DETECTION OF DEPRESSION USING THE UCLA THREE-ITEM LONELINESS SCALE IN OLDER CHINESE

Abstract Loneliness is a significant and independent risk factor for later life depression. This study aimed to validate the Chinese version of the UCLA 3-item Loneliness Scale and to ascertain the cut-off point in detecting depression in community-dwelling older adults. The English version of the UCLA was translated into Chinese by six experienced social workers, clinical psychologists and researchers, and content validity was established by consultation and revision with 10 older adults. 1,919 older adults aged 60 years and over (average age = 76.3±8.0) were recruited from local NGOs, they were interviewed for demographic information, and assessed using the 3-item loneliness scale and the Patient Health Questionnaire (PHQ-9). Cronbach’s α of the Chinese loneliness scale was 0.87; the average score was 4.0 ± 3.0 out of 9, and it significantly correlated with living alone (r = 0.18, p < 0.001), unmarried (r = 0.12, p < 0.001), no emotional support (r = 0.14, p < 0.001), and depression (r = 0.41, p < 0.001). Using PHQ-9 cut-off score of 5 for mild and above depression, the area under the curve (AUC) was 0.73 ± 0.1 (p < .001, 95% CI 0.71-0.76) with 77% sensitivity and 61% specificity. We determined a cut-off point of 3 for loneliness using the Youden index, which revealed better sensitivity over alternative definitions of loneliness. A cut-off point of 3 in the Chinese UCLA 3-item loneliness scale can reliably identify possible depression in community-dwelling older Chinese.

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Using Everyday Technology Independently When Living with Forgetfulness: Experiences of Older Adults in Barcelona

Gerontology and Geriatric Medicine ◽

10.1177/2333721421993754 ◽

2021 ◽

Vol 7 ◽

pp. 233372142199375

Author(s):

Samuel Briones ◽

Louise Meijering

Keyword(s):

Older Adults ◽

Qualitative Methodology ◽

Local Community ◽

Phenomenological Study ◽

Later Life ◽

Learning Opportunities ◽

Individual Characteristics ◽

Community Dwelling ◽

Community Dwelling Older Adults ◽

The Capability Approach

Older adults living with forgetfulness encounter difficulties when engaging with changing and dynamic everyday technology (ET). The capability to use ET is important for independence in later life and is affected by the contextual and individual characteristics of older adults. Using the capability approach as a theoretical lens, this phenomenological study aims to explore the experiences of older adults living with forgetfulness, in order to identify contextual and individual factors that facilitate the use of ET in everyday life. A qualitative methodology was used to interview 16 community-dwelling older adults participating in memory and technology workshops at local community centres in Barcelona. Findings show that motivation and openness to learning played a facilitating role in our participants’ use of ET. The presence of social support in the form of “technology experts” and community centres offering learning opportunities were also enhancing factors that encourage independence when engaging with ET. In conclusion, our study demonstrates the importance of expanding intergenerational ET learning opportunities, through the creation of age-friendly spaces.

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Reclaiming Social Space: Adapting Neighbourhoods to Support an Ageing Population

10.26686/wgtn.17057993 ◽

2021 ◽

Author(s):

◽

Lisa McClintock

Keyword(s):

Older Adults ◽

Age Structure ◽

Social Space ◽

Later Life ◽

Community Dwelling ◽

Ageing Population ◽

Age In Place ◽

Creative Solutions ◽

Community Dwelling Older Adults ◽

Unique Potential

<p>The age structure of New Zealand’s population is expected to undergo a dramatic change in the next few decades. By 2050, it is thought that approximately one quarter of the population will be aged 65+. Research indicates that the overwhelming preference of older adults is to age in their own homes and communities if possible. However, loneliness among community-dwelling older adults is widespread. Architecture as a discipline has unique potential to critique existing neighbourhood design and generate creative solutions to provide a more socially fulfilling environment for residents to age in place. Architecture for ageing must combat loneliness and enable continued contact in later life. This research explores the sensitive adaptation of inner suburban Wellington neighbourhoods with the aim of empowering inhabitants to age positively in the community.</p>

