scholarly journals Back to Life, Back to Reality: Participation and Function After Acute Hospitalization in Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 544-544
Author(s):  
Maya Arieli ◽  
Racheli Kizony ◽  
Efrat Gil ◽  
Maayan Agmon

Abstract This study aims to describe and compare functional trajectories (i.e., participation versus basic daily function) from pre-hospitalization period to one and three-months post-discharge, among older adults hospitalized for acute medical illness, of two age groups: ages 65-75, n=39, >75, n=38. A Prospective longitudinal study was conducted, starting during hospitalization in internal ward and followed by home visits (1 month) and telephone interviews (3 months). Participation was measured by the Activity Card Sort (ACS) that queries about instrumental (e.g. shopping), leisure (e.g. physical activity), and social activities. Basic daily function was measured by the Modified Barthel Index (mBI). Wilcoxon test was used to compare between the ACS and mBI total retained scores within age groups. A mixed model repeated measures ANCOVA was used to compare time by group effects in ACS total scores. The results showed that basic function in both age groups was preserved, and both groups experienced a significantly greater decrease in participation level compared with basic function at one month (z=-4.1, p=.001, z=-4.5, p=.001) and at three months (z=-4.1, p=.001, z=-4.1, p=.001) in the “younger” and “older” groups, respectively. Participation trajectories were similar among age groups, however, the “older” group experienced a significantly greater decrease in participation (F(1)=(4.3), p=.042, η2= .056). Findings indicate that the traditional measure of basic function does not capture the broad spectrum of older adults’ full life and overshadows the reduced participation in meaningful activities. Health care professionals should adopt a comprehensive approach toward functional assessment to encompass participation beyond basic daily function.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7071-7071
Author(s):  
Shabbir M.H. Alibhai ◽  
Henriette Breunis ◽  
Narhari Timilshina ◽  
Mark D. Minden ◽  
Vikas Gupta ◽  
...  

7071 Background: The treatment of AML with intensive chemotherapy (IC) is associated with significant short-term toxicities. We previously showed similar impairments in QOL and physical function among younger (age 18-59) and older (age 60+) patients with AML at diagnosis, with similar recovery over 3 cycles of IC. We now comprehensively describe QOL and physical function recovery over 1 year from diagnosis. Methods: Younger and older AML patients undergoing IC without stem cell transplant were enrolled in a prospective, longitudinal study. Assessments were done at baseline (pre-IC) and at 7 time points over the next year. At each visit, patients completed the EORTC QLQ-C30 and the FACT-Fatigue to measure QOL and fatigue, respectively, in addition to 3 physical function tests (grip strength, 2-minute walk test (2MWT), and timed chair stands). Analyses involved multivariable linear regression analyses stratified by age group. Results: 243 patients were recruited (147 younger and 96 older, 56% male). Attrition was greater in older adults due to death or disease progression/relapse. Among patients remaining in remission after IC, global QOL and fatigue improved significantly over time (p<0.001 for both); trends were similar between older and younger patients. All 5 QOL domains improved or remained stable over time; the greatest improvements were seen in social function and role function and were similar in both age groups. Grip strength increased slightly over time (p=0.04) whereas both timed chair stands (p<0.001) and the 2MWT (p<0.001) had moderate to large improvements, with trends toward greater improvement in younger patients (p=0.07 and 0.09, respectively). Results were similar when missing data were imputed. Conclusions: Survivors of AML after successful conventional chemotherapy achieve significant improvements in QOL, fatigue, and physical function over time. The course of recovery is remarkably similar in younger and older AML patients, although significant attrition in older adults is a noteworthy limitation. These data suggest that appropriately selected older patients do well following IC for AML.


Author(s):  
Padmini Bissessar ◽  
Kenesha Adams ◽  
Gina Chin ◽  
Sheena Chin ◽  
Paul Garraway ◽  
...  

