scholarly journals Utility of the Late Life Function and Disability Instrument (LLFDI) in rehabilitation services for older adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 882-882
Author(s):  
Pamela Toto ◽  
Anne Stankiewicz
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Skilled Nursing Facility ◽  
Late Life ◽  
Activity Limitation ◽  
Self Report ◽  
Rehabilitation Services ◽  
Activity Limitations ◽  
Participation Restriction ◽  
Life Function

Abstract Introduction The Late Life Function and Disability Instrument (LLFDI) is a valid self-report tool that quantifies disability based on activity limitations and participation restrictions in everyday life. Both the original longer tool (LLFDI) and the shorter computer adaptive version (LLFDI-CAT) offer practitioners a method for measuring function independent or in conjunction with performance-based assessment. Objectives: Examine scores of the LLFDI and LLFDI-CAT for measuring disability in older adults who are receiving rehabilitation services in community and institution settings. Method: A secondary data analysis was conducted comparing scores from occupational therapy evaluations with older adults from 3 groups: 1) older adults in primary care using the LLFDI; 2) older adults in primary care using the LLFDI-CAT; older adults in a skilled nursing facility (SNF) using the LLFDI-CAT. Results Mean scores for Activity Limitation and Participation Restriction were lowest for older adults in a SNF indicating greater disability. A one-way Analysis of variance on ranks showed a main effect for Activity Limitation, χ2 (2) = 22.267, p < 0.001, and Participation Restriction, χ2 (2) = 60.372, p < 0.001. Post-hoc analyses revealed significant differences between groups based on tool (i.e. LLFDI vs. LLFDI-CAT) for Activity Limitations and setting (i.e. primary care vs. SNF) for Participation Restriction. Conclusion The LLFDI-CAT may be the preferred instrument to measure disability in older adults across treatment settings. Additional research is warranted to understand how personal and environmental factors influence LLFDI-CAT outcomes.

scholarly journals Measuring Activity Limitations Within the National Health and Aging Trends Study (NHATS)

2019 ◽  
Vol 60 (1) ◽  
pp. e11-e19 ◽  
Author(s):  
Elizabeth E Marfeo ◽  
Pengsheng Ni ◽  
Tamra Keeney ◽  
Alan Jette
Keyword(s):  
Older Adults ◽  
National Health ◽  
Population Level ◽  
Activity Limitation ◽  
Self Report ◽  
Activity Limitations ◽  
Wide Range ◽  
Sample Score ◽  
Design And Methods ◽  
Future Work

Abstract Background and Objectives To better understand the disablement process among older adults, improved measures of activity limitations are needed. Traditional population-level measures lack the ability to distinguish precise gradations of activity limitation and are unable to detect degrees of differences over a wide range of ability levels. Therefore, we used contemporary measurement methods to improve upon current methodologies for characterizing activity limitations within the National Health and Aging Trends Study (NHATS) . Research Design and Methods We used the NHATS Round 1 cohort to assess the feasibility of constructing an Activity Limitations scale using Rasch item response theory methods. Factor analysis was used to develop the scale from a set of existing items in the NHATS Mobility, Self-Care, and Household Activity domains. Psychometric properties of the scale were evaluated and the scale was used to examine change in activity limitations among the sample from 2011 to 2015. Results Results supported an 18-item scale (N = 7,609). Rasch infit and outfit statistics were within acceptable range for all items (Cronbach’s alpha = 0.95; sample score reliability = 0.83). From 2011 to 2015, 5.88% older adults demonstrated increase in function, 15% showed decrease in function, and 78% of the sample showed no change (did not exceed ± MDC90). Discussion and Implications Findings demonstrate that a unidimensional, interval scale of activity limitations can be constructed using traditional survey measures nested within the NHATS. Results revealed concerns regarding ceiling effects within the current self-report items of activity limitations suggesting future work is needed to expand the range of ability currently represented in the NHATS Activity Limitation items.

scholarly journals BROODING MODERATES THE RELATIONSHIP BETWEEN CEREBROVASCULAR BURDEN AND VASCULAR DEPRESSION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S877-S878
Author(s):  
Manuel Herrera Legon ◽  
Daniel Paulson
Keyword(s):  
Older Adults ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Late Life ◽  
Community Dwelling ◽  
Self Report ◽  
Future Research ◽  
Late Life Depression ◽  
Vascular Depression ◽  
The Relationship

Abstract Objective: The vascular depression hypothesis posits that cerebrovascular burden confers risk for late-life depression. Though neuroanatomical correlates of vascular depression (prefrontal white matter hyperintensities) are well established, little is known about cognitive correlates; the identification of which may suggest therapeutic targets. Aims of this study are to examine the hypothesis that the relationship between cerebrovascular burden and depressive symptoms is moderated by brooding, a type of rumination. Method: A sample of 52 community-dwelling, stroke-free, individuals over the age of 70, without history of severe mental illness or dementia completed the Ruminative Responses Scale, and provided self-report (cardiac disease, hypertension, diabetes, high cholesterol) CVB data. The Geriatric Depression Scale was used to assess depressive symptomatology. Results: Results of a bootstrapped model were that self-reported measures of CVB predicted depressive symptomatology. This relationship was significantly moderated by brooding. Among older adults, those who self-reported high CVB and medium to elevated levels of rumination experienced disproportionately more depressive symptomatology. Conclusions: These findings suggest that brooding rumination may be one correlate of the vascular depression syndrome. Future research should examine neuroanatomical correlates of rumination among older adults, and further explore brooding as a therapeutic target for those with late-life depression.