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Impact of Personality Features and Interpersonal Problems on Anxiety Among Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.3233 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 897-898

Author(s):

Olivia Noel ◽

Katie Granier ◽

Daniel Segal ◽

Marissa Pifer ◽

Lisa Stone

Keyword(s):

Older Adults ◽

Personality Traits ◽

Psychosocial Functioning ◽

Interpersonal Problems ◽

Later Life ◽

Community Dwelling ◽

Clinical Syndromes ◽

Personality Features ◽

Development Of Anxiety ◽

Community Dwelling Older Adults

Abstract Introduction Anxiety is a significant mental health problem among older adults and is associated with multiple other mental disorders, poor psychosocial functioning, and reduced quality of life. Personality traits and disorders, along with interpersonal problems, may play a significant role in anxiety, but these relationships are not well understood among older adults. This study examined relationships between anxiety with normative personality traits, personality disorder (PD) features, and interpersonal problems. Method: Community-dwelling older adults (N = 130) completed the Geriatric Anxiety Scale (GAS), Coolidge Axis Two Inventory (CATI), Big Five Inventory-2 (BFI-2), and Circumplex Scales of Interpersonal Problems (CSIP). Results Anxiety was positively correlated with 13 of 14 CATI PD scales, ranging from .23 (Narcissistic) to .61 (Depressive). Regarding normative personality, anxiety was associated with Agreeableness (-.23), Conscientiousness (-.30), Extraversion (-.31), and Negative Emotionality (.56). Regarding interpersonal problems, anxiety was positively related to all eight CSIP scales: Self-Sacrificing (.30), Domineering (.31), Exploitable (.40), Intrusive (.41), Self-centered (.47), Nonassertive (.50), Socially Inhibited (.60), and Distant/Cold (.62). Regression analyses indicated that PD features accounted for the most variance in anxiety (53%), followed by interpersonal problems, (46%) and normative personality traits (33%). Discussion Anxiety appears to be meaningfully associated with PD features, several aspects of normative personality, and interpersonal problems, suggesting that these variables may play a role in the development of anxiety, or vice versa. Our findings especially speak to the growing awareness of the deleterious impact of PD features on clinical syndromes in later life, as evidenced by strong comorbidities with anxiety.

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Psychometric Properties of the Taiwanese Version of the Tilburg Frailty Indicator for Community-Dwelling Older Adults

Healthcare ◽

10.3390/healthcare9091193 ◽

2021 ◽

Vol 9 (9) ◽

pp. 1193

Author(s):

Chia-Hui Lin ◽

Chieh-Yu Liu ◽

Jiin-Ru Rong

Keyword(s):

Older Adults ◽

Psychometric Properties ◽

Roc Curve ◽

Goodness Of Fit ◽

Community Dwelling ◽

Self Report ◽

Youden Index ◽

Tilburg Frailty Indicator ◽

Community Dwelling Older Adults ◽

Frailty Indicator

Screening the frailty level of older adults is essential to avoid morbidity, prevent falls and disability, and maintain quality of life. The Tilburg Frailty Indicator (TFI) is a self-report instrument developed to assess frailty for community-dwelling older adults. The aim of this study was to explore the psychometric properties of the Taiwanese version of TFI (TFI-T). The sample consisted of 210 elderly participants living in the community. The scale was implemented to conduct a confirmatory factor analysis (CFA) test for validity. The models were evaluated through sensitivity, specificity, area under the curve, and receiving operating characteristic (ROC) curve. CFA was performed to evaluate construct validity, and the TFI-T has a goodness of fit with the three-factor structure of the TFI. Totally, the 15 items of TFI-T have acceptable internal consistency (Cronbach’s alpha = 0.78), and test–retest reliability (r = 0.88, p < 0.001). The criterion-related validity was examined, the TFI-T correlation with the Kihon Checklist (KCL) score (r = 0.74; p < 0.001). The cutoff of 5.5 based on the Youden index was considered optimal. The area under the ROC curve analysis indicated that the TFI-T has good accuracy in frailty screening. The TFI-T exhibits good reliability and validity and can be used as a sensitive and accurate instrument, which is highly applicable to screen frailty in Taiwan among older adults.