Objectives: To assess the knowledge of weaning, of parents and guardians, of children under two-years-old, attending David Rose Health Centre. To assess whether there is an association between selected demographic variables, and the weaning knowledge. To educate the parents and guardians on the World Health Organisation recommended weaning practices. To assess the change in knowledge of weaning after the delivery of an educational intervention. Design and Methods: A prospective longitudinal study with repeated measures design obtained 120 participants using a convenient, non-probability sampling method. Data was collected using a pre-intervention and post-intervention questionnaire. The data was processed using the SPSS Version 24 Software Program and analysed with a scoring system developed by the researchers using the PAHO/WHO “Guiding Principles for Complementary Feeding of the Breastfed Child”. Results: Both educational interventions increased the participants knowledge from good to almost 100%. Conclusions: Most parents and guardians had good baseline knowledge. However, there were certain aspects where they lacked or had inaccurate knowledge. Overall, their knowledge improved regardless of the type of educational intervention they were exposed to. Recommendations: Future studies should be held in classroom settings, with more time allowed to assess change of knowledge.


2020 ◽  
pp. 140349482090462
Author(s):  
Frode Lysberg ◽  
Siw Tone Innstrand ◽  
Milada Cvancarova Småstuen ◽  
Cathrine Lysberg ◽  
Magnhild Mjåvatn Høie ◽  
...  

Background: The aim of the study was to investigate changes in self-rated health (SRH) between different age groups and sexes over a 20-year period. Methods: Data were retrieved from the large longitudinal Health Survey of North Trøndelag, Norway, which includes data collected from more than 190,000 participants aged 20–70+ years between the years 1984 and 2008. Data were analysed using logistic regression and adjusted for sex. Results: From 1984 to 2008, the odds of scoring higher on SRH decreased by 46% in the youngest age group (20–29 years) and increased by approximately 35% in the middle-aged and older age groups (40–70+ years). When considering sex differences, women in most age groups scored lower than the men on their SRH. Conclusions: Our finding suggest a trending shift in SRH, with a reduction in the youngest age group (20–29 years) and an increase in the middle-aged and older age groups (40–70+ years). Despite the sex differences being small, our data indicate that in most age groups, women tend to score lower than men on their SRH. Future studies should focus on these trends to understand better the mechanisms underlying these changes in SRH and to follow future trends to see if the trend is reinforced or diminished.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S192-S192
Author(s):  
Scott R Beach ◽  
Sara J Czaja ◽  
Richard Schulz ◽  
David Loewenstein ◽  
Peter Lichtenberg

Abstract This paper presents study design and preliminary results from a new study funded by the National Institute on Aging that is examining financial exploitation (FE) among 720 White, African-American and Hispanic adults age 60+ (240 per group; 120 age 60-79; 120 age 80+). A conceptual model linking socio-demographics, physical health, social support / integration, cognitive function, financial skills / supports, and psychosocial factors to FE is being evaluated. Three assessments (baseline, 12; 24 mos.) include: a detailed cognitive battery, web-based banking simulation tasks, scam scenarios, and a standardized battery of self-report measures assessing socio-demographic and psychosocial variables. Preliminary baseline results from ~200 participants show support for the proposed model. Exposure to sales, remote purchasing behavior, and telemarketer receptivity (scam exposure); and scam vulnerability as measured by credibility ratings of “legitimate” and “fake” scam scenarios are positively associated with reports of both stranger-initiated and trusted other FE. Older adults with smaller social networks and less social support were more likely to report both exposure and vulnerability to scams. Higher general cognitive abilities, financial skills, and numeracy; and better performance on online banking tasks correlate with less scam exposure and vulnerability. Preliminary analyses of psychosocial factors also show that more depressed, impulsive, and trusting older adults report more exposure and scam vulnerability. The paper will present updated analyses of ~500 baseline participants. Understanding multiple pathways to FE is important to advance theory and for the development of interventions to minimize risk.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11526-11526
Author(s):  
Grant Richard Williams ◽  
Yanjun Chen ◽  
Kelly Kenzik ◽  
Andrew Michael McDonald ◽  
Shlomit S. Shachar ◽  
...  