scholarly journals The prognosis of depression in late life versus mid-life: implications for the treatment of older adults

2005 ◽  
Vol 17 (4) ◽  
pp. 533-538 ◽  
Author(s):  
Hari Subramaniam ◽  
Alex J. Mitchell
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Nursing Homes ◽  
Late Life ◽  
Clinical Excellence ◽  
Late Life Depression ◽  
Medical Settings ◽  
Nice Guidelines ◽  
Primary Care Settings

Depression in late life is extremely common. Of those aged 65 years or older, 2–5% have syndromal depression, but up to 20% of elderly people have depressive symptoms (Horwath et al., 2002). Both syndromal and subsyndromal depression carry a high risk of long-term complications and both are associated with elevated risks of morbidity and mortality (Penninx et al., 1999). Despite repeated alerts, depression is consistently under-recognized in acute medical settings, in nursing homes and in primary care (Volkers et al., 2004). For reasons that are inadequately understood, late-life depression seems to be under-treated to an even greater extent than depression in mid-life (Mackenzie et al., 1999). This issue is particularly important, given that effective and safe treatments for depression are available (Bartels et al., 2003), even though the evidence regarding maintenance therapies in older people is inconsistent (Geddes et al., 2003; Wilson et al., 2003). Recent evidence suggests that a package of care can improve the care of older depressed patients in primary care settings (Bruce et al., 2004) and in nursing homes (Ciechanowski et al., 2004). This has led to the development of several clinical guidelines specifically for late-life depression (Baldwin et al., 2003; Charney et al., 2003; Lebowitzet al., 1997). Yet, in the recent National Institute of Clinical Excellence (NICE) guidelines for the management of depression in primary and secondary care, no distinction was made between early, middle and late-life depression (Malone and Mitchell, 2005).

scholarly journals NEUROMUSCULAR ATTRIBUTES ARE ASSOCIATED WITH POOR MOBILITY IN OLDER ADULTS WITH VASCULAR RISK CONDITIONS

2019 ◽  
pp. 1-7
Author(s):  
A.J. Jor’dan ◽  
M.E. Jacob ◽  
E. Leritz ◽  
J.F. Bean
Keyword(s):  
Older Adults ◽  
Range Of Motion ◽  
Physical Performance ◽  
Lower Limb ◽  
Gait Speed ◽  
Knee Flexion ◽  
Late Life ◽  
Vascular Risk ◽  
Leg Strength ◽  
Life Function

Background: The mobility of older adults is limited by the compounding effects of vascular health conditions, or vascular risk burden. However, little is known about the role of neuromuscular attributes among those in which vascular risk burden contributes to mobility limitations. Objective: We investigated (1) the relationship between the absence/presence of type 2 diabetes, hypertension, and/or obesity and mobility measures and neuromuscular attributes, and (2) whether the association between vascular risk burden and mobility is mediated by lower limb neuromuscular attributes. Design: Cross-sectional analysis of baseline data from 430 older adults within the Boston RISE Study. Measurements: Measures of mobility were the Short Physical Performance Battery, habitual gait speed, and functional mobility as measured by the Late Life Function Instrument. We also evaluated lower limb neuromuscular attributes, namely leg strength, leg velocity, trunk extensor muscle endurance, knee and ankle range of motion, and sensory loss. Results: Participants self-reported the presence of None (n=93), One (n=179), Two (n=114), or Three (n=44) of the following conditions: diabetes, hypertension, and obesity. Multivariable regression models indicated that those with a greater vascular risk burden had worse performance on the Short Physical Performance Battery (p=0.01), slower gait speed (p=0.0003) and lower Basic and Advanced Late Life Function Instrument scores (p<0.003). These associations were independent of multiple covariates. Vascular risk burden was also found to be negatively associated with leg strength (p=0.0002) and knee flexion range of motion (p<0.0001) and an associated non-significant trend was observed with leg velocity (p=0.06). In addition, the association between vascular risk burden and mobility outcomes were found to be partially mediated by leg strength, leg velocity, and knee flexion range of motion. Conclusions: Among older adults with vascular risk burden and mobility problems, neuromuscular impairments in attributes such as leg strength, leg velocity, and knee range of motion may need to be treatment priorities.

scholarly journals Need to Belong and Social Ties in Late Life

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 926-926
Author(s):  
Zexi Zhou ◽  
Yijung Kim ◽  
Shiyang Zhang ◽  
Karen Fingerman
Keyword(s):  
Older Adults ◽  
Social Network ◽  
Social Ties ◽  
Late Life ◽  
Well Being ◽  
Self Report ◽  
Weak Ties ◽  
Similar Amount ◽  
Need To Belong ◽  
Social Encounters