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Validation study on a Japanese version of the three‐item UCLA Loneliness Scale among community‐dwelling older adults

Geriatrics and Gerontology International ◽

10.1111/ggi.13758 ◽

2019 ◽

Vol 19 (10) ◽

pp. 1068-1069 ◽

Cited By ~ 3

Author(s):

Tami Saito ◽

Noriko Cable ◽

Jun Aida ◽

Kokoro Shirai ◽

Masashige Saito ◽

...

Keyword(s):

Older Adults ◽

Validation Study ◽

Japanese Version ◽

Community Dwelling ◽

Loneliness Scale ◽

Community Dwelling Older Adults

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Intrinsic Capacity vs. Multimorbidity: A Function-Centered Construct Predicts Disability Better Than a Disease-Based Approach in a Community-Dwelling Older Population Cohort

Frontiers in Medicine ◽

10.3389/fmed.2021.753295 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jing Zhao ◽

Jagadish K. Chhetri ◽

Yi Chang ◽

Zheng Zheng ◽

Lina Ma ◽

...

Keyword(s):

Older Adults ◽

Chronic Diseases ◽

Area Under The Curve ◽

Community Dwelling ◽

The Status ◽

Intrinsic Capacity ◽

Adl Disability ◽

Community Dwelling Older Adults ◽

Better Than

Objective: This study aimed to assess the status of intrinsic capacity (IC)—a novel function-centered construct proposed by the WHO and examine whether impairment in IC predicts subsequent 1-year activities of daily living (ADL) disability better than a disease-based approach, i. e., multimorbidity status.Methods: This study included data of community-dwelling older adults from the Beijing Longitudinal Study on Aging II aged 65 years or older who were followed up at 1 year. Multivariate logistic regressions were performed to estimate the odds of ADL disability at baseline and 1-year follow-up.Results: A total of 7,298 older participants aged 65 years or older were included in the current study. About 4,742 older adults were followed up at 1 year. At baseline, subjects with a higher impairment in IC domains showed higher odds of ADL disability [adj. odds ratio (OR) = 9.51 for impairment in ≥3 domains, area under the curve (AUC) = 0.751] compared to much lower odds of ADL disability in subjects with a higher number (≥3) of chronic diseases (adj. OR 3.92, AUC = 0.712). At 1-year follow-up, the overall incidence of ADL disability increased with the impairment in IC domains higher than the increase in multimorbidity status. A higher impairment in IC domains showed higher odds of incidence ADL disability for impairment in 2 or ≥3 IC domains (adj. OR 2.32 for impairment in ≥3 domains, adj. OR 1.43 for impairment in two domains, AUC = 0.685). Only subjects who had ≥3 chronic diseases had higher odds of 1-year incident ADL disability (adj. OR 1.73, AUC = 0.681) that was statistically significant.Conclusion: Our results imply that a function-centered construct could have higher predictability of disability compared to the multimorbidity status in community older people. Our results need to be confirmed by studies with longer follow-up.

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Motor Performance and Physical Activity as Predictors of Prospective Falls in Community-Dwelling Older Adults by Frailty Level: Application of Wearable Technology

Gerontology ◽

10.1159/000445889 ◽

2016 ◽

Vol 62 (6) ◽

pp. 654-664 ◽

Cited By ~ 40

Author(s):

M. Jane Mohler ◽

Christopher S. Wendel ◽

Ruth E. Taylor-Piliae ◽

Nima Toosizadeh ◽

Bijan Najafi

Keyword(s):