11526 Background: Progressive loss of muscle mass and strength (sarcopenia) is a well-known phenomenon of aging; however, little is known about the contribution of a cancer diagnosis to sarcopenia and its subsequent impact on disability. Using a prospective cohort of older adults from pre- to post-cancer diagnosis and a similarly-followed non-cancer cohort, we examined the trajectory of sarcopenia measures and their association with overall survival (OS) and major disability among those with cancer. Methods: The Health, Aging, and Body Composition (Health ABC) Study is a prospective longitudinal study where 3,075 community-dwelling older adults (70-79y) underwent 6 annual assessments of body composition and were followed for development of sentinel events (cancer, disability, death). Appendicular lean mass (ALM [kg]) was a sum of DXA-based lean tissue of all extremities. Hand grip strength (HGS [kg]) was averaged from 2 trials per hand. Gait speed (GS) was evaluated over a 20m course. We used linear mixed effect models to compare the change in ALM, HGS, and GS between individuals who subsequently developed cancer and those who did not, adjusting for age, race, gender, enrollment site. Among patients with cancer, we used multivariable cox regression for time from cancer diagnosis to mortality and major disability (cane/walker, inability to walk 0.25 mile/climb 10 steps, assistance with activities of daily living) treating sarcopenia measures as time-varying covariates. Results: Mean age at enrollment was 75y; 52% female; 42% black; 515 new cancers (prostate: 23%, colorectal: 15%, lung: 13%, breast: 11%). Compared with non-cancer controls, we found significantly steeper declines in HGS ( p= 0.03) and GS ( p< 0.001), and a trend in ALM ( p= 0.07) prior to cancer diagnosis; and a significantly steeper decline in ALM ( p< 0.001), but no difference in HGS ( p= 0.6) or GS ( p= 0.4) after cancer diagnosis. Slow GS was associated with a 44% increase in mortality ( p= 0.02) and a 70% increase in disability ( p= 0.02), but not ALM or HGS. Conclusions: Accelerated loss in sarcopenia measures both prior to and after a cancer diagnosis, and association with disability and mortality in older adults with cancer, present opportunities for targeted interventions.


2011 ◽  
Vol 26 (8) ◽  
pp. 484-489 ◽  
Author(s):  
A.-L. Sutter-Dallay ◽  
L. Murray ◽  
L. Dequae-Merchadou ◽  
E. Glatigny-Dallay ◽  
M.-L. Bourgeois ◽  
...  

AbstractBackgroundFew studies of the effects of postnatal depression on child development have considered the chronicity of depressive symptoms. We investigated whether early postnatal depressive symptoms (PNDS) predicted child developmental outcome independently of later maternal depressive symptoms.MethodsIn a prospective, longitudinal study, mothers and children were followed-up from birth to 2 years; repeated measures of PNDS were made using the Edinburgh Postnatal Depression Scale (EPDS); child development was assessed using the Bayley Scales II. Multilevel modelling techniques were used to examine the association between 6 week PNDS, and child development, taking subsequent depressive symptoms into account.ResultsChildren of mothers with 6 week PNDS were significantly more likely than children of non-symptomatic mothers to have poor cognitive outcome; however, this association was reduced to trend level when adjusted for later maternal depressive symptoms.ConclusionEffects of early PNDS on infant development may be partly explained by subsequent depressive symptoms.


2021 ◽  
Vol 12 ◽  
Author(s):  
Andreas Chadjikyprianou ◽  
Marilena Hadjivassiliou ◽  
Savvas Papacostas ◽  
Fofi Constantinidou