Abstract According to socioemotional selectivity theory, older adults are more selective and tend to shrink their social network to their closest ties. However, a heightened need to belong, which is characterized by a stronger desire for acceptance and motivation to affiliation, may alter this common pattern. We know little about how the need to belong shapes social network structure, especially in late life. This study investigated the associations between the need to belong, size of social network, and engagement with social ties among older adults. Participants (N = 314) aged over 65 years from the Daily Experiences and Well-being Study completed a baseline interview regarding their close ties (i.e., social convoy members), and weak ties, as well as a self-report measure of need to belong. They completed ecological momentary assessment (EMA) surveys reporting their social encounters every 3 hours over 5 to 6 days. Need to belong was unrelated to the number of close ties. In contrast, participants with a higher need to belong reported more less close (but still important) ties and weak ties than those with a lower need to belong, but spent a similar amount of time (i.e., proportion of EMA involving social encounters) with either their close ties or weak ties. These results suggest that the need to belong may motivate older adults to go beyond their closest ties to weaker ties, and highlight the discrepancies between the sense of being connected to social partners and the actual engagement with them in this process.

scholarly journals STRENGTHENING LATE-LIFE DEPRESSION COLLABORATIVE CARE THROUGH COMMUNITY ENGAGEMENT: CARE PARTNERS INITIATIVE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S572-S573
Author(s):  
Ladson Hinton ◽  
Theresa J Hoeft ◽  
Stuart Henderson ◽  
Melissa M Gosdin ◽  
Laura Rath ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Collaborative Care ◽  
Late Life ◽  
Lessons Learned ◽  
Successful Implementation ◽  
Depression Care ◽  
Late Life Depression ◽  
Primary Care Clinics ◽  
Care Partners

Abstract Despite the availability of effective treatments for late life depression, many older adults with depression either do not access or fully engage in treatment. The goal of this study was to examine the feasibility and two-year outcomes from an Archstone Foundation funded Care Partners Initiative to strengthen depression care for adults 65 years of age and older. Seven sites throughout California implemented evidence-based collaborative care through partnerships between primary care organizations, community-based organizations (CBOs), and families of older adults with depression. Evaluation used a mixed-methods approach incorporating both qualitative and quantitative data. Of the seven sites, six formed partnerships between primary care clinics and CBOs and one site only focused on engaging family members in treatment. In the first two years, 274 patients were enrolled and rates of depression improvement were comparable to prior depression care effectiveness trials. Overall, 49% of patients at CBO sites interacted 3+ times with CBO staff/clinicians, while at the family site, 79% of patients had 3+ contacts including a family member. Using data from key informant interviews, focus groups, and site progress documents, seven core components were identified that facilitated successful implementation and delivery of partnered collaborative care, including three foundational components: strong stakeholder buy-in, effective patient engagement, and the promotion of depression treatment as a core value across organizations. Multiple complexities of partnering between primary care clinics and CBOs or families were identified. Challenges and lessons learned from this initiative will also be discussed.

Experimental examination of worry among older and young adults

2014 ◽  
Vol 27 (7) ◽  
pp. 1177-1190 ◽  
Author(s):  
Christine E. Gould ◽  
Lindsay A. Gerolimatos ◽  
Barry A. Edelstein
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Emotional Experience ◽  
Late Life ◽  
Preliminary Evidence ◽  
Community Dwelling ◽  
Self Report ◽  
Penn State ◽  
Induction Type ◽  
State Worry

ABSTRACTBackground:Worry is experienced by many older adults, yet our understanding of the emotional experience of late-life worry is poor as findings regarding older adults are inferred from findings of studies conducted with young adults. In the present study, we aimed to characterize age differences in affect, self-reported arousal, and physiological arousal experienced during worry.Methods:Fifty-three young (M = 21.4, SD = 2.6 years) and 55 older community-dwelling adults (M = 69.1, SD = 8.1 years) participated in an experimental induction of worry or pleasant/neutral recall. Measures collected included: Penn State Worry Questionnaire (PSWQ), worry intensity item, Multiple Affect Adjective Checklist-Revised (MAACL-R), Self-Assessment Maniken arousal item, and heart rate. Standardized residual scores were calculated to represent change from baseline for self-report and psychophysiological measures.Results:Older adults had lower trait worry and worry intensity at baseline. A significant age by induction type interaction was found for the MAACL-R subscales of anxiety, depression, hostility, and positive affect. Compared with young adults, older adults experienced smaller changes in emotions in response to the worry induction than in the recall induction. For both worry and recall inductions, older adults exhibited less change in self-reported arousal and interbeat intervals from baseline compared with young adults.Conclusions:Findings from the present study illuminate both similarities and differences in the experience of worry for older and young adults. This study provides preliminary evidence for the characterization of late-life worry as generating less anxiety than worry during young adulthood.

Sign in / Sign up

Export Citation Format

Share Document