Physical Activity ◽

Older Adults ◽

Motor Performance ◽

Area Under The Curve ◽

Community Dwelling ◽

Bout Duration ◽

Frailty Status ◽

Eyes Closed ◽

Community Dwelling Older Adults ◽

Balance Deficit

Background: Few studies of the association between prospective falls and sensor-based measures of motor performance and physical activity (PA) have evaluated subgroups of frailty status separately. Objective: To evaluate wearable sensor-based measures of gait, balance, and PA that are predictive of future falls in community-dwelling older adults. Methods: The Arizona Frailty Cohort Study in Tucson, Arizona, followed community-dwelling adults aged 65 years and over (without baseline cognitive deficit, severe movement disorders, or recent stroke) for falls over 6 months. Baseline measures included Fried frailty criteria: in-home and sensor-based gait (normal and fast walk), balance (bipedal eyes open and eyes closed), and spontaneous daily PA over 48 h, measured using validated wearable technologies. Results: Of the 119 participants (36% non-frail, 48% pre-frail, and 16% frail), 48 reported one or more fall (47% of non-frail, 33% of pre-frail, and 47% of frail). Although balance deficit and PA were independent fall predictors in pre-frail and frail groups, they were not sensitive to predict prospective falls in the non-frail group. Even though gait performance deteriorated as frailty increased, gait was not a predictor of prospective falls when participants were stratified based on frailty status. In pre-frail and frail participants combined, center of mass sway [odds ratio (OR) = 5.9, 95% confidence interval (CI) 2.6-13.7], PA mean walking bout duration (OR = 1.1, 95% CI 1.0-1.2), PA mean standing bout duration (OR = 0.94, 95% CI 0.91-0.99), and a fall in previous 6 months (OR = 7.3, 95% CI 1.5-36.4) were independent predictors of prospective falls (area under the curve: 0.882). Conclusion: This study suggests that independent predictors of falls are dependent on frailty status. Among sensor-derived parameters, balance deficit, longer typical walking episodes, and shorter typical standing episodes were the most sensitive predictors of prospective falls in the combined pre-frail and frail sample. Gait deficit was not a sensitive fall predictor in the context of frailty status.

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Dying to Belong: The Importance of Familiarity in Later Life

Gerontology and Geriatric Medicine ◽

10.1177/2333721420941976 ◽

2020 ◽

Vol 6 ◽

pp. 233372142094197

Author(s):

Lucia Carragher ◽

Catherine Ryan

Keyword(s):

Older Adults ◽

Lived Experience ◽

Population Aging ◽

Later Life ◽

Evidence Base ◽

Community Services ◽

Community Dwelling ◽

Physical And Mental Health ◽

Services And Supports ◽

Community Dwelling Older Adults

Despite the large amount of research into loneliness, the evidence base around effective ways of tackling loneliness among older adults is limited. Up to one-half of all older adults regularly feel lonely, negatively impacting physical and mental health. In light of population aging, family dispersal, and in the aftermath of COVID-19, it is vital that we grow the evidence base around the lived experience of older people, knowing what they want and why, and ensuring community services and supports are meaningful to them. Method: Three focus groups were held with community-dwelling older adults in Ireland. Results: Loneliness is associated with the loss of familiarity and connection to community. Conclusions: Understanding loneliness in later life is increasingly important with population aging. As plans for ending confinement linked to COVID-19 are devised, a mechanism is urgently needed to sustain the positive changes to communities which have meaningfully connected with older adults.

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Diagnostic Accuracy of the Short Physical Performance Battery for Detecting Frailty in Older People

Physical Therapy ◽

10.1093/ptj/pzz154 ◽

2019 ◽

Cited By ~ 2

Author(s):

Monica R Perracini ◽

Mateus Mello ◽

Roberta de Oliveira Máximo ◽

Tereza L Bilton ◽

Eduardo Ferriolli ◽

...

Keyword(s):

Older Adults ◽

Area Under The Curve ◽

Positive Likelihood Ratio ◽

Community Dwelling ◽

Cutoff Point ◽

Frailty Syndrome ◽

Cross Sectional ◽

Cutoff Points ◽

Community Dwelling Older Adults

Abstract Background The Short Physical Performance Battery (SPPB) is widely used to predict negative health-related outcomes in older adults. However, the cutoff point for the detection of the frailty syndrome is not yet conclusive. Objective The aim of this study was to determine the diagnostic value of the SPPB for detecting frailty in community-dwelling older adults. Design This was a population-based cross-sectional study focusing on households in urban areas. A total of 744 people who were 65 years old or older participated in this study. Methods Frailty was determined by the presence of 3 or more of the following components: unintentional weight loss, self-reported fatigue, weakness, low level of physical activity, and slowness. Diagnostic accuracy measures of the SPPB cutoff points were calculated for the identification of frailty (individuals who were frail) and the frailty process (individuals who were considered to be prefrail and frail). Receiver operating characteristic curves were constructed. Odds ratios for frailty and the frailty process and respective CIs were calculated on the basis of the best cutoff points. A bootstrap analysis was conducted to confirm the internal validity of the findings. Results The best cutoff point for the determination of frailty was ≤8 points (sensitivity = 79.7%; specificity = 73.8%; Youden J statistic = 0.58; positive likelihood ratio = 3.05; area under the curve = 0.85). The best cutoff point for the determination of the frailty process was ≤10 points (sensitivity = 75.5%; specificity = 52.8%; Youden J statistic = 0.28; positive likelihood ratio = 1.59; area under the curve = 0.76). The adjusted odds of being frail and being in the frailty process were 7.44 (95% CI = 3.90–14.19) and 2.33 (95% CI = 1.65–3.30), respectively. Limitations The external validation using separate data was not performed and the cross-sectional design does not allow SPPB predictive capacity to be established. Conclusions The SPPB might be used as a screening tool to detect frailty syndrome in community-dwelling older adults, but the cutoff points should be tested in another sample as a further validation step.

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Does self-report of multimorbidity in later life predict impaired physical functioning, and might this be useful in clinical practice?

Aging Clinical and Experimental Research ◽

10.1007/s40520-020-01500-8 ◽

2020 ◽

Vol 32 (8) ◽

pp. 1443-1450

Author(s):

Michael A. Clynes ◽

Gregorio Bevilacqua ◽

Karen A. Jameson ◽

Cyrus Cooper ◽

Elaine M. Dennison

Keyword(s):

Older Adults ◽

Physical Function ◽

Physical Functioning ◽

Later Life ◽

Community Dwelling ◽

Self Report ◽

Timed Up And Go ◽

Increased Risk ◽

Community Dwelling Older Adults ◽

Function Testing

Abstract Background Multimorbidity has been shown in several studies to relate to impaired physical function in later life. Aims To examine if self-report of multimorbidity predicts impaired physical functioning, as assessed by formal physical function testing, in community-dwelling older adults. Methods Non-communicable diseases (NCDs) were self-reported by 443 older community-dwelling UK adults via questionnaire, asking the question: ‘Have you been told by a doctor that you have any of the following conditions?’ Assessments of walking speed, chair stands and balance allowed us to create a composite score (0–12) on which impaired physical functioning was defined as ≤ 9. Results The mean age of participants was 75.5 ± 2.5 years for men and 75.8 ± 2.6 for women. The proportion of individuals with impaired physical functioning was 71.2% in women and 56.9% in men. Having four or more NCDs was associated with an increased risk of poor physical function in men and women (p < 0.05). The number of medications and medicated systems was associated with gait speed (p < 0.03 and < 0.02, respectively) and timed up-and-go tests (p < 0.03 and < 0.02, respectively) in women but not men. Discussion and conclusion Self-report of 4 or more NCDs was associated with an increased risk of poor physical function, an outcome which has previously been associated with adverse clinical sequelae. This observation may inform development of a simple screening tool to look for poor physical function in older adults.

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