scholarly journals Functional Trajectories for People With Dementia and Other Comorbidities in the Last Years of Life

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 158-158
Author(s):  
Lauren Palmer ◽  
Emily Graf ◽  
Qinghua Li ◽  
Zhanlian Feng ◽  
Helen Lamont ◽  
...  
Keyword(s):  
Older Adults ◽  
Survival Time ◽  
Functional Ability ◽  
Daily Living ◽  
Functional Decline ◽  
Activity Of Daily Living ◽  
Appropriate Care ◽  
People With Dementia ◽  
The Impact ◽  
Retirement Study

Abstract A hallmark of end-of-life (EOL) is reduced functional ability. However, the impact of dementia and other comorbidities on EOL decline for older adults is less well understood. We estimated the effect of having dementia and comorbidities on activity of daily living (ADL) scores using the 2000-2012 Health and Retirement Study. We identified 5,853 people over age 65 who died and predicted monthly ADL impairments in the last 4 years of life controlling for dementia and other characteristics. Stroke and obesity were associated with significantly higher ADL scores, regardless of dementia status. However, if both dementia and either stroke or obesity were present, dementia was associated with significantly higher ADL scores approximately 1-4 years before death. Functional decline occurred closer to death if they had these conditions and no dementia. Differences in function when patients have dementia and comorbidities may affect understanding of survival time and access to appropriate care.

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 The impact of near visual impairment on instrumental activities of daily living among community-dwelling older adults in Selangor

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Qiu Ting Kee ◽  
Mohd Harimi Abd Rahman ◽  
Norliza Mohamad Fadzil ◽  
Zainora Mohammed ◽  
Suzana Shahar
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Visual Impairment ◽  
Daily Living ◽  
Visually Impaired ◽  
Community Dwelling ◽  
Activity Of Daily Living ◽  
Instrumental Activities ◽  
Iadl Disability ◽  
The Impact

Abstract Objective Near visual impairment (VI) is a common disability in an aging population. Near vision is crucial in activity of daily living including reading, smartphone and computer use and meal preparation. This study was conducted to determine the association between near visual acuity (VA) and contrast sensitivity (CS) with activity of daily living (ADL) among visually impaired older adults. Results A total of 208 participants aged  ≥  60 were recruited from the population-based longitudinal study on neuroprotective model for healthy longevity. Habitual near VA and CS were measured using Lighthouse near VA chart and Pelli-Robson CS chart, respectively. Lawton instrumental activities of daily living (IADL) was used to assess ADL. There are 41.8% participants with near visual impairment and 28.7% among them had IADL disability. Independent t test showed significant lower mean IADL score among visually impaired participants [t(206)  =  2.03, p  =  0.04]. IADL score significantly correlated with near VA (r  =   − 0.21, p  =  0.05) but not with CS (r  =   − 0.14, p = 0.21). Near VA (B  =   − 0.44, p  =  0.03) and age (B  =   − 0.07, p  =  0.01) significantly predicted IADL. The findings show poorer VA renders higher IADL disability, which may necessitate interventions to improve ADL among visually impaired older adults.

scholarly journals The Impact of Function Focused Care From Acute Care to Home Care and Nursing Homes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 629-629
Author(s):  
Silke Metzelthin ◽  
Sandra Zwakhalen ◽  
Barbara Resnick
Keyword(s):  
Older Adults ◽  
The Netherlands ◽  
Home Care ◽  
Acute Care ◽  
Long Term Care ◽  
Functional Decline ◽  
Term Care ◽  
The Us ◽  
The Impact

Abstract Functional decline in older adults often lead towards acute or long-term care. In practice, caregivers often focus on completion of care tasks and of prevention of injuries from falls. This task based, safety approach inadvertently results in fewer opportunities for older adults to be actively involved in activities. Further deconditioning and functional decline are common consequences of this inactivity. To prevent or postpone these consequences Function Focused Care (FFC) was developed meaning that caregivers adapt their level of assistance to the capabilities of older adults and stimulate them to do as much as possible by themselves. FFC was first implemented in institutionalized long-term care in the US, but has spread rapidly to other settings (e.g. acute care), target groups (e.g. people with dementia) and countries (e.g. the Netherlands). During this symposium, four presenters from the US and the Netherlands talk about the impact of FFC. The first presentation is about the results of a stepped wedge cluster trial showing a tendency to improve activities of daily living and mobility. The second presentation is about a FFC training program. FFC was feasible to implement in home care and professionals experienced positive changes in knowledge, attitude, skills and support. The next presenter reports about significant improvements regarding time spent in physical activity and a decrease in resistiveness to care in a cluster randomized controlled trial among nursing home residents with dementia. The fourth speaker presents the content and first results of a training program to implement FFC in nursing homes. Nursing Care of Older Adults Interest Group Sponsored Symposium