Objective: The effects of normal cognitive aging on executive functions (EF), Verbal Episodic Memory (VEM) and the contribution of age, sex, education, and APOΕ ε4 in a group of old Greek Cypriots across a five-year period were investigated.Design: NEUROAGE, the first project on cognitive aging in Cyprus, is a prospective longitudinal study with a rolling admission process. Participants are assessed at baseline and retested every 24–30 months.Subjects: 170 participants completed all three testing cycles; 86 men and 84 women with ages ranging between 60 and 88 years (mean = 73.21, SD = 5.84); education, 2–20 years (mean = 9.07, SD = 4.27).Results: Α Repeated Measures Multivariate Analysis of Covariance was conducted with one between-subject factor: sex; two covariates: age and education, while Time (time 1, time 2, time 3) served as a within – subject factor. Time did not have an effect on mini mental status examination in Greek (MMSE), EF or VEM. Also, sex had no effect on MMSE, EF and VEM. There was no time by sex interaction. Age and Education significantly predicted the EF performance, F(1, 168) = 11.23, p &lt; 0.05; F(1, 158) = 90.03, p &lt; 0.001 and VEM performance, F(1, 171) = 17.22, p &lt; 0.001; F(1, 171) = 61.25, p &lt; 0.001. Furthermore, there was a significant interaction effect between time and education, for EF, F(2, 167) = 7.02, p &lt; 0.001. Performance of the APOE ε4 carriers did not differ on any of the above measures as compared to performance of non-carriers in this older adult group.Conclusion: Cognitively healthy adults maintained overall cognitive performance across the five-year period. Male and female participants performed similarly and the pattern of change over time was similar across the two sexes. Education was predictive of VEM and EF performance across time. Furthermore, those with higher education maintained higher levels of EF performance. APOE results did not differentiate performance at baseline. Implications of findings are discussed.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 864-864
Author(s):  
Courtney Millar ◽  
Alyssa Dufour ◽  
Marian Hannan ◽  
Shivani Sahni

Abstract Depression affects more than 250 million people worldwide. Although epidemiological studies have linked higher dietary flavonoids with depression prevention in older women, it is unknown if increasing dietary flavonoids could effectively reduce depression. Mixed berries (blueberry, blackberry, and raspberry) are a rich source of flavonoids, particularly anthocyanin, flavanol, and flavan-3-ol subclasses. Our aim was to determine the association of mixed-berry flavonoid intake with change in depressive symptoms over ~8 years in older adults from the Framingham Heart Study. This community-based prospective longitudinal study included 1,278 adults with assessments on diet (food frequency questionnaire) and depressive symptoms (Center for Epidemiologic Studies Depression, CES-D) at baseline (1998-2001) and follow-up (2005-2008). Absolute change in mixed-berry flavonoid intake (defined as sum of anthocyanin, flavanol, and flavon-3-ols, mg/day) and change in CES-D scores were calculated. Linear regression estimated beta and standard error (SE) for change in CES-D scores per 250 mg/day increase in mixed-berry flavonoids (obtained from ~3/4 cup of mixed berries), adjusting for baseline age, sex, energy-intake, current smoking, body mass index, physical activity, cardiovascular disease, and non-melanoma cancer. Mean age was 59±9 years (range: 33-81), 57% female and mean change in mixed-berry flavonoid intake was 15.0±72.8 mg/day over ~8 years. In adjusted models, each 250 mg/day increase in mixed-berry flavonoid intake was associated with a 1-point reduction in depressive symptoms (beta: -1.06, SE: 0.61, p=0.08) over ~8 years, although this was not statistically significant. These data highlight the need for randomized clinical trials of flavonoid-rich berries to target depressive symptoms in older adults.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 265-266
Author(s):  
Anne Dickerson ◽  
Juliette Leonardo

Abstract While there is validity of using driving simulation as a proxy for on-road performance, few studies have examined hazard detection at night. Night driving is a self-restricting practice with little evidence demonstrating the need with healthy older adults. This study’s objective was to analyze night driving using eye-tracking technology examining differences between on-road/simulated drives and older/younger adults. A 2 (old, young) x 2 (simulator, on-road) repeated-measures design measured three roadway “hazards” of pedestrains looking at their cell phone while posed to cross the roadway. Pupil glances were recorded using outcome measures of total fixation duration, number of fixations, and time-to-first fixation for the pedestrains on-road and on a specifically designed scenario matching the on-road route. Thirty-three healthy, community-living drivers age 65+ years (N=16) and drivers age 20-40 years (N=17) completed both drives. Using non-parametric statistics, results demonstrated that night hazard detection was similar across driving conditions except for time-to-first fixation, which was faster on-road for both age groups (p&lt;.001). At some hazard locations, there were significant differences between the two age groups, with older adults taking longer to initially see hazards. Results suggest, older adults detected hazards similarly to younger adults, especially during on-road performance, suggesting avoidance of night driving may not be necessary. Results also support using driving simulation as a proxy for on-road with night driving needing to be incorporated. Additionally, eye-tracking has the potential for research in hazard detection with emphasis on the time-to-first fixation outcomes when considering driving analysis.


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