending dance therapy sessions for 3 months. All of them self reported problems of balance and repeated falls alongwith difficulties in performing Activities of Daily Living. Twenty one of them were females and 3 males. The mean age of the participants was 75.5 years. Limits of Stabililty (LOS) was used to measure balance and pre tests and post tests were performed. Results showed that the Limits of Stability were significantly higher (17.5%) in older persons after participating in the dance therapy sessions. This study supports that dance therapy using movements derived from Indian classical dance forms can support older persons to function with reduced risk of falls, improved balance, safely carry out mobility tasks and perform better Activities of Daily Living . Further studies can show how dance therapy can facilitate healthy ageing and influence State policies on healthy ageing.

scholarly journals Impairment in activities of daily living and readmission in older patients with heart failure: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044416
Author(s):  
Tan Van Nguyen ◽  
Huyen Thanh Dang ◽  
Mason Jenner Burns ◽  
Hiep HH Dao ◽  
Tu Ngoc Nguyen
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Tertiary Hospital ◽  
Logistic Regression Models ◽  
Hospitalised Patients ◽  
Patients With Heart Failure ◽  
The Impact

ObjectivesThis study aims to investigate the prevalence of impairment of activities of daily living (ADLs) in older patients with heart failure (HF), and to examine the impact of ADL impairment on readmission after discharge.Design and settingsA prospective cohort study was conducted in patients aged ≥65 years with HF admitted to a tertiary hospital in Vietnam from August 2016 to June 2017. Difficulties with six ADLs were assessed by a questionnaire. Participants were classified into two categories (with and without ADL impairment). The associations of ADL impairment with 3-month readmission were examined using logistic regression models.ResultsThere were 180 participants (mean age 80.6±8.2, 50% female) and 26.1% were classified as having ADL impairment. The most common impaired activity was bathing (21.1%), followed by transferring (20.0%), toileting (12.2%), dressing (8.9%), eating (3.3%), and continence (2.8%). During 3-month follow-up, 32.8% of the participants were readmitted to hospitals (55.3% in participants with ADL impairment, 24.8% in those without ADL impairment, p<0.001). ADL impairment significantly increased the risk of 3-month readmission (adjusted OR 2.75, 95% CI 1.25 to 6.05, p=0.01).ConclusionsIn summary, ADL impairment was common in older hospitalised patients with HF and was associated with increased readmission. These findings suggest further studies on ADL assessment and intervention during transition care for older patients with HF after discharge to prevent readmission.

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