scholarly journals Places Visited, Maintained, or Abandoned Outside Home: A Community Mobility Need of Older Adults With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 673-673
Author(s):  
Isabel Margot-Cattin ◽  
Sophie Gaber ◽  
Nicolas Kuhne ◽  
Camilla Malinowski ◽  
Louise Nygard
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Health Condition ◽  
Driving Cessation ◽  
Age In Place ◽  
Community Mobility ◽  
People With Dementia ◽  
The Uk ◽  
The Impact

Abstract For older adults to “age in place”, they need to keep engaged and mobile in their communities, whatever their health condition. The impact of age and cognitive decline on community mobility is a growing problem in Europe and worldwide. Engaging in occupations outside home implies being able to get to those places where activities are performed. Yet little is known regarding the types of places visited, maintained or abandoned for older adults with/without dementia. This study addresses community mobility needs through the places people visit, maintain or abandon. People with and without dementia, aged 55+, were interviewed using the Participation in ACTivities and Places OUTside the Home (ACT-OUT) questionnaire across Switzerland (n=70), Sweden (n=69) and the UK (n=128). Results show that people with dementia experience a higher rate of abandonment for more places than regular older adults. Insights about driving cessation and access to travel passes will be presented.

scholarly journals The Prevalence and Impact on Patient Outcomes of Malnutrition Among Older Adults Presenting at an Irish Emergency Department: A Secondary Analysis of the OPTIMEND Trial

2020 ◽  
Author(s):  
Anne Griffin ◽  
Aoife O´Neill ◽  
Margaret O´Connor ◽  
Damien Ryan ◽  
Audrey Tierney ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Ability ◽  
Hospital Admissions ◽  
Functional Decline ◽  
Secondary Analysis ◽  
Adverse Outcomes ◽  
Nutrition Status

Abstract BackgroundMalnutrition is common among older adults and is associated with adverse outcomes but remains undiagnosed on healthcare admissions. Older adults use emergency departments (EDs) more than any other age group. This study aimed to determine the prevalence and factors associated with malnutrition on admission and with adverse outcomes post-admission among older adults attending an Irish ED. MethodsSecondary analysis of data collected from a randomised trial exploring the impact of a dedicated team of health and social care professionals on the care of older adults in the ED. Nutritional status was determined using the Mini Nutritional Assessment- short form. Patient parameters and outcomes included health related quality of life, functional ability, frailty, hospital admissions, falls history and clinical outcomes at index visit, 30-day and 6-month follow up. Aggregate anonymised participant data linked from baseline to 30-days and 6-month follow-up were used for statistical analysis.ResultsAmong 353 older adults (mean age 79.6 years (SD=7.0); 59.2% (n=209) female) the prevalence of malnutrition was 7.6% (n=27) and ‘risk of malnutrition’ was 28% (n=99). At baseline, those who were malnourished had poorer quality of life scores, functional ability, were more frail, more likely to have been hospitalised or had a fall recently, had longer waiting times and were more likely to be discharged home from the ED than those who had normal nutrition status. At 30-days, those who were malnourished were more likely to have reported another hospital admission, a nursing home admission, reduced quality of life and functional decline than older adults who had normal nutrition status at the baseline ED visit. At 6-months, a reported further decline in functional ability was more likely among those who were malnourished compared to those who had normal nutritional status. ConclusionOver one-third of older adults admitted to an Irish ED are either malnourished or at risk of malnourishment. Malnutrition was associated with a longer stay in the ED, functional decline, poorer quality of life, increased risk of hospital admissions and a greater likelihood of admission to long-term care at 30 days. Trial registration: Protocol registered in ClinicalTrials.gov, ID: NCT03739515, first posted November 13, 2018. https://clinicaltrials.gov/ct2/show/NCT03739515

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.

scholarly journals Risk Model for Decline in Activities of Daily Living Among Older Adults Hospitalized With Acute Myocardial Infarction: The SILVER‐AMI Study

2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Alexandra M. Hajduk ◽  
John A. Dodson ◽  
Terrence E. Murphy ◽  
Sui Tsang ◽  
Mary Geda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Risk Model ◽  
Functional Decline ◽  
Activity Of Daily Living ◽  
Mobility Impairment

Background Functional decline (ie, a decrement in ability to perform everyday activities necessary to live independently) is common after acute myocardial infarction (AMI) and associated with poor long‐term outcomes; yet, we do not have a tool to identify older AMI survivors at risk for this important patient‐centered outcome. Methods and Results We used data from the prospective SILVER‐AMI (Comprehensive Evaluation of Risk Factors in Older Patients With Acute Myocardial Infarction) study of 3041 patients with AMI, aged ≥75 years, recruited from 94 US hospitals. Participants were assessed during hospitalization and at 6 months to collect data on demographics, geriatric impairments, psychosocial factors, and activities of daily living. Clinical variables were abstracted from the medical record. Functional decline was defined as a decrement in ability to independently perform essential activities of daily living (ie, bathing, dressing, transferring, and ambulation) from baseline to 6 months postdischarge. The mean age of the sample was 82±5 years; 57% were men, 90% were White, and 13% reported activity of daily living decline at 6 months postdischarge. The model identified older age, longer hospital stay, mobility impairment during hospitalization, preadmission physical activity, and depression as risk factors for decline. Revascularization during AMI hospitalization and ability to walk a quarter mile before AMI were associated with decreased risk. Model discrimination (c=0.78) and calibration were good. Conclusions We identified a parsimonious model that predicts risk of activity of daily living decline among older patients with AMI. This tool may aid in identifying older patients with AMI who may benefit from restorative therapies to optimize function after AMI.

scholarly journals A TRIAL TO IMPROVE MEDICATION SAFETY IN OLDER ADULTS: RECRUITMENT CHALLENGES HAVE GENERALIZABILITY IMPLICATIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S711-S711
Author(s):  
Kathryn Anzuoni ◽  
Terry Field ◽  
Kathleen Mazor ◽  
Yanhua Zhou ◽  
Timothy Konola ◽  
...  
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Odds Ratio ◽  
Adverse Drug Events ◽  
Functional Decline ◽  
Post Discharge ◽  
Recruitment Challenges ◽  
Hospital To Home ◽  
The Impact ◽  
Visiting Nurse

Abstract For older adults, the transition from hospital to home is a high-risk period for adverse drug events, functional decline, and hospital readmission. Randomized trials of interventions to improve this transition must recruit potential subjects immediately after hospital discharge, when people are recovering and tired. Within a randomized trial assessing the impact of a pharmacist home visit to provide medication assistance immediately post-discharge, we determined whether individuals who enrolled were comparable to those who were invited but did not enroll, and described reasons for not enrolling. Individuals ≥50 years of age discharged from the hospital and prescribed a high-risk medication were eligible. We attempted to recruit individuals by phone within 3 days of discharge, and recorded reasons for not enrolling. Of 3,606 eligible individuals reached, 3,147 (87%) declined, 361 (10%) were enrolled, and 98 (3%) were initially recruited but did not complete a consent form. Individuals ≥80 years of age (odds ratio 0.45, CI 0.25, 0.78) and those with an assigned visiting nurse (odds ratio 0.64, CI 0.48, 0.85) were least likely to enroll. Among those who provided a reason for declining (2,473) the most common reason given was the belief they did not need medication assistance (22%). An additional 332 (13%) declined because they were receiving visiting nurse services. Recruiting older adults recently discharged from the hospital is difficult and may under-enroll the oldest individuals, limiting the ability to generalize findings across older patient populations. Researchers planning RCTs among newly discharged older adults may need creative approaches to overcome resistance.

scholarly journals A Friend in Need? Exploring the Influence of Disease and Disability Onset on the Number of Close Friends Among Older Adults

2019 ◽  
Vol 74 (8) ◽  
pp. e119-e124 ◽  
Author(s):  
Kenzie Latham-Mintus
Keyword(s):  
Older Adults ◽  
Heart Disease ◽  
Panel Data ◽  
Daily Living ◽  
Change Score ◽  
Network Activation ◽  
Life Threatening ◽  
Lagged Dependent Variable ◽  
Using Data ◽  
Retirement Study

Abstract Objectives This research examines whether onset of life-threatening disease (i.e., cancer, lung disease, heart disease, or stroke) or activities of daily living disability influences the reported number of close friends. Method Using data from the Health and Retirement Study (HRS; 2006–2012), this research capitalizes on panel data to assess changes in number of close friends over a 4-year period. Lagged dependent variable (LDV) and change score (CS) approaches were used. Results Both the LDV and CS models provide evidence that onset of life-threatening disease was associated with reporting more friends 4 years later. In particular, onset of cancer was associated with reporting more close friends. Discussion This research provides evidence of the network activation hypothesis following onset of life-threatening disease among older adults.